THE PROBLEM WITH FINLAND

At 4zzz. We acknowledge the traditional owners of the land on which we broadcast. We pay our respects to the elders, past, present and emerging of the Turrbal and Jagera people. We acknowledge that their sovereignty over this land was never ceded and we stand in solidarity with.

Mission on 4zzz amplifying the trans and gender diverse community of Mean in Brisbane and beyond. You're listening to Transmission on 4 Triple Z. We are going to be talking about some pretty heavy stuff today, so before we introduce ourselves, I'm just gonna push a little play on this. This programme includes discussion of suicide, restrictive health practises, child sexual abuse and transphobia. Listener discretion is advised. If this content raises concerns for you, support is available at lifeline Australia on 13, 11, 14 or Q Life on 1-800-184527. That's right Listener, look after yourself. This morning I am in Studio Esme he him with the wonderful Bet, she, they and Bet. What are we chatting about today?

We're going to talk about Finland. I've been putting this off since the cast review came out, so that's two years now. I realised that came out in April 2024. You'll remember we did a two episode special on it here and I did mention Finland at the time, but I said it was just too heavy to talk about on air. So I've rethought that. So sorry people, we are going to talk about it. Yeah, look, if you're feeling delicate, you do not have to know this information. It's going to be focused on young people in Finland especially and on one person. Her name is Rita Kertu Kala. She's a psychiatrist who's very involved in gender affirming. Well, she calls it gender affirming medical care for young people in Finland. It's disputable whether that's what it really is. All I could say the first time around was that I'd read some testimonies from Finnish young peoples and their experiences in Finnish gender clinics and it had made me so sad that I'd curled up on my couch in the foetal position crying. And I also said that despite that, the CAS review had upheld the finished model as something to emulate. And then when I read the vine review late last year, I realised that they were upholding the finished model as something to emulate. So I'm just going to go through what the vine review A few points the vine review made about Finland. So firstly they cited Kelciala. Twice they repeated her claim that there is little evidence to support a reduction in completed suicide among trans young people who access gender affirming medical treatment. They claimed that the approach in Finland appears representative of a truly neutral approach regarding matters like pronouns, names or attire. And I said at the time, it's worth noting that Finland does not have gendered pronouns. So that was easy.

That part baked into the fabric of culture. So, you know.

Yeah. And they stated that the VINE reviews panel had met with key clinicians from Finland who described their model of care they hadn't met with with physicians from any other country. So I'm not exactly sure why they prioritise Finland. I'm sure that some anti trans campaigner whispered that idea in their ear. So, according to the VINE review, relevant components of the Finnish approach include respecting diverse identities while ensuring a neutral, comprehensive assessment. Sounds good, doesn't it? Meanwhile, the JBI review, which was the systematic review attached to the VINE review, made it clear that the Finnish guidance establishes one of the most restrictive frameworks identified in this review. And it's worth remembering that they're comparing it to, among other guidelines, the guidelines of the Gender Exploratory Therapy association, which practises what some people have credibly called conversion therapy.

Conversion, yeah.

