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The legal framework with regard to the needs of vulnerable asylum seekers is part of the 1994 Law on the Reception of Asylum Seekers (LMA). The LMA provides the legal framework and briefly mentions the provision for the needs of vulnerable groups. These are not defined but the Migration Agency has set out guidelines, routines, for the reception of vulnerable asylum seekers, mainly including minors, unaccompanied minors, disabled people, elderly people, pregnant women, single parents with minor children, victims of human trafficking, persons with mental disorders and persons who have been subjected to torture, rape or other serious forms of psychological, physical or sexual violence, such as victims of female genital mutilation^[1] (see Reception Conditions).

Screening of vulnerability

All asylum seekers are offered health screening and in practice a majority of them choose to undergo a health check. This is particularly important in relation to survivors of torture and traumatised persons. However, because of confidentiality rules, this information is not automatically available to caseworkers. The legal counsel can however request access to this information with the permission of the applicant.

The Swedish Migration Agency does not yet collect disaggregated statistics on the number of asylum seekers identified as vulnerable, with the exception of unaccompanied minors.^[2] Under the routine mentioned above, all Migration Agency staff are required to report vulnerabilities in an official note that is fed into a common database, mentioning at which stage in the procedure vulnerability is observed and what measures this has led to. It is stressed that a vulnerability assessment must always be made in the initial process.

This routine is monitored by the Swedish Migration Agency to evaluate whether assessments of special needs have been made in all cases, how the documentation of these needs has been recorded and what measures have resulted from the assessment. It is noted in the guideline that the list of vulnerabilities in the EU Directives is not exhaustive. Some special needs need not be registered in an official note. Examples of these are when the Swedish Migration Agency notifies the need for a guardian or informs a municipality that an unaccompanied child needs protection there, or the response of an applicant who has requested a case officer, interpreter or public counsel of a specific gender.

In 2024, 684cases of suspected human trafficking were identified at the Migration Agency, including 181216 women and 503 360 men. 11 were children, out of which 5 girls and 6 boys. The Migration Agency provided information to the regional coordinators at the Gender Equality Agency and to the Police Authority. The Migration Agency does not always require the consent of the applicant to do so.[3] In 133 cases the applicant gave consent and the Swedish Migration Agency has reported to the Police Authority on 219 occasions. A police report can include several potential victims.

According to Chapter 5 Section 15 of the Aliens Act a temporary residence permit should be granted to witnesses upon the investigative leader’s request. In 2024, a total of 56 persons were granted such temporary residence permits, out of which 30 women and 26 men (including 1 minor boy).^[4]

Age assessment of unaccompanied children

The Migration Court of Appeal clarified in a precedent-setting ruling of 2014 that the burden of proof lies with the applicant to establish their stated age as probable, with the aid of supporting documents, where available.^[5] Where documents or other evidence proving the applicant’s age as probable are not available, the age stated at the time of lodging of the application is noted down.

If there are strong indications that the applicant has reached majority, then the claimed age can be altered in the records and the person transferred to the procedure for adults. These assessments made by the Swedish Migration Agency have been subject to criticism, as reported in previous versions of this AIDA report. In a legal position regarding age assessments, the Swedish Migration Agency clarifies that it can only be applied in unambiguously clear cases, where there is no room for a different assessment than that the applicant is an adult.^[6] It must be obvious that the applicant is an adult, or that there is evidence proving the applicant´s age, otherwise the age should not be altered.

An applicant can make their date of birth and/or minority probable. When there is a doubt on the minority (but not obvious as mentioned above) the Aliens Act foresees that the Swedish Migration Agency must make a temporary decision on the age.^[7] In the legal position the Migration Agency states that the starting point is that such an age assessment should primarily be made on the basis of documentary evidence together with the applicant’s own oral information. Documentary evidence can in some cases be considered to have low evidentiary value because the authorities consider them easy to falsify, or because they are based on oral statements. If this evidence is not sufficient and the Swedish Migration Agency therefore considers making a decision whereby the applicant is assessed to be an adult, the Agency is obliged to offer the applicant a medical age assessment.^[8] Consent of the applicant and their guardian is required.  A refusal of consent to a medical age assessment without an acceptable reason may have the consequence that the applicant is assessed to be 18 years of age or older. The cost of such an examination is borne by the State.

The temporary decision on the age of the applicant can be appealed but applies immediately even if it is appealed. However, the Migration Court may decide that a temporary decision will not apply until further notice. At the same time, when the Swedish Migration Agency takes a decision regarding the asylum claim, it must make a final assessment of the applicant’s age. The consideration of the applicant’s age in the decision in the asylum case replaces the temporary decision on age.

Any authority that comes into contact with unaccompanied asylum-seeking children needs to take an independent position on the applicant’s age within the framework of its activities and the rules governing it.

