Finnish study: Transgender surgeries for minors do not solve mental health issues

A comprehensive new study from researchers in Finland found that providing adolescents with transgender drugs or surgeries does not appear to solve the underlying mental health problems faced by youths who struggle with their gender identity.

While some lawmakers and transgender activists have claimed that puberty-blocking drugs and transgender surgical procedures are "life-saving medicine," the study disputes that claim. The research did not find any statistically significant reduction in suicides among adolescents who received "medical gender reassignment" through hormonal or surgical interventions.

"[The research] does not support the claims that [gender reassignment] is necessary in order to prevent suicide," the researchers wrote in the study. "[Gender reassignment] has also not been shown to reduce even suicidal ideation, and suicidal ideation is not equal to actual suicide risk."

The study analyzed the mortality rates, including the suicide rates, of Finns under the age of 23 who had sought psychiatric help for gender identity issues between the years 1996 and 2019. The researchers published the study inthe peer-reviewed BMJ Mental Health.

According to the researchers, suicide was rare among adolescents who sought psychiatric help within the time frame analyzed in the study, regardless of whether they received transgender drugs or surgeries.

Although adolescents who struggle with gender identity issues did have higher rates of suicide than the general population, this discrepancy appears to be rooted in deeper underlying psychological health problems the youths were facing rather than a lack of access to transgender drugs or surgeries.

The study noted that adolescents who struggle with their gender identity commonly have other underlying psychological health problems.

"Psychiatric morbidities are also common in this population," the study argues. "Therefore, the risk of suicide related to transgender identity and/or [gender dysphoria] per se may have been overestimated."

The researchers, however, noted limitations in their study. Particularly, they pointed out that the individuals studied were young and would likely require follow-up periods of up to several decades to learn more. They further noted the increase in adolescents seeking transgender drugs and surgeries has mostly occurred in the last decade.

Dr. Michael Artigues, the president of the socially conservative American College of Pediatricians (ACPeds), told CNA that the Finnish study confirms findings from a recent review of 60 studies published by ACPeds, which found that "any increase in suicide in this population was not based on lack of such intervention but based on comorbidities, such as depression."

"This emphasizes the need to aggressively treat underlying mental health disorders as well as to address adverse childhood experiences rather than sending children down the road of transgender interventions that often lead to the use of puberty-blocking drugs, cross-sex hormones, or surgeries that destroy their healthy body parts," Artigues said.

The study comes at a time when lawmakers in Western countries, including the United States, are debating whether transgender-identifying children should have access to puberty-blocking drugs, transgender hormone therapy, and surgical sex changes. Supporters often assert that access to such drugs and surgical procedures will prevent suicide. Opponents frequently reject that characterization and warn against irreversible life-changing procedures on minors that they may ultimately regret.

In some European countries, such as Finland and the United Kingdom, only adults can receive surgical sex changes. In Sweden and the Netherlands, minors cannot receive genital surgeries, but teenagers can receive chest surgeries once they reach 16 years old. Fewer than half of the states in the United States prohibit transgender surgeries for minors -- but the number of states banning such procedures has increased substantially over the last few years.

Mary Rice Hasson, the director of the Person and Identity Project at the conservative Ethics and Public Policy Center, told CNA that the Finnish study is "critically important" because it is the "first large-scale, reliable study using matched controls and a significant follow-up time (six years), to assess the suicide risk of youth with gender dysphoria."

"Contrary to claims that young people with gender dysphoria (identity or body-related distress) are more likely to [die by] suicide and that 'gender transition' interventions will prevent suicide, this study proves that preexisting psychiatric problems explain the suicide rates of these young people -- and that, in fact, the suicide rate is far lower than typically reported," Hasson said.

"This is good news, and it points the way to more effective treatment for young people with 'gender dysphoria' and confirms the direction taken by several European countries already," she added. "They are providing gender-dysphoric young people with psychotherapy and addressing underlying psychiatric issues rather than attempting to heal their inner wounds through surgery or hormones."

Jay Richards, the director of the DeVos Center for Life, Religion, and Family at the conservative Heritage Foundation, told CNA that the assertion that these drugs and procedures will prevent suicide "is probably the No. 1 myth of folks advocating this approach."

Richards warned that the supporters of transgender procedures for children will often use this claim as a form of "emotional blackmail" against parents who are hesitant about facilitating a sex change for their children. He suggested that parents take "a watchful waiting approach" rather than "a hyper-medicalized approach," noting that most children will reconcile with their sexed body if permitted to go through natural puberty.

If you or someone you know is having thoughts of suicide, please contact the Suicide & Crisis Lifeline at 988 or 1-800-273-TALK (8255) in the United States, or go to Suicide.org to find hotlines in other countries.