Thread by @LeorSapir

BREAKING: Dr. Riittakerttu Kaltiala, Finland's leading expert on pediatric gender medicine and chief psychiatrist at its largest gender clinic (Tampere University), just gave an interview to the country's leading newspaper, Helsingin Sanomat.

The interview highlights just how out of step the U.S. medical establishment is with its European counterparts on pediatric gender medicine. Doctors and medical groups in Finland have been willing and able to stand up to activists, including within their own ranks.

The context: Finland is considering a gender self-ID law for adults. The Finnish equivalent of Stonewall, a trans activist group, is quietly lobbying for the law to apply also to minors. Helsingin Sanomat interviewed Dr. Kaltiala for her thoughts on whether this is a good idea.

While it is "important to accept the child as they are," Kaltiala said, it's also necessary to recognize that "four out of five" children with cross-gender ID grow out of it during puberty and come to terms with their body/sex.

Accepting a child as they are, Kaltiala explained, means neither pressuring them to conform to sex-typical behaviors nor "negating the body" by confirming the gender self-ID. "In either case, the child gets a message that there is something wrong with him or her."

Changing the legal sex marker in youth, Kaltiala told the newspaper, is not a formality which states a fact, but a strong psychological and social intervention that guides the development of a young person. "It's a message saying that this is the right path for you."

For teenagers whose dysphoria began in childhood and intensified in puberty, discordant ID seems more stable. But for those in whom dysphoria began in adolescence, "the phenomenon is new, and therefore there is no scientific knowledge about the constancy of this experience."

"The developmental mission of youth is not helped by the fact that young people's self-expression
is supported and directed from the outside... The environment should also not commit to identity experiments in a way that might make a later
change of direction anxiety-inducing."

This is also what Dutch clinician-researcher Dr. Thomas Steensma and his colleagues advised in a 2011 study.

journals.sagepub.com/doi/10.1177/13…

Helsingin: Many young people grab the idea available in the media & social media that their problems are caused by gender identity & will be solved if others start to see them as members of the other sex.

That does not work, says Kaltiala. "A balance of the mind does not come from making others do and see what you want."

Helsingin: Activists... calling for hormone treatments for minors & legal gender recognition often repeat that trans youth have an increased risk of suicide & therefore urgently need care & support. "It's purposeful disinformation, & spreading it is irresponsible," says Kaltiala.

Suicidal thoughts and behavior are related to simultaneous psychiatric disorders also in young people who problematize their gender. "Mentally healthy young people who experience their sex in a way that is different from their biological bodies are not automatically suicidal."

[LS: This is the unfounded minority stress theory that co-occurring mental health problems, including suicidality, are secondary to "unaffirmed" gender and manageable only through social & medical transition. The suicide discourse relies on a correlation/causation fallacy.]

Helsingin: Suicide was a very rare occurrence in about ten years among young people seeking gender identity diagnoses. On the other hand, in a large Swedish study, suicide mortality had clearly increased among adults who had received gender reassignment treatments.

"Therefore 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," says Kaltiala.

Kaltiala told the Finland Parliament Social & Health Committee that it would be better to not start any physical treatments based on gender identity before adulthood. A Finnish study found that the mental health of many minors who had received hormonal care... deteriorated.

Asked about the dominance of the suicide discourse, Kaltiala said: "adults who have themselves benefited from gender reassignment, have a desire to go out and save children and young people. But they lack the understanding that a child is not a small adult. "

In its statement to the Social and Health Committee, the Finnish Pediatric Society (equivalent to @AmerAcadPeds) said gender self-ID should not be extended to minors.

[LS: American schools de-facto practice gender self-ID for kids as young as kindergarten]

Link to Helsingin article: hs.fi/tiede/art-2000…

Thanks to my translator.

If any of you see a mistake in translation, please let me know.

One additional point: although Kaltiala implies that gender dysphoria is more permanent if it begins in childhood and persists into adolescence, we actually don't have high quality, well-controlled studies showing this. It might be true, but we don't know this.

As a reminder, Dr. Kaltiala is the one who told me that @grace_huckins of @WIRED "total[ly] mischaracteriz[ed] our research" when she cited a peer-reviewed article by Kaltiala in support of the "affirm or suicide" mantra.

Screenshot of email upon request.