UPDATE ON IMPORTANT NEW FINLAND STUDY | Professor Kaltiala has responded to criticism of the Finnish study, which found that mental health may get worse after young people undergo medical gender transition. One critique of the study argues that psychiatric appointments are part and parcel of the gender-transition process in Finland and therefore may not point to serious psychiatric morbidity. In their paper, Professor Kaltiala and her colleagues acknowledged the limitation that their study could not analyse in detail why these patients needed psychiatric services. Asked about this issue, she told me that the healthcare register data used for the study included diagnoses and in-patient periods but not treatment nor information about a patient’s problems related to family life, romantic relationships or work. However, Professor Kaltiala said the young people seen by specialised psychiatric services in her country would have “severe disorders”. These services were focused on “those really in need”, consistent with national criteria for health equity. “In Finland, you do not get admitted to specialist-level services if you don’t have mental disorders at all or [have only] mild disorders and problems,” she said. “Primary-level services are available for needs related to milder disorders and psychosocial difficulties.” She said the gender-referred youth in the new study were much more likely than matched controls to have a history of severe mental disorders, often dating back some years before they reached the gender clinic. “Thus, many developed feelings of gender dysphoria in the context of severe disorders,” she said. “Severe mental disorders during adolescence generally have potential to complicate identity development. It rather seems that feelings of gender dysphoria are sometimes secondary to severe mental disorders.” If it were the other way around, and the mental disorders were secondary to the dysphoria, those disorders would be “expected to subside with medical gender reassignment”, according to the Dutch treatment protocol adopted internationally, she said. But this did not happen in the new Finnish study. Instead, the need for specialist psychiatric services—and therefore the scale of serious mental disorders—increased after medical transition, as the study by Professor Kaltiala and her colleagues reported. Updated news report ⬇️ open.substack.com/pub/gender…