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Mia Hughes: Finnish data shows gender treatments increase psychiatric needs. Canada lags behind

A major registry study adds to the growing body of evidence that medical transition fails to deliver promised mental health benefits

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A major new study from Finland casts fresh doubt on the use of puberty blockers, cross-sex hormones and surgeries for adolescents experiencing gender distress. For more than a decade, supporters of these interventions have argued that they reliably improve mental health and can even be “life-saving” for trans-identified youth. Yet this Finnish study — one of the largest and most robust to date — found no such benefit. Instead, it linked the treatments to a marked worsening of mental health.

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Canada has so far paid little heed to the accumulating warnings from systematic evidence reviews and clinical course corrections abroad. Whether these latest findings will finally prompt Canadian gender clinics to reconsider their treatment approach remains an open question.

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The study, published in Acta Paediatrica, is a rare gem in a field renowned for poor methodological rigour. Drawing on Finland’s centralized health registries, it includes complete data for all 2,083 young people who presented to gender clinics before age 23 between 1996 and 2019.

The findings are sobering.

Researchers measured specialist-level psychiatric treatment both before referral to a gender clinic and two or more years afterwards. Overall, “gender-referred” adolescents required far more psychiatric care than the general population at both points. But drilling down on the numbers produced some alarming results.

The researchers examined the cohort in two ways. First, they divided patients by referral period: 1996–2010 and 2011–2019. This distinction matters. The later period captures the sharp global rise in referrals to gender clinics, when caseloads surged and the sex ratio shifted dramatically from predominantly young boys to overwhelmingly adolescent girls.

The study found that those referred after 2010 showed significantly higher psychiatric needs overall, leading the authors to conclude that for some young people, “mental health challenges may manifest as concerns related to gender identity.”

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This is in line with detransitioner testimony and what critics of paediatric gender medicine have argued for years: that many adolescents are misinterpreting ordinary mental health problems as evidence that they are transgender because they are coming of age in a decade saturated with gender identity ideology.

The researchers also compared those who received medical interventions (38.2 per cent) with those who did not. The non-medicalized group had high psychiatric needs at referral — unsurprising, given Finland’s strict criteria that reserved treatment for the most stable adolescents — and showed little change in mental health status at the follow-up point two or more years later.

Yet in the medicalized group — those selected precisely because they initially presented with relatively stable mental health — specialist psychiatric care use rose sharply after commencing medical treatment: from roughly 10 per cent to 61 per cent among males receiving “feminizing” treatment, and from 22 per cent to 55 per cent among females receiving “masculinizing” treatment.

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To be sure, there is a need for caution when interpreting these findings. The study is observational, so it cannot prove that the medical treatments caused the sharp rise in psychiatric care. It shows only that the surge happened, and all the authors can do is offer hypotheses for why that might be.

One possible explanation given is that estrogen therapy might cause depression in young males as seen in women and adult trans-identified males. For the female cohort, the sharp decline is more puzzling, since testosterone often boosts energy and quickly brings desired cosmetic changes, which should alleviate gender dysphoria and improve mental health. Instead, the opposite occurred.

In measured language, the authors suggest that this may arise from “treatments not meeting the expectations placed upon them.”

Put plainly: they were promised relief, and it failed to materialize.

These concerning findings raise the obvious question: if these interventions do not improve mental health, and unquestioningly compromise physical health, what possible defence remains for continuing this experiment on young people?

And what does all this mean for Canada?

Though some will undoubtedly try to wave this study away as irrelevant, the parallels are impossible to ignore. Our gender clinics saw the same explosion in referrals, the same sudden shift from young boys to adolescent girls, and the same accompanying array of complex psychiatric comorbidities.

The crucial difference? Unlike Finland, which always required comprehensive psychiatric assessment before any medical intervention, many of Canada’s gender clinics offer puberty blockers or cross-sex hormones on the first appointment without any need for psychological assessment.

And while Finland drastically restricted access to these treatments in 2020 after a systematic review found no solid scientific basis, Canada continues to rely on that same evidence that is consistently rated as low to very low quality. Of note, much of the evidence that purportedly shows improved mental health relies on self-reported surveys — a notoriously unreliable measure.

Still, for all its strengths, this latest study is unlikely to pierce the ideological armour that surrounds Canadian gender medicine.

After all, Sweden and Finland’s systematic reviews, and the U.K.’s landmark Cass Report changed nothing. The comprehensive 2025 report by the U.S. Department of Health and Human Services has been effectively ignored. Even a systematic review conducted on home soil at McMaster University failed to shift clinical practice.

This stubborn willful blindness points to one simple truth: Gender medicine in Canada is driven by ideology, not science — so no study, no matter how strong, will inspire the field to self-correct. Meaning, unless Canadians force a reckoning and demand safer and better care for these vulnerable youth, this medical scandal will continue unabated.

Mia Hughes specializes in researching pediatric gender medicine, psychiatric epidemics, social contagion and the intersection of trans rights and women’s rights. She is the author of “The WPATH Files,” a senior fellow at the Macdonald-Laurier Institute and director of Genspect Canada.

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