Riittakerttu Kaltiala, a Finnish medical doctor and the chief psychiatrist in the department of adolescent psychiatry at Finland’s Tampere University Hospital, has written a powerful account of the politicization of clinical treatment for gender-distressed minors.
In her essay in the Free Press, Kaltiala, who was tasked with overseeing Tampere’s gender clinic in 2011, recalls having “serious questions” when “being told to intervene in healthy, functioning bodies simply on the basis of a young person’s shifting feelings about gender.” She says that many of her colleagues across Europe had doubts, but, due to immense pressure, “no one was saying anything publicly.”
Kaltiala noticed that patients who were being treated as the opposite sex socially and medically were “deteriorating.”
Sometimes the young people insisted their lives had improved and they were happier. But as a medical doctor, I could see that they were doing worse. They were withdrawing from all social activities. They were not making friends. They were not going to school. We continued to network with colleagues in different countries who said they were seeing the same things.
Kaltiala then pursued her own follow-up along with concerned colleagues to document the harm being done to patients. In addition, she prompted Finland’s national health-care system to investigate the practice.
In 2015 I personally asked a national body, called the Council for Choices in Health Care (COHERE), to create national guidelines for treatment of gender dysphoria in minors. In 2018 I renewed this request with colleagues, and it was accepted. COHERE commissioned a systematic evidence review to assess the reliability of the current medical literature on youth transition.
COHERE released its findings in 2020:
It concluded that the studies touting the success of the “gender-affirming” model were biased and unreliable—systematically so in some cases.
The authors wrote: “In light of available evidence, gender reassignment of minors is an experimental practice.” The report stated that young patients seeking gender transition should be instructed about “the reality of a lifelong commitment to medical therapy, the permanence of the effects, and the possible physical and mental adverse effects of the treatments.” The report warned that young people, whose brains were still maturing, lacked the ability to properly “assess the consequences” of making decisions they would have to live with for the “rest of their lives.”
COHERE also recognized the dangers of giving hormone treatments to young people with serious mental illness. The authors concluded that for all these reasons, gender transition should be postponed “until adulthood.”
Finland’s is not the only European health authority to have turned away from “gender affirmation.” More on that here.