Then they listed the different guidance that they'd synthesised from around the world. They listed Australian guidance first, followed by Finland, the UK WPATH Endocrine Society, in that order. So that kind of shows what they were prioritising. Now, I'm not going to go any further about that. It should, in a nutshell, make our blood run cold. I'm sure it makes your blood run cold, as you already know where this is going. And yeah, you know, people have said to me, you know, the vine review, that's water under the bridge, don't need to worry about that now. Well, this is Finland making incursions into the way we talk about healthcare for young trans people in this country. And the reason why I decided to do this show this week was because Rita Kathu Kaltiala has been doing webinars for physicians in this country. Now, the first one she was scheduled to do for now, I've forgotten the name now, the Royal Australian College of GPs for a special interest group attached to that group. So basically she was going to do a webinar for a bunch of gps. Now, that got temporarily, at least cancelled thanks to the efforts of some lovely doctors who are looking out for trans young people, but she rescheduled and she did it somewhere else. Now, I forgot to take note of where that was, but it was for an organisation where you expect this kind of thing. But they're saying she's going to come back. So I was going to do a quick recap on where this might head if the Finnish model takes hold here. So we did our episode on Pathways Project or the Pathways suite of studies as they call it, and you'll remember types of experiences that young people and their parents were having in the newly formed Children and Young People's Gender Service in the uk. So this is after the, the CASS review, basically I said it upheld the Finnish guidelines. In fact, Hilary Cass seems to have adored the Finnish guidelines. She praises them above all else. And Kaltiala, as I've said before, was involved in the CASS review on the advisory board for the CAS review or the so called Clinical Expert Group. And you can see that on Kaltiala's website. I discovered, by the way, she's not, she's not hiding that unlike some other people who were involved. So in the uk, since they've started to obviously remake their system in line with Finland, we've been hearing things like a young person who said they were all. And this is when they were going through a so called assessment to get gender affirming medical treatment. A young person said they were always like, you're not displaying enough distress or gender dysphoria. And in my final session I was screaming at the guy, I was crying and I was like, are you happy now? Another young person described having been forced to undergo an unwanted genital examination. A parent described a barrage of inappropriate questions. Another parent felt their parenting was being probed, that doctors were looking for negative parental influence on their child's identity. And a third parent said that the physicians at the CYPGs seemed to question whether trans identity even exists and they refused to use the term trans. The parents said, my child is not safe to be in that room. So just to be clear, none of that is even slightly surprising given the influence of the Finnish model of care on the CAS review. In fact, we would almost certainly expect to hear much worse in the coming years. We know, for instance, that young people participating in the Pathways studies will be routinely asked inappropriate questions about their sex lives. Have they had their genitals fondled? Have they performed oral sex? Do they think about sex too much? While their parents will be asked whether the young people play with their sex parts in public, what that has to do with assessing someone's transness, if transness even needs to be assessed in the first place, I don't know. But none of it should surprise us, but because in Finland it's much, much worse. So that's the context. Finland's influence is spreading. It has been spreading for about 10 years now, but it's really ramped up since the CASS review. Now, I know it might seem strange that a small country like Finland can have this kind of outsized influence on the world because it's not just influencing healthcare in the uk, it influenced healthcare in the us but. But it's not that strange that one country could have such an outsized effect because the Netherlands had an outsized effect on kicking this whole chapter in trans history off. The Netherlands was where the Dutch protocol was developed. They became by far the leading country in gender affirming medical treatment for young people. That occurred starting about 1988. So we're almost on 50 years now. People are still calling this case care experimental. It's been around that long, thanks to the Netherlands. Now I'm going to focus on Rita Kertu Kaltiala. It's not totally clear to me how influential she's been in this. She definitely has been very, very influential and she definitely is the main spokesperson for the Finnish model. Let's do a timeline on kaltiala. So in 2011 she was not working in a gender clinic. They didn't have a gender service for anyone under 18 in Finland in 2011. Now, as Kaltiala puts it, she kind of had to bow to activist so called and political pressure. And she reluctantly agreed to deliver paediatric care at the tier. I don't know if I'm saying that right, Tampere University Hospital or the T A Y S, but according to her, the young people who referred in for treatment did not resemble the the Dutch cohort. And that's what everyone was basing their care on at the time was the Dutch cohort. She worried that the Finnish cohort were mostly afab, whereas in the Dutch cohort they were mostly amab. She worried that they had excessive psychiatric, what she always calls comorbidities. And again, in the Dutch cohort, the young people were fairly rigorously screened for psychiatric conditions. She then, funnily enough, later in about 2016, when Lisa Lippman's rapid onset gender dysphoria study came out. Junk science, by the way. She worried that even though the young people she was starting to see had fewer psychiatric conditions now, they spent too much time with other trans people and that was transing them. Funnily enough, in 2011 she'd been worried that the young people she was seeing were Too isolated. In any case, throughout the 2000 and tens, she spent her time resisting pressure to provide better access to care and publishing studies that appeared to justify that. So in 2019, she published a study claiming that medical gender reassignment is not enough to improve functioning and relieve psychiatric comorbidities among adolescents with gender dysphoria. So this is something she says quite often, and it's a familiar straw man argument used by anti trans campaigners. They claim that gender affirming care is supposed to solve all of a young person's psychiatric issues. But that's not a claim I've ever seriously seen.

