Finnish psychiatrist warns of 'crisis of confidence' caused by rush to perform sex changes on kids

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A Finnish psychiatrist is condemning the rush to perform life-altering surgeries on trans-identified minors in the United States, alleging a pattern of dishonesty and politicization within the medical community that has begun to correct itself in other parts of the world. 

Dr. Riittakerttu Kaltiala wrote a letter published by The Free Press on Monday titled "Gender-Affirming Care Is Dangerous. I Know Because I Helped Pioneer It."

A foreword at the beginning of the letter said Kaltiala was assigned to oversee "the establishment of a gender identity service for minors" in 2011, "making her among the first physicians in the world to head a clinic devoted to the treatment of gender-distressed young people."

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Kaltiala wrote that the "new protocol" calling for "the social and medical gender transition of children and teenagers who experienced gender dysphoria" dates back to a 2011 paper by clinicians with the Amsterdam University Medical Center. She noted that the paper argued 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." 

Kaltiala wrote that as the so-called "Dutch protocol" became "the gold standard treatment in this new field of pediatric gender medicine," a "movement that declared gender transition was not just a medical procedure, but a human right" emerged.

As a result, she said, Finland's Ministry of Social Affairs and Health worked to "create a national pediatric gender program," and in 2011, "my department was tasked with opening this new service, and I as the chief psychiatrist became the head of it."

"We were being told to intervene in healthy, functioning bodies simply on the basis of a young person's shifting feelings about gender," she recalled.

"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."

Kaltiala said that "90 percent of our patients were girls, mainly 15 to 17 years old" and that "few had expressed any gender dysphoria until their sudden announcement of it in adolescence."

She said that, in most cases, "they were coming to us because their parents, usually just mothers, had been told by someone in an LGBT organization that gender identity was their child's real problem, or the child had seen something online about the benefits of transition."

Kaltiala found that her colleagues in other countries had the same experience, with her reporting a widespread "feeling of pressure to provide what was supposed to be a wonderful new treatment" among medical professionals as they developed "a crisis of confidence." 

As a result, "people stopped trusting their own observations about what was happening" and "having doubts about [their] education, clinical experience, and ability to read and produce scientific evidence."

The "crisis of confidence" accelerated when her hospital found that the children they treated for gender dysphoria were "deteriorating" by "withdrawing from all social activities" in addition to "not making friends" and "not going to school."

"I became so concerned that I embarked on a study with my Finnish colleagues to describe our patients. We methodically went through the records of those who had been treated at the clinic [in] its first two years, and we characterized how troubled they were — one of them was mute — and how much they differed from the Dutch patients," she asserted.

While Kaltiala hoped that the 2015 publication of her study would lead to a course correction in the medical community, her field "became more committed to expanding these treatments."

Kaltiala lamented the embrace of the "gender-affirming care" standard in the U.S., which "urged clinicians simply to accept a child's assertion of a trans identity, and to stop being 'gatekeepers' who raised concerns about transition."

Kaltiala also talked about "detransitioners" who came back to the gender clinic she worked at to discuss how "they now regretted their transition."

"It is devastating to speak to patients who say they were naive and misguided about what transition would mean for them, and who now feel it was a terrible mistake," she said.

Kaltiala and her colleagues also published a paper investigating the origin of the rising number of gender dysphoric children in 2018, which concluded that 80% of such children see their distress with their gender disappear by the end of puberty.

Kaltiala cited a 2020 report from Finland's national medical body, called the Council for Choices in Health Care or COHERE, which concluded that "hormonal interventions may be considered before reaching adulthood in those with firmly established transgender identities, but it must be done with a great deal of caution, and no irreversible treatment should be initiated."

"Information about the potential harms of hormone therapies is accumulating slowly and is not systematically reported. It is critical to obtain information on the benefits and risks of these treatments in rigorous research settings," COHERE added.

While Kaltiala expressed gratitude that she was "vindicated," she remains concerned about the continued embrace of so-called "gender-affirming" care in the U.S., proclaiming that "gender transition has gotten out of hand." 

In August, the American Academy of Pediatrics announced that they were conducting a systematic review of the evidence on "gender-affirming care" for minors while still supporting a 2018 statement in support of the controversial practice. 

"An updated policy statement, plus companion clinical and technical reports, will reflect data and research on gender-affirming care since the original policy was released and offer updated guidance," stated the AAP.

"The AAP opposes any laws or regulations that discriminate against transgender and gender-diverse individuals, or that interfere in the doctor-patient relationship."

Ryan Foley is a reporter for The Christian Post. He can be reached at:

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