Adolescents who claim to be “transgender” have significantly worse mental health after being subjected to “medical gender reassignment”, a large Finnish study has found.
The study, published in medical journal Acta Paediatrica on April 4, found a “significantly higher” incidence of mental disorders after so-called medical gender reassignment, which includes the use of irreversible and dangerous genital surgery, hormones and puberty blockers.
The researchers noted that medical gender reassignment “is often suggested to be beneficial, even vital, for the mental health of adolescents suffering from gender dysphoria”, but that the evidence supporting the popular claim was “very limited”.
The study compared 2,083 individuals who were referred to gender identity clinics in Finland before the age of 23 between 1996 and 2019 to a matched control group, and found much higher psychiatric morbidity both before (47.9% vs. 15.3%) and more than two years after (61.3% vs. 14.2%) referral.
Among those who underwent medical gender reassignment, “psychiatric morbidity increased markedly during follow-up”, the study found, rising from 9.8% to 60.7% in males who underwent “feminising” reassignment, and 21.6% to 54.5% in females in “masculinising gender reassignment”.
“After adjusting for prior psychiatric treatment, all gender-referred adolescents had similarly elevated risks of psychiatric morbidity, with hazard ratios approximately three times higher than female controls and five times higher than male controls,” the researchers found.
“These adolescents had markedly higher psychiatric morbidity than controls before and after referral, with treatment needs often persisting and even intensifying after medical interventions – on some, they might even have a negative impact.”
The study also found that adolescents referred after 2010 “displayed noticeably more psychiatric morbidity than those referred earlier”, which the researchers said suggested increasing referrals of adolescents with severe mental health issues to gender identity services.
The researchers said the “considerable increases” in need for psychiatric treatment among those “seeking change towards female” could be due to the use of the hormone estrogen, which can cause depressive symptoms, but noted that similar increases were seen among those given testosterone.
“Masculinising hormones may temporarily improve mood, and testosterone-related bodily changes – typically emerging within a few month – could be expected to alleviate gender dysphoria and subsequently psychiatric treatment needs,” the researchers stated.
“However, psychiatric treatment needs were also markedly increased among those who obtained masculinising gender reassignment. Subsequent morbidity burden may also arise from treatments not meeting the expectations placed on them.”
The researchers concluded that the results showed a need for further studies into why medical gender reassignment appears linked to mental health deterioration, and called for more thorough psychiatric assessments before referral.
“The effects of medical gender reassignment and the expectations of the patient must be addressed before commencing the treatment. The considerable severe psychiatric morbidity prior to contacting the gender identity service, and its increase over time, suggest that for some of these adolescents, gender dysphoria may be secondary to other mental health challenges,” the researchers concluded.
“This underscores the need to thoroughly assess and appropriately treat mental disorders among those seeking gender reassignment before and after undergoing irreversible medical treatments. Psychiatric needs must be adequately met.”
Editor’s note: The Noticer generally does not use terms such as “medical gender reassignment” – which falsely suggests genders can be medically reassigned – but for the purposes of clarity we have used the terminology of the researchers throughout our report on this study.
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