But how can you solve all of any individual's psychiatric elements with one blanket solution?

I think they've made a bit of a leap of logic there where they claim that they sometimes meet young people who think that gender affirming care is going to solve all of their problems. I guess I can see how they could get that impression. Young people sometimes are very focused on gender affirming care. I'm not sure that I've ever met one that thought that it was going to solve all their problems, but I guess I could see how they could make that misunderstanding. But they leap from that to saying that researchers and physicians are claiming that gender affirming care is going to solve all of a young person's problems. So there's a little short interview. I'll put it in the show notes on the the podcast episode Kaltiala and someone from the Australian Christian lobby. And it shows you, well how Kaltiala's kind of argument goes. She gets asked in that interview three times about harms because the person interviewing her from the Christian lobby is obviously convinced that there are these terrible harms associated with gender affirming medical treatment. And Kaltiela can't come up with even one harm. She doesn't even even mention any harms. All she says is that the expected improvements in mental health weren't seen in the young people that she treats. The kicker here is that that study that I mentioned, it hides a little secret in table number two, where we actually find substantial drops in psychiatric consultations for depression, anxiety and suicidality after initiation of the gender affirming hormone treatment. So she's just fantastic at drawing conclusions from data that when you look closely at the data, you're like, huh, how did you get that conclusion? I'm going to move on because I'm going to come back to the data in a minute in 2020. Kaltiala participates in the drafting of Treatment guidelines for trans children and young people in Finland via Cohere. The Council for Children Choices in Healthcare in Finland. In 2022, Kaltiala, along with SEGA members Richard Stevens, who's also in the Bayswater support group in the uk. Have you heard of them?

No.

They're like a transphobic parent group. They're horrific. They've had a horrific influence on UK politics. And Richard Bing from Segum. They all met with the Florida Board of medicine under Governor Ron DeSantis before the gender affirming. Immediately before the gender affirming care bans came in there where gender affirming medical treatment was banned for anyone under 18 minutes of the meeting reveal they were all there and that they were all in advisory positions for the CAS review. In 2023 and 24, Kaltiala writes three letters to the Finnish Parliament regarding a proposed ban on conversion therapy. These hit all the bases you'd expect. She cites the CAS review, she cites Roberto D. D', Angelo, the president of Segum, and she claims that there's no need for a ban on conversion therapy because conversion therapy doesn't exist these days.

Huh.

She gets very defensive about whether or not psychiatric treatment of co occurring mental health conditions in trans young people automatically qualifies as conversion therapy. Spoiler, it doesn't. And she goes off on a tangent about how quote unquote constructed people penises cannot get erections and constructed vaginas are at risk of growing shut. She even references uber turf Helen Joyce. Do you remember her?

Oh, no.

