Mental health worsens after medicalized gender transitions, three-decade youth study finds

When Children's Hospital Los Angeles pediatrician Johanna Olsen-Kennedy found no improvement in mental health for gender-confused youth who went on puberty blockers and cross-sex hormones, she hid the results of her taxpayer-funded study for several years for fear the findings would be used to limit so-called gender-affirming care.

A massive Finnish study of gender-confused adolescents and young adults referred to "specialised gender identity services" over three decades, published this month in a peer-reviewed pediatrics journal, is already making waves around the world for its even more troubling implications for the highly experimental field.

Researchers tracked all "gender-referred individuals" under 23 years old in Finland from 1996 to 2019, a population of nearly 2,100, and matched them to more than 16,000 controls, according to their study in the Wiley-Blackwell journal Acta Paediatrica.

"Gender-referred adolescents showed significantly higher psychiatric morbidity than controls" before referral, 45.7% versus 15%, and the gap widened after referral, to 61.7% versus 14.6%, they found.

Referrals after 2010 – the year Instagram was founded, and the beginning of a plunge in adolescent mental health indicators – "had greater psychiatric needs than earlier cohorts, both before (47.9% vs. 15.3%) and ≥ 2 years after (61.3% vs. 14.2%) referral," the study says.

The results were especially alarming for adolescents who received hormonal and surgical interventions to resemble the opposite sex. Psychiatric morbidity rose from 9.8% to 60.7% for males seeking to resemble females ("feminising gender reassignment"), and from 21.6% to 54.5% for females seeking to resemble males ("masculinising").

"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 authors wrote.

The authors include Tampere University Hospital Department of Adolescent Psychiatry chief psychiatrist Riittakerttu Kaltiala, who has led "a nationally centralized gender identity service for minors" since 2011, her curriculum vitae says. 

"Gender-Affirming Care Is Dangerous. I Know Because I Helped Pioneer It," she told The Free Press in 2023.

 The Society for Evidence-Based Gender Medicine wrote on X: "Finland’s data are critical in the current debates on pediatric gender medicine" because it is the only known country "reporting full registry data, meaning outcomes are captured for all patients."

The follow-up studies for the so-called Dutch protocol, which forms the basis for gender-affirming treatment of youth, "rely on later volunteers, with dropout rates near 50% which introduces a major risk of bias," the group wrote. 

Several SEGM-associated researchers co-wrote the U.S. Department of Health and Human Services' youth gender medicine review in 2025. National Institutes of Health Director Jay Bhattacharya recently spoke to them about the "euphemisms" that dominate the field, which he said "leads you to a particular conclusion" in favor of such treatment.

"This is the evidence that we have needed for a long time," British chartered clinical psychologist Dionne Joseph told GBNews, praising the study's design for making comparisons possible with other Finnish youngsters of the same age. By contrast, proponents of gender-affirming care "lied, they hid, they obfuscated" and didn't follow up with patients.

"We are literally teaching children to be suicidal" when clinicians tell gender-confused youth and their parents their risk of suicide increases without medicalized transitions, Joseph said. "We call it making misattributions and therapists know [...] they are doing wrong."

'Anyone who questions is a transphobe'

The Finnish study authors defended the strengths of the study, including the robustness of the "register datasets" and the rigorous acceptance criteria for "specialist-level psychiatric treatment," but also acknowledged lacking "more detailed information on patients' reasons for using the psychiatric services" and inability to "control for socioeconomic background." 

The authors also emphasized that "the overrepresentation of prior psychiatric treatment in those who did not proceed to treatment probably reflects the fact that severe psychiatric morbidity may be a contraindication" for medical gender reassignment. (Psychiatric morbidity is generally defined as the presence or prevalence of mental health disorders from anxiety to schizophrenia.)

Transgender activists rejected the study on its merits but also smeared advocates of open inquiry on the contentious subject. One critic seemed not to understand control groups.

Harvard Law School instructor Alejandra Caraballo wrote a lengthy Bluesky post rebutting the study but also repeatedly called co-author Kaltiala "abusive," citing advocacy journalist Erin Reed's purported exposé. Both are males who identify as women.

Reed wrote a "fact-check" that dismissed the study in a "low-impact journal" because it "does not actually measure what it claims to measure, its headline finding is a massive artifact of surveillance bias, the clinics [sic] practices were abusive, and it operates within a system where its findings were essentially baked in from the start."

Kaltiali responded briefly to Reed's rebuttal in Australian journalist Bernard Lane's Gender Clinic News, prompting a longer unsatisfied response from Reed.

Caraballo also accused Foundation for Individual Rights and Expression CEO Greg Lukianoff of "being extremely transphobic," because Lukianoff responded to the Finnish study by saying, "I never saw anything become as immediately radioactive as views that ran counter to the narrative on trans issues" in Lukianoff's career defending free speech.

"Caraballo proceeds, utterly predictably, to act out exactly the kind of behavior that created the chill," Lukianoff responded. "Anyone who disagrees, anyone who questions, is a transphobe, a right-wing conspiracist, or otherwise an evil un-person." 

Civil rights attorney Carilyn Johnson said she has been "similarly shocked at the overwhelming wave of support for suppression of free speech" on gender identity debate "from those who formerly claimed to be classical liberals."

Promoters of medicalized transitions "tried to quash scientific debate on its effects through name-calling" and by claiming the mental health benefit is "settled science," Duke political scientist Timur Kuran wrote. "It’s now clear why they feared open scientific inquiry."

"In Australia, two clinicians who raised these exact concerns faced regulatory action," Queensland psychiatrists Andrew Amos and Jillian Spencer, Australian Christian activist Kurt Mahlburg wrote in response to the study.

The Royal Australian College of General Practitioners reportedly canceled a March 10 webinar with Kaltiala that already had 200 registered attendees, apparently in response to a pressure campaign by the activist group GPDU for Gender-Affirming Healthcare.

Kaltiala explored the dynamics of gender identity and bullying in a 2021 study of 140,000 Finnish students published in Frontiers in Psychology, which found transgender identities were "more strongly associated with perpetration of bullying than subjection to bullying."