Tablet: Finland's top gender medicine doctor on social transition

Jazz wrote about this two weeks ago but there’s a new story up at Tablet which includes some additional details. Dr. Riittakerttu Kaltiala is considered Finland’s top pediatric gender doctor who has been overseeing childhood transitions since 2011. A couple weeks ago Dr. Kaltiala gave an interview to a leading newspaper in which she explained that most kids will adjust to their bodies, unless they are socially transitioned.

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Asked by Helsingin Sanomat what she thought of gender self-identification for minors—a proposed element of the new Finnish law that did not ultimately pass—Kaltiala emphasized that it is “important to accept [children] as they are,” but this means neither pressuring a child to conform to behaviors traditionally associated with the child’s sex nor “negating the body” by confirming that the child’s gender self-identification is real. “In either case,” said the psychiatrist, “the child gets a message that there is something wrong with him or her.” Evidence from a combined 12 studies to date demonstrates that when children with cross-gender or gender variant behavior are left to develop naturally, the vast majority—“four out of five,” according to Kaltiala—come to terms with their bodies and learn to accept their sex. When they are socially transitioned, virtually none do

Unlike progressive elites in the United States, who seem to regard social affirmation of “transgender children” as little more than an act of kindness, Kaltiala sees it as a powerful intervention in a young person’s psychosocial development with potential for iatrogenic harm (i.e., harm caused by the treatment itself). Gender self-identification in youth is not a mere clerical “formality.” In Kaltiala’s words, “it’s a message saying that this is the right path for you.” Kaltiala thus concurs with NHS England, which recently noted that social transition—using a child’s preferred name and pronouns—is “not a neutral act” but rather one that can solidify what is otherwise likely to be a passing phase into a more permanent state of mind, or “identity,” and put the minor on a path to drugs and surgeries. The NHS now warns of the risks of social transition in children and recommends it only for adolescents who have been diagnosed with gender dysphoria and have provided informed consent.

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Another issue Dr. Kaltiala discussed in the interview was suicide, which is frequently raised by activists as the prime reason why “gender affirming care” is necessary.

Turning to the question of suicide, which has become virtually the only argument that “gender affirming” activists make in support of their preferred practice, Kaltiala did not pull her punches. The popular “transition or suicide” narrative used by activists to push back against state reform efforts is, in Kaltiala’s words, “purposeful disinformation, and spreading it is irresponsible.”…

Why the obsessive emphasis on the suicide issue? The obvious reason is that if suicide is the expected outcome, any risk from hormones and surgeries is probably worth it. The suicide discourse has the effect, and probably also the intent, of preventing patients and clinicians from doing a careful weighing of pros and cons when deciding on treatment options. It strikes fear into the hearts of parents who worry about the risks and uncertainties about blocking their children’s natural puberty, pumping them full of synthetic hormones, and amputating their healthy breasts as early as age 13. It is also powerful tool for silencing critics and—crucially—deterring those who have questions about hormonal interventions from raising them in the first place.

If you’ve spent any time on Twitter discussing or watching others discuss trans issues. The references to suicide are always the first line of defense for activists. Anyone who disagrees with them on any point is framed as wanting trans kids to die or simply killing trans kids. It’s not a way to discuss the issue, it’s a way to avoid discussing it.

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Unlike the American Pediatric Association, the equivalent body in Finland has come out against a law that would have allow children to self-identify their gender. The same law did pass for adults.

This argument is far from over but it’s good to see there are some experts willing to say as much rather than acting like activists and claiming the issue is settled.

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