A rapid change in public opinion

News from Sweden:

For several days this week the veteran Swedish journalist Malou von Sivers will cover the same topic in every episode of her nightly TV chat show: the extraordinary rise in diagnoses of gender dysphoria among teenage girls.

The immediate trigger for Von Sivers’s themed week is a report from Sweden’s Board of Health and Welfare which confirmed a 1,500% rise between 2008 and 2018 in gender dysphoria diagnoses among 13- to 17-year-olds born as girls.

But it also reflects a rapid change in public opinion. Just a year ago, there seemed few official obstacles left in the way of young people who wanted gender reassignment treatment.

Which is to say, puberty blockers, aka an uncontrolled medical experiment on children.

In the autumn of 2018, the Social Democrat-led government, under pressure from the gay, lesbian and transgender group RFSL, proposed a new law which would reduce the minimum age for sex reassignment medical care from 18 to 15, remove all need for parental consent, and allow children as young as 12 to change their legal gender.

Then in March last year, the backlash started. Christopher Gillberg, a psychiatrist at Gothenburg’s Sahlgrenska Academy, wrote an article in the Svenska Dagbladet newspaper warning that hormone treatment and surgery on children was “a big experiment” which risked becoming one of the country’s worst medical scandals.

And the big experiment rests on the premise that children will reliably continue to want what they say they want right now, for the rest of their lives. That seems like a very shaky premise to base such a drastic experiment on. When I was 11 the closest I could get to having an idea of what I wanted to do with my life was a fantasy of driving around the western US having adventures. I’m glad nobody gave me a car and waved goodbye.

In April, Uppdrag Granskning, an investigative TV programme, followed up with a documentary profiling a former trans man, Sametti, who regretted her irreversible treatment.

In October, the programme turned its fire on the team at Stockholm’s Karolinska University hospital, which specialises in treating minors with gender dysphoria. The unit has been criticised for carrying out double mastectomies on children as young as 14, and accused of rushing through treatment and failing to consider adequately whether patients’ other psychiatric or developmental issues might better explain their unhappiness with their bodies. The Karolinska disputed the claim, saying it carefully assessed each case.

But who is assessing what “carefully” means?

On 20 December, the Swedish Agency for Health Technology Assessment, which the government had asked to review the scientific research into the recent surge in teenagers reporting gender dysphoria, reported that there was very little research either into the reason for the increase or the risks or benefits of hormone treatment and surgery.

First, do no harm.

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