Finland’s leading expert on pediatric gender medicine says “four out of five” children will grow out of their gender confusion.
Dr. Riittakerttu Kaltiala, the chief psychiatrist at Tampere University, Finland’s largest pediatric gender clinic, recently had an interview with the country’s top newspaper about her reluctance to recommend surgical and chemical sex change services for minors who identify as transgender.
Dr. Kaltiala explained that while it is “important to accept the child as they are,” it is also necessary to recognize that it is common for children to strongly identify with the opposite sex at some point in their lives, but four out of five children who identify as transgender will grow out of it during puberty.
“That’s why it’s wise to monitor the situation, give the child peace of mind and treat the family’s anxiety and possible related problems,” said Dr. Kaltiala.
Finland is considering a gender self-ID law for adults, and Seta, a transgender activist group, is pushing for the law to apply to minors. Dr. Kaltiala, who has evaluated hundreds of children and adolescents experiencing gender confusion, argues that the age limit should not be lowered.
Dr. Kaltiala said it is common for young people to experiment with “different identities” and be “prone to suggestion.” She believes that in adolescence, the construction of identity is just underway and the final outcome is not known. According to Dr. Kaltiala, changing a legal sex marker in youth is not a simple formality, but a strong psychological and social intervention that guides the development of a young person. She said that this kind of intervention sends the message that this is the “right path” for the young person.
Dr. Kaltiala said that when she began her work, cases of “gender identity” issues among children and young people were scarce. However, since 2015, the number of patients has risen tenfold, and the profile of the patient population has shifted.
Previously, most patients were young boys struggling with gender distress, but now the majority of Dr. Kaltiala’s patients are biological girls in their teenage years. Additionally, three out of four of her patients also struggle with significant mental health issues.
Transgender advocacy groups like Seta frequently rely on the debunked affirm-or-suicide narrative to lobby for early medicalization of childhood gender dysphoria.
Dr. Kaltiala calls the notion that hormone treatments and legal gender recognition for minors are urgently needed due to increased suicide risk “purposeful disinformation” and “irresponsible.” Suicidal thoughts and behavior in young people with “gender identity” issues are related to concurrent psychiatric disorders, not just “unaffirmed” gender, she explained.
“Mentally healthy young people who experience their gender in a way that differs from their biological body are not automatically suicidal,” said Dr. Kaltiala.
In a large Swedish study, suicide mortality significantly increased among adults who received sex-change treatments, and a Finnish study found that the mental health of many minors who received hormonal care deteriorated.
“Therefore, it is not justified to tell the parents of young people experiencing transgenderism that the young person is at risk of suicide without corrective treatment and that the danger can be countered with gender reassignment treatment,” says Dr. Kaltiala. She recommends not beginning medicalization before adulthood.
Regarding the dominance of the suicide discourse, Dr. Kaltiala noted that adults who claim to have benefited from chemical and surgical sex change services have a desire to help children and young people, but lack the understanding that “a child is not a small adult.”
In its statement to the Social and Health Committee, the Finnish Pediatric Society said that gender self-ID should not be extended to minors.
Finland, like Sweden and England, has conducted systematic reviews of the available evidence on pediatric medical transition, as has Florida’s Boards of Medicine, with each concluding that the risks far outweigh any benefits. This resulted in the closure of prominent gender clinics, strict restrictions on the use of cross-sex hormones, and banning gender-related surgeries for minors. Italy, Australia, and Spain’s medical bodies have also recently raised similar concerns.
Meanwhile, U.S.-based medical groups have used poor evidence to support their positions and have refused to conduct systematic reviews. Instead, they have “devoted themselves to promoting deeply flawed and ideologically driven research,” according to Leor Sapir, a Manhattan Institute fellow who wrote his Ph.D. dissertation on the rapid proliferation of the “transgender rights movement.”
In the U.S., children are put in the driver’s seat of their own sex change operations despite the fact that a body of research indicates that roughly 60–90% of children who identify as transgender, but who do not socially or medically transition, will no longer identify as transgender in adulthood, and many will grow up to be gay and lesbian adults. The “gender-affirming” model of care discourages therapy that could help minors feel more comfortable in their bodies and instead provides puberty blockers, cross-sex hormones, and surgeries, to “affirm” minors in their chosen trans identity.
“The interview highlights just how out of step the U.S. medical establishment is with its European counterparts on pediatric gender medicine,” said Sapir. “Doctors and medical groups in Finland have been willing and able to stand up to activists, including within their own ranks.”