Finland’s leading transgender treatment expert said that “four out of five” teenagers who question their gender accept their bodies if they don’t receive medical intervention.
dr Riittakerttu Kaltiala previously only performed gender-affirming treatment in patients who met restrictive requirements, but after observing a significant increase in adolescent patients in the 2010s, she became skeptical that the treatment was the solution to the problem.
In a recent interview with Finnish newspaper Helsingin Sanoma, Kaltiala made a number of points – including the fact that overwhelming evidence showed that desire for sex reassignment surgery was rising among teenage female friend groups exposed to social media.
This evidence supported her claim that far too little is known about the current wave of gender dysphoria to provide life-changing treatments for children.
She also said doctors who are weaponizing parents’ suicidal fears to spur treatments have called it “deliberate disinformation and dissemination irresponsible.”
Testifying before the Florida Board of Medicine and the Florida Board of Osteopathic Medicine last year, she said there was no evidence to support gender-affirming treatments for patients who first experienced gender dysphoria as adolescents.
Kaltiala’s findings, used as the basis for treatment across much of Europe, stand in stark contrast to the US approach to gender treatment.
dr Riittakerttu Kaltiala started treating adolescent gender reassignment surgery in 2011 as senior psychiatrist at one of Finland’s two state-approved pediatric centers
This chart shows insurance claims for gender dysphoria diagnoses by year. These have doubled since 2017
Kaltiala started treating adolescent gender reassignment surgery in 2011 as a senior psychiatrist at one of Finland’s two state-approved pediatric centers.
There, she initially adhered to a treatment protocol that required patients to have experienced gender dysphoria before and into puberty. In addition, they could not have had any serious recurrent mental health problems, had to undergo six months of psychotherapy and had family support for hormone treatment.
However, after a few years, Kaltiala found that these requirements were not regulating the number of patients who came to her and that more and more patients were seeking treatment.
She found that the majority were adolescent girls who had never experienced gender dysphoria as children, and that 75 percent had previously had serious mental health problems, according to Tablet.
In 2019, Kaltiala and her colleagues published an article saying there wasn’t enough data on the gender crisis teenagers were experiencing to justify serious body-altering treatments.
“Research on gender dysphoria in adolescents is sparse and optimal treatment options have not been established,” she wrote. “The reasons for the sudden increase in treatment requests for gender dysphoria/transgender identification in adolescents are unknown.”
Their findings led to health authorities in Finland, Sweden and the UK launching reviews of their practices for delivering gender-affirming treatments.
This chart shows puberty blocker insurance claims in the United States by year. It shows claims have doubled since 2017
In her recent interview, Kaltiala suggested that the kind of gender-affirming treatments being practiced in the US would perpetuate rather than treat patients’ problems.
She said things like using children’s preferred names or pronouns could be an act just as serious as changing their bodies because their psyche hardens that something is wrong with their bodies.
“It’s a message that says 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 no gender-affirming treatments could lead to her suicides, used by many doctors in the US to pressure parents into approving treatment for their children.
“There is no justification for telling the parents of young people who identify as transgender that without medical treatment a young person is at risk of suicide and that risk can be mitigated by gender reassignment surgery,” she said.
She said the suicide narrative could be driven by “adults who have themselves benefited from sex reassignment surgery and have a desire to go out and save children and young children. But they lack the understanding that a child is not a small adult.’
The debate over whether to restrict care for children in the US has intensified in recent months, as a growing number of former patients who regret irreversible procedures as children say their desire for a medical transition is not challenged enough became.
Data on how many transitioners change their minds and seek exit, or are urged to do so by relatives or employers, is not reliable, but estimates range from 1 to 8 percent.
These graphs of selected states show gender dysphoria diagnoses with an increasing trend
The number of Americans who identify as trans people has skyrocketed in recent years.
According to a report from the University of California, Los Angeles (UCLA), the number of Americans who identified as trans nearly doubled from 2017 to 2020, with 300,000 now identifying as trans.
