‘Better a live daughter than a dead son.’ For years, this brutal phrase was delivered to the parents of gender-confused children by therapists, campaigners and supporters of charities like Mermaids. The uncompromising message was that if mum and dad did not wholeheartedly affirm their child’s new gender identity, they ran the risk of their child taking their own life.
If we accept the findings of this Finnish study, we need to acknowledge that, rather than gender transition being ‘life-saving’ for troubled children, it can do more harm than good
The connection between refusing to accept a transgender child and the likelihood of them suffering mental health problems, including, at worst, committing suicide, was so entrenched that it made it to prime-time television. ‘I want a happy daughter, not a dead son,’ said the mother played by Anna Friel in the 2018 ITV drama Butterfly.
To be clear, the argument being promoted was not that gender-confused children are also likely to suffer from a range of other mental health issues and that wanting to transition could, indeed, be a symptom of underlying problems. Instead, parents were hearing that their otherwise perfectly happy children would struggle only if their desire to live as the opposite sex was thwarted. Transition, in other words, was literally ‘life saving’.
Suspicion began to grow that this emotional blackmail was not grounded in evidence but was merely a crude attempt to intimidate parents into helping their child assume a new name, pronouns and wardrobe, breast binders or ‘tucking’ pants and, eventually, puberty blockers, cross-sex hormones and gender reassignment surgery. The excellent advocacy group Transgender Trend called the transgender-suicide pipeline into question back in 2018. In 2024, the Cass Review recognised that the suicide risk in children and young people with gender dysphoria was higher than average, but that it was comparable to rates for people with a ‘similar range of mental health and psychosocial challenges.’ Crucially, Cass noted, there was no evidence to suggest that medical transition reduced suicide risk.
However, the Cass Review also pointed to the alarming lack of data surrounding the clinical outcomes of children who had been prescribed puberty blockers or cross-sex hormones. The little data gathered was deemed low-quality, and there had been little effort to follow patients long-term.
Now, finally, from Finland comes vital research into the prevalence of severe psychiatric disorders among ‘gender-referred adolescents’, focusing particularly on ‘outcomes related to medical gender reassignment’. This study is remarkably extensive; it covers everyone in Finland under the age of 23 who was referred for clinical support with gender dysphoria between 1996 and 2019. The findings absolutely shatter the myth of the child made suicidal through thwarted gender transition.
The Finnish study shows that children who are distressed about their gender have significantly higher rates of psychological problems than in the general population, both before (46 per cent versus 15 per cent) and around two years after referral (62 per cent versus 15 per cent). In other words, struggles with the process of transitioning from one gender identity to another do not cause mental illness; instead, children with underlying mental health issues are more likely to see themselves as ‘born in the wrong body’.
Crucially, this study also shows that a child or young adult’s psychiatric needs do not subside after medical gender reassignment. This means that affirming a child’s delusions about their sex and allowing them to medically transition does nothing to alleviate their mental health difficulties. In fact, the researchers found that in adolescents who underwent medical gender reassignment, rates of mental illness actually increased markedly – from around 10 to 60 per cent in those undergoing ‘feminising gender reassignment’, or boys who wanted to become girls, and from roughly 20 per cent to 55 per cent among girls who underwent masculinising procedures.
If we accept the findings of this Finnish study, we need to acknowledge that, rather than gender transition being ‘life-saving’ for troubled children, it can do more harm than good. This could be because underlying psychiatric problems are more likely to remain untreated while parents and practitioners obsess about gender identity. It could be because taking testosterone or estrogen during adolescence has an impact on a person’s emotions. Or it could be that, having been sold a dream that gender transition is easy, young adults are frustrated to discover that not even a lifelong regime of medical intervention will make them truly change sex.
This new research must signal a complete end to all discussion about medical trials to evaluate the efficacy of puberty-blocking hormones in gender dysphoric children. And it is yet another reminder that distressed youngsters need psychiatric help rather than having their delusions affirmed. Parents sold the lie that accepting a child’s new identity and helping them through the process of transition was the only way to keep them alive are owed an apology.
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