November 1, 2023

In Brief: ‘Gender-Affirming Care Is Dangerous’

“I know because I helped pioneer it.” But “there is no solid evidence supporting the medical transitioning of young people.”

The Free Press brought us the whistleblower from a children’s gender clinic in St. Louis. Now the Free Press is bringing us the confessions of Dr. Riittakerttu Kaltiala, a Finnish-born and trained adolescent psychiatrist who led the way in creating “gender-affirming” care for adolescents in Finland. It was a disaster, she reveals in an essay, and she says the U.S. should take note.

Kaltiala says she knew early on that she wanted to be a psychiatrist. “I decided to specialize in treating adolescents because I was fascinated by the process of young people actively exploring who they are and seeking their role in the world,” she wrote. But then:

Over the past dozen or so years there has been a dramatic development in my field. A new protocol was announced that called for the social and medical gender transition of children and teenagers who experienced gender dysphoria — that is, a discordance between one’s biological sex and an internal feeling of being a different gender.

She ascribes respectable motives to the initial quest, as people hoped to help people avoid painful transitions later in life for medical treatments begun in the 1950s.

The most prominent advocates of youth transition were a group of Dutch clinicians. They published a breakthrough paper in 2011 establishing that if young people with gender dysphoria were able to avoid their natural puberty by blocking it with pharmaceuticals, followed by receiving opposite-sex hormones, they could start living their transgender lives earlier and more credibly.

It became known as the “Dutch protocol.” The patient population the Dutch doctors described was a small number of carefully selected young people — almost all male — who, from their earliest years, insisted they were girls. These patients, apart from their gender distress, were mentally healthy and high-functioning. The Dutch clinicians reported that following early intervention, these young people thrived as members of the opposite sex. The protocol was quickly adopted internationally as the gold standard treatment in this new field of pediatric gender medicine.

Concurrently, there arose an activist movement that declared gender transition was not just a medical procedure, but a human right. This movement became increasingly high profile, and the activists’ agenda dominated the media coverage of this field. Advocates for transition also understood the power of the emerging technology of social media. In response to all this, in Finland the Ministry of Social Affairs and Health wanted to create a national pediatric gender program. The task was given to the two hospitals that already housed gender identity services for adults. In 2011, my department was tasked with opening this new service, and I as the chief psychiatrist became the head of it.

Even so, I had some serious questions about all this. We were being told to intervene in healthy, functioning bodies simply on the basis of a young person’s shifting feelings about gender. Adolescence is a complex period in which young people are consolidating their personalities, exploring sexual feelings, and becoming independent of their parents. Identity achievement is the outcome of successful adolescent development, not its starting point.

Nevertheless, she took part in “transitioning” roughly 500 people. There were far more patients than expected, and instead of generally young boys, she was surprised to see a surge of young girls. She describes at length the typical profile of these girls, as well as the growing number of health professionals asserting that all a patients mental health issues could be solved by hormone therapy or more.

Then reality hit:

The young people we were treating were not thriving. Instead, their lives were deteriorating. We thought, what is this? Because there wasn’t a hint in studies that this could happen. 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 began to study these effects and what she found is what we’d call predictable, including what she realized was social contagion-linked gender dysphoria. Yet the pressure to not speak up was immense. At length, she explains that and her further studies regarding the implications of this sort of treatment before concluding:

Gender transition has gotten out of hand. When medical professionals start saying they have one answer that applies everywhere, or that they have a cure for all of life’s pains, that should be a warning to us all that something has gone very wrong.

Read the whole thing here.

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