Despite the initial lack of interest and awareness in the few years that followed, competition between sledge hockey teams started up in 1971 that included five teams in Europe. In 1981, Great Britain established their first sledge hockey team, and that was shortly followed by Canada in 1982. It was not until 1990 that the United States developed their first ice sledge hockey team. Sled hockey continued to expand when Estonia and Japan developed their teams in 1993. Sledge hockey was introduced to the Winter Paralympics in 1994, with Sweden claiming the first gold medal. Since 2010, sledge hockey has been a mixed-gender event.