The National Board of Forensic Medicine (Rättsmedicinalverket, RMV) is responsible for medical age assessments. Assessments are conducted based on medical examination of wisdom teeth and knee joints. RMV’s medical age assessments to determine whether a person is under or over 18 years are based on an overall assessment of two studies: X-ray irradiation of wisdom teeth (panoramic image), and an MRI of the lower part of the femur. Scanning and two independent analyses of the respective images will be made by external clinics. Based on the results of these studies, RMV makes a medical age assessment using a standardised matrix. A coroner in RMV will then issue a forensic opinion on the age in the form of a probability assessment in text form. The forensic opinion is thus designed as a probability assessment.^[9]

The statement from RMV will then become part of the supporting evidence that the Migration Agency uses to issue a decision on age.

Source: National Board of Forensic Medicine, Statistik, available in Swedish here.   

Critique on reliability and accuracy

As reported in previous AIDA reports, the methods used for age assessments have been heavily criticised by the medical community, including by the experts obliged to carry out the tests. Both the Paediatric Medical Association, as well as international experts on age assessment, have distanced themselves from the method of measuring the knee joint. Background information on the matter is included in the previous versions of this AIDA report.

In January 2020, the Swedish Bar Association elaborated on their position from 2016 in their guidance to lawyers representing vulnerable clients. It was inter alia stated that a lawyer’s involvement in the client’s age assessment is at risk of being considered contrary to good practice, but that the situation is complex, as the client’s refusal to undergo a medical age assessment may, for example, risk being interpreted to the client’s detriment. Great caution is required in these cases and advice from the lawyer on participation must be preceded by careful consideration and explanations for the client and a possible legal guardian.^[10]

As mentioned in the previous AIDA report, age assessment procedures have also been litigated before courts.

As mentioned in the previous AIDA report, after several critiques by the Swedish Council on Medical Ethics, the Council of Europe Commissioner for Human Rights, NGOs and lawyers, it was decided that a commission of inquiry was to assess the situation through an independent review. The national inquiry published its first findings in an interim report on 28 October 2021.^[11]The Inquiry stated initially that in a European context, RMV’s method is unique. It is the only method to include an MRI of the knee as part of the assessment. The Inquiry concluded that there are uncertainties in RMV’s probability model. Furthermore, RMV’s estimated percentages are subject to uncertainty. In December 2022 the (new) Swedish government decided that the inquiry should be discontinued. The decision to discontinue the inquiry has been criticised by several organisations, including the Swedish Refugee Law Center.[12]

On 11 June 2021, RMV stated that the authority sees an opportunity to further differentiate the forensic opinion on age. In the future, RMV would respond in the documentation to the Swedish Migration Agency with different degrees of probability that a person is under or over 18 years of age, depending on the combination of results of the two different surveys.^[13]

RMV published an updated methodological description on 5 September 2022, containing a more comprehensive account of uncertainties and factors affecting the model.  The basis for assessment or the form of statements were not changed.^[14]

The RMV has updated the model used in the asylum process to more closely resemble the one used in criminal cases when it comes to the assessment of wisdom teeth. In the asylum process, the RMV has so far only assessed whether the wisdom teeth have reached the final stage or not. As of 1 November 2024, the total staging of wisdom teeth will be used in all cases. According to the RMV, the model enables a more precise assessment of how the age of the person examined relates to the different age limits.[15]

^{[1] Migration Agency, Rutin: Ta ställning till särskilda behov, initialt and Rutin: Insatser för asylsökande med särskilda behov.}

^{[2] Information provided by the Migration Agency, January 2018.}

^{[3] Information provided by the Migration Agency, 2023.}

^{[4] Migration Agency, Annual Report 2024, Dnr:  1.3.2-2025-1844, p.107, available here.}

^{[5] Migration Court of Appeal, MIG 2014:1, UM 2437-13, 11 February 2014, available at: http://bit.ly/2jQwVWr.}

^{[6] Migration Agency, Rättsligt ställningstagande Åldersbedömning, RS/040/2021, citing Government, prop. 2016/17:121, Åldersbedömning tidigare i asylprocessen, available in Swedish here, 17-18.}

^{[7] Chapter 13, Section 17, Aliens Act.}

^{[8] Chapter 13, Section 18, Aliens Act.}

^{[9] New findings regarding the reliability of the methods vis-à-vis female asylum seekers led to a suspension of age assessments in November 2017 pending the outcome of a more in-depth investigation by the RMV.  The investigation resulted in new guidelines regarding female asylum seekers and the tests were resumed.}

^{[10] Swedish Bar Association, Promemoria Advokatens uppdrag för svaga och utsatta klienter, updated January 2020, 35-36, available in Swedish here.}

^{[11] Swedish Government Official Report (2021) SOU 2021:84, Granskning av Rättsmedicinalverkets metod för medicinsk åldersbedömning i asylprocessen, Summary available in English here.}

^{[12] Swedish Refugee Law Center, Kommentar till nedlagd utredning om medicinska åldersbedömningar, 19 January 2023, available in Swedish here.}

^{[13] National Board of Forensic Medicine, 21 June 2021. Only available in Swedish here.}

^{[14] National Board of Forensic Medicine, ‘Uppdaterad metodbeskrivning för medicinska åldersbedömningar’, 5 September 2022, available in Swedish here.}

^{[15] Rättsmedicinalverket – Uppdaterad modell för medicinska åldersbedömningar – Rättsmedicinalverket}