Long-term study revealed that mental health worsens after medicalized gender transitions

Longitudinal research conducted in Finland over more than 30 years has ignited an intense international debate about the effects of medical interventions on young people with gender dysphoria. The study, published in the scientific journal Acta Paediatrica, concludes that adolescents referred to gender identity clinics have high levels of psychiatric morbidity that, far from decreasing, tend to increase after interventions.

The findings have been endorsed by some scientific sectors as long-awaited evidence, while activists and advocates of so-called "gender-affirming care" question its methodology and warn of possible biases.

An unprecedented study in scope

The research analyzed nearly 2,100 young Finns under age 23 who were referred to specialized gender identity services between 1996 and 2019, comparing them with a control group of more than 16,000 people.

The results show that, prior to any intervention, 45.7% of these adolescents already had psychiatric disorders, compared with 15% in the control group. However, after referral, the figure increased to 61.7%, further widening the gap (vs. 14.6% in the controls).

The study also identified a worsening in more recent cohorts, particularly after 2010. In that period, researchers observed increased psychiatric needs both before and after referral, in a context that coincides with the general deterioration of adolescent mental health in the age of social media.

Impact after medical interventions

The data are particularly significant in the case of young people who received hormonal or surgical treatments. In males seeking feminizing transition, psychiatric morbidity increased from 9.8% to 60.7%. In females seeking masculinizing transition, it increased from 21.6% to 54.5%.

The study authors caution:

"These adolescents had markedly greater psychiatric morbidity than controls before and after referral, and treatment needs often persisted and even intensified after medical interventions; in some cases, they could even have a negative impact."

The researchers include Riittakerttu Kaltiala, chief psychiatrist at Tampere University Hospital, who has been a key figure in the development of gender identity services for minors in Finland.

In 2023, the psychiatrist herself stated in an interview: "Gender-affirming medical care is dangerous."

Strengths and limitations of the study

One of the main strengths noted by the authors is the use of comprehensive national registries, which allows for exhaustive follow-up of the entire population analyzed. This differentiates it from other international studies based on voluntary samples with high dropout rates.

Nevertheless, the researchers acknowledge relevant limitations, such as the lack of detailed data on the specific causes of psychiatric treatment or the impossibility of controlling for variables such as socioeconomic status.

They also warn that some young people with severe psychiatric disorders may not have accessed medical interventions, which could influence the results.

An increasingly polarized debate

The publication of the study has reignited a deeply divided global debate. Figures such as Greg Lukianoff, an advocate of free speech, pointed out that the issue has become "extraordinarily sensitive," where questioning certain positions can lead to personal disqualifications.

Along these lines, political scientist Timur Kuran argued that for years there has been an attempt to present the benefits of these interventions as "settled science," which would have hindered open debate.

International context and pressure on research

The impact of the study is not limited to Finland. In countries such as Australia, some practitioners who have raised doubts about similar treatments have faced regulatory pressure, reflecting the climate of tension surrounding the issue.

In addition, cancellations of academic events and pressure campaigns against researchers have been reported, which, according to various analysts, could affect scientific freedom in this field.

An open and evolving issue

Beyond the opposing positions, the Finnish study introduces relevant data in a complex discussion that combines science, health policy and individual rights.

The evolution of scientific evidence, together with the development of regulatory and ethical frameworks, will be key in determining the future of treatments related to gender identity in minors, in a context where medical decisions have profound long-term implications.