This is going around on X, a new study by SEGM member Riittakerttu Kaltiala (the abusive head of a clinic in Finland) is getting picked up as proof that gender-affirming care doesn't work. The data actually shows something very different from what the authors claim. It's purposefully distorted. 🧵
The biggest issue is the outcome variable isn't "psychiatric morbidity." It's a proxy that is "contact with specialist psychiatric services." Kids in gender clinics are in constant clinical surveillance. Population controls are not. You are measuring detection, not disease. This is epidemiology 101. The headline finding: psychiatric morbidity skyrocketed among adolescents who got medical gender reassignment. 9.8% → 60.7% in one group. Sounds devastating. But the authors bury a critical fact: severe psychiatric morbidity was a contra-indication for treatment in Finland. So the group that got treatment was selected for having low baseline psych issues. The "increase" is likely regression to the mean + the fact that these kids are in intensive clinical monitoring that catches conditions controls never get screened for Here's what the study actually shows: when you adjust for prior psychiatric treatment, the hazard ratios between those who got medical gender affirming care and those who didn't equalize. GR status has no independent effect. That's in Tables 4 and 5. The authors just don't mention it. The minority stress analysis is one paragraph. Their argument: society is more accepting now, so minority stress can't explain the findings. They cite zero data on actual minority stress in Finland. Meanwhile Finland spent the 2010s publicly restricting gender care for minors. The secular trends claim—that post-2010 referrals are more psychiatrically ill—rests on comparing 186 people in the early cohort to 1,897 in the later one. The early cohort difference didn't even reach their own significance threshold. Senior author Kaltiala sat on the Cass Review advisory board and was the architect of Finland's restrictive protocols. She's been accused of abusive practices. She worked with DeSantis and other Republicans in Florida to ban care there. erininthemorning.com
www.erininthemorning.com
What this study actually demonstrates: trans youth carry elevated psychiatric burden regardless of treatment pathway. That's an argument for integrated psychiatric + gender-affirming care, not against affirming care. The authors intentionally chose the opposite frame to mislead people. Every time one of these studies drops, it gets laundered through policy bodies and court filings as settled science. It isn't. The data doesn't say what the authors want it to say. They had to selectively use data and a proxy to get it to say what they wanted and rely on misinformation online. Given their absurd levels of access to records in Finland, the fact they had to use a proxy like this speaks volumes. Why use utilization of psychiatry services? Why not psychiatric hospitalizations, medication utilization or any other number of measures of psychiatric health they have access to? This is exactly what Kaltiala and SEGM do. They severely distort the science, P-hack their data, attack practitioners and experts in the field, sow confusion, and utilize the epistemological chaos to ban care. Over on X, that disinformation gets rewarded by the biases of their audience. @mattyglesias.bsky.social Since you shared it over on X, here's what the actual study said and did. Not the distorted view of hostile actors. Oh, and this was the author of the article. She assigned children masturbation as "homework." assignedmedia.org
www.assignedmedia.org