This increase has been strongest among young people, and this is what lawmakers have focused on so far.
About 1.5 percent of American teens identify as trans, the highest of any age group.
Many trans-identifying children undergo hormonal treatments in hopes of preventing themselves from developing gender characteristics related to their birth sex.
These often include puberty blockers, which delay the onset of the process, and drugs that increase either estrogen or testosterone levels. Puberty blockers are used to pause puberty and consider transitioning.
By stopping the body’s production of sex hormones, gender-specific traits such as a deeper voice in men or the development of breasts in women can be stopped. The long-term effects of these drugs are not fully understood, but it can take years for the body to start producing hormones naturally 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 they are healthy — but they are used off-label for transgender care.
Hormone therapy can then induce desirable sexual characteristics in a trans teenager. By giving testosterone to a female-born person or estrogen to a male-born person, they will develop traits appropriate to their desired gender instead.
The long-term consequences of taking these drugs in adolescence have not yet been determined, which many experts fear given recent increases in their use.
Gender-affirming surgeries, often referred to as top or bottom surgery, make changes to either a child’s genitals or breast to accommodate the new gender. These are irreversible and can render a person infertile.
In numbers: the explosion of children seeking gender care
The US has seen an explosion in the number of children identifying as a gender different from what they were assigned at birth in recent years. Thousands of families are weighing profound decisions in an emerging field of medicine as they seek so-called gender-affirming care for their children.
The spotlight fell on Sunny Bryant, 8,’s trans identification earlier this year, when Texas lawmakers outlawed the hormone treatments she planned to undergo after reaching puberty
About 42,000 children and teens in the United States were diagnosed with gender dysphoria in 2021, nearly three times the number in 2017, according to data from Komodo Health, a tech company compiled for Portal. Gender dysphoria is defined as the distress caused by a discrepancy between a person’s gender identity and the gender identity assigned to them at birth.
Overall, the analysis found that between 2017 and 2021, at least 121,882 children aged 6 to 17 were diagnosed with gender dysphoria. income families.
Gender-affirming care encompasses a spectrum of interventions. It can mean adopting a child’s preferred name and pronouns and having them dress according to their gender identity—this is called social transition.
It may involve therapy or other forms of psychological treatment. And from about the onset of puberty, medical interventions such as puberty blockers, hormones, and in some cases surgery may be added. The main aim is to support and affirm the gender identity of the child.
These medical treatments don’t begin until the onset of puberty, typically around age 10 or 11.
But families taking the medical route are venturing into uncertain territory where science has yet to catch up with practice. While the number of gender clinics treating children in the US has grown from zero to over 100 in the last 15 years – and waiting lists are long – there is little clear evidence of the effectiveness and possible long-term effects of this treatment.
Puberty blockers and sex hormones do not have US Food and Drug Administration (FDA) approval for child sex maintenance. No clinical studies have demonstrated its safety for such off-label use. The drugs’ long-term effects on fertility and sexual function remain unclear.
New Yorkers took to the streets of Manhattan to participate in the Reclaim Pride Coalition’s (RPC) fourth annual Queer Liberation March, which focused on transgender rights among other issues in June
And in 2016, the FDA ordered makers of puberty blockers to add a warning about psychiatric problems on the drug’s label after the agency received multiple reports of suicidal thoughts in children taking them.
More generally, no large-scale studies have followed people who received gender-related medical care as children to determine how many were satisfied with their treatment in old age and how many eventually regretted the transition. The same lack of clarity applies to the controversial issue of detransition, when a patient stops or reverses the transition process.
The National Institutes of Health, the US government agency responsible for medical and public health research, told Portal that “evidence on whether these treatments pose short-term or long-term health risks for transgender and other gender-biased youth is limited.”
The NIH funded a comprehensive study to examine the mental health and other outcomes of approximately 400 transgender youth treated at four US children’s hospitals. However, long-term results are still years away and may not address concerns such as fertility or cognitive development.
– From Portal