On Monday in the Free Press, Riittakerttu Kaltiala issued a warning to US gender clinicians: “Gender-affirming care is dangerous. I know because I helped pioneer it.”
Kaltiala serves as chief psychiatrist in the department of adolescent psychiatry at Tampere University in Finland, and is the head of one of the country’s two nationalised gender services for youth. In the Free Press piece, Kaltiala describes her disillusionment with a “gender-affirming” approach to gender-distressed youth, starting with her initial scepticism about “being told to intervene in healthy, functioning bodies simply on the basis of a young person’s shifting feelings about gender”.
Kaltiala noticed early on that her patients did not look or sound like those which other clinics claimed to have treated with such success. More troubled, her patients’ distress often started at puberty rather than early childhood. Starting around 2015, Kaltiala noticed a sudden, unexplained surge in adolescent girls seeking transition. These new patients delivered scripted responses, “telling the same life stories and the same anecdotes about their childhoods, including their sudden realisation that they were transgender”.
Eventually, detransitioners started showing up at the clinic, too: “These were another kind of patient who wasn’t supposed to exist,” Kaltiala notes. She goes on:
Kaltiala set about researching her questions and concerns. What she found helped lead Finland to change course on youth gender medicine, but she observed that “instead of acknowledging the problems we described, [the field] became more committed to expanding these treatments.”
These dynamics produced the sprawling medical scandal we see today. At the 2022 World Professional Association for Transgender Health conference, clinicians praised themselves and one another for overcoming their reservations and doubts about providing “gender-affirming care” to an ever-widening group of patients. Naturally, the doctors did not put their accomplishments in those terms. Instead, they spoke of “checking their cisgender privilege” and “following [their] patients’ lead”.
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