Finland‘s leading transgender treatment expert said ‘four out of five’ teens who question their gender come to accept their bodies if they don’t receive medical intervention.
Dr. Riittakerttu Kaltiala previously administered gender-affirming treatment only to patients who met restrictive requirements, but after seeing a significant increase in adolescent patients in the 2010s became skeptical that treatment was the solution to the problem.
In a recent interview with the Finnish newspaper Helsingin Sanoma, Kaltiala laid out a number of points – including that overwhelming evidence showed the desire for gender transitions spiked among female teenage friend groups exposed to social media.
That evidence supported her assertion that far too little is known about the current wave of gender dysphoria to be administering life-altering treatments to children.
She also said physicians who weaponize parents’ fears of suicide to push treatments, calling it ‘purposeful disinformation, and spreading it is irresponsible.’
Kaltiala’s findings, used as the basis for treatment in much of Europe, are in stark contrast to the United States approach to gender treatment.
Dr. Riittakerttu Kaltiala began handling youth gender transition treatments in 2011 as the chief psychiatrist of one of Finland’s two government-approved pediatric centers
This chart shows insurance claims for diagnoses of gender dysphoria by year. These have doubled since 2017
Kaltiala began handling youth gender transition treatments in 2011 as the chief psychiatrist of one of Finland’s two government-approved pediatric centers.
There she initially stuck to a treatment protocol which required patients to have experienced gender dysphoria before puberty and continued into adolescence. Additionally, could not have had any serious recurring mental health issues, needed to partake in six months of psychotherapy, and have their family’s support for hormonal treatment.
After a few years however, Kaltiala found those requirements were not regulating the numbers of patients who came to her and that more and more patients were seeking treatment.
She found the majority were adolescent girls who had never experienced gender dysphoria as a child, and that 75 percent had experienced serious mental health problems before, according to Tablet.
In 2019, Kaltiala and her colleagues published an article saying there was not enough data about the gender crisis teens were experiencing to justify serious body-altering treatments.
‘Research on adolescent onset gender dysphoria is scarce, and optimal treatment options have not been established,’ she wrote. ‘The reasons for the sudden increase in treatment-seeking due to adolescent onset gender dysphoria/transgender identification are not known.’
Her findings resulted in health officials in Finland, Sweden, and the United Kingdon opening reviews of their processes for administering gender-affirming treatment.
This chart shows insurance claims for puberty blockers in the US by year. It shows claims have doubled since 2017
In her recent interview Kaltiala suggested that the kind of gender-affirming treatments administered in the US were likely to solidify problems patients were experiencing, rather than treat them.
She said doing things like using children’s preferred names or pronouns could be as severe an act as altering their bodies, because it solidifies in their psyches that there is something wrong with their body.
‘It’s a message saying that this is the right path for you,’ she said, adding that changing names and pronouns is ‘not a neutral act.’
Kaltiala also spoke out against the warning that not giving children gender-affirming treatments might lead to their suicides, which has been employed by many doctors across the US to pressure parents into approving treatment for their children.
‘It is not justified to tell the parents of young people identifying as transgender that a young person is at risk of suicide without medical treatments and that the danger can be alleviated with gender reassignment,’ she said.
She said the suicide narrative might be pushed by ‘adults who have themselves benefited from gender reassignment, have a desire to go out and save children and young children. But they lack understanding that a child is not a small adult.’
Debate about whether to restrict child gender care in the US has intensified in recent months, as a growing number of former patients who regret having irreversible procedures as children say their desire to medically transition was not challenged enough.
The data on how many transitioners change their minds and seek to detransition, or are pressured to do so by relatives or employers, is not reliable, but estimates are in the range of 1 to 8 percent.
These graphs of selected states show gender dysphoria diagnoses heading upwards
The number of Americans identifying as trans has rocketed in recent years.
A report by the University of California, Los Angeles (UCLA) found the number of Americans who identified as trans nearly doubled from 2017 to 2020, with 300,000 now identifying as such.
This rise has been strongest among young people, and that is where legislators have so far focused their efforts.
Around 1.5 percent of American teens identify as trans, the highest of any age group.
Many trans-identifying children will undergo hormone treatments, hoping to prevent themselves from developing sex-based characteristics linked to their birth gender.
These often include puberty blockers, which push back the start of the process, and medication that boosts either estrogen or testosterone levels. Puberty blockers are used to pause puberty and consider whether they want to transition.
By stopping the body’s production of sex hormones, gendered characteristics like a deeper voice in men or the development of breasts in women can be halted. The long-term effects of these drugs are not fully understood, but it can take years for the body to naturally start producing hormones after stopping the drugs.
The Food and Drug Administration has approved the drugs to stop precocious puberty – when a child goes through the process earlier than when is healthy – but they are used off-label for trans care.
Hormone therapy can then trigger desired sexual characteristics in a trans teen. By giving a person born as a female testosterone, or a person born male estrogen, they will instead develop traits that match their wanted gender.
The long-term consequences of taking these drugs in youth has not yet been determined, leaving many experts fearful of the recent increase in their use.
Gender-affirming operations, often called top or bottom surgery, will either make changes to a child’s genitalia or chest to match that of their new sex. These are irreversible and can leave a person infertile.