Helen Joyce is not a physician. Yeah, and she references another non physician, Abigail Shrier, who wrote the Pot Boiler Irreversible Damage, the Transgender Craze Seducing Our daughters. So in 2024, to return to the the data, she's the senior author of the infamous Trans Youth Suicide study, AKA Ruska et al, which claimed that allowing trans people access to gender affirming medical treatment does not decrease finished suicides. So that phrase, quote unquote finished suicides is a favourite of Kaltiala. Keep in mind, like they analyse data of thousands of young people, I forget how many, and they had seven suicides. So it's. Even though it was a huge data set, in one way it's tiny. In another way, there's only seven suicides there. And this is probably why, I imagine not many people do studies on finished suicides for these cohorts because they're just not big enough to get meaningful data. But she criticises studies that focus on rates of suicidal ideation and she says this wild thing, which is that a 40 to 60% rate of suicide, suicidal ideation in young people is just misleading because only 0.3% actually suicide. Now, I mean, obviously we're not claiming that, that many of them are going to suicide, we're just saying, wow, that's a very elevated rate of suicidality that these young people have. So anyway, the fact that the 0.3 that actually suicide is three times the rate found in WHO control group, she then explains away by controlling for psychiatric visits. This is kind of hard to explain because it's so wild, but basically she's saying that the presence or absence of gender dysphoria is not important in determining someone's risk of suicide, but the presence of some coexisting mental illness represented by a trip to a psychiatrist is. So in other words, gender dysphoria, dysphoria couldn't possibly cause suicidal ideation. And yes, it sounds crazy to me too, but anti trans campaigners lap this up. And meanwhile, she pulls the same trick she pulled in the 2019 study, not even commenting on the fact that according to this study, Ruska et al, hormones and surgery are actually associated with a drastic reduction in suicide risk. But again, that's hidden in the fine print, of course.

Of course, yeah.

So I did want to make the point point that that suicide study, Ruska et al, has been incredibly influential. It had a huge influence on gender affirming care bans in the UK and the us. It makes up the bulk of the evidence cited by the CASS Review to downplay the risk of suicide. And as we know, that was a claim that was proven tragically false when data was released via a Freedom Information request earlier this year showing a 400% increase in finished trans youth suicides.

Oh, my Lord.

In the year immediately following the first ban on puberty blockers through the NHS in 2020. Now, that wasn't a full ban, it was just a ban through the nhs. Now they have outlawed puberty blockers. God knows how many young people have died. We won't find out for a while because this data takes a while to emerge. And I hate to say say this, but God knows how many young people have died or will die here in Queensland because of the ban that's going on here. So Celtiala and Ruska et al are partly to blame for all of that in 2024. Ktiala spoke at a segum conference in Paris in 2025, as, as I said, she turned up in the Vine Review. And now in 2026, she has a new study and she's in the news again. That's another reason for doing this show. Now, the new study claims that she's gone a step further. She claims that severe psychiatric conditions get worse in Finnish young people under 23 following gender reassignment. Now, what exactly gender reassignment entails was not spelled out. Epidemiologist Gideon Meyerowitz Katz says there are obvious issues with the analysis which makes make it largely useless as a scientific investigation. So I'll link to his response in the show notes. I'm not going to go deeply into it. They've been arguing back and forth online. One obvious problem with the study that I will point out is that it regards a single visit to what it calls a specialist level psychiatrist as a marker of a severe psychiatric condition. And it doesn't make any distinction between someone who's been there once and someone who's been there 20 times. Of course, anti trans campaigners are saying that it proves gender affirming care doesn't work. But as I said earlier, it's debatable whether or not Finland actually practises gender affirming care. Finland instead seems to practise an old school style of excessive gatekeeping that, judging by this study, appears to be traumatising its patients. Evan Urquhart Transman at Assigned Medias, says her studies claim Finland's results are poor, but she also says that other countries should adopt Finland's approach. Riddle me that, Batman. Okay, let's look closely at that approach. And this is where the big content warning comes. So this is from an article in a LGBTQIA online magazine called I'm going to mispronounce this. Karaja came out in 2021 and this is what I've read when the cast review came out that had me crying on my couch. And I'll put the link in the show notes. Okay, so I'm going to read from it and keep in mind that I've put this through Google Translate and I had to do a little bit of an edit to that. I tried not to change the sense of it at all, just the grammar. A young girl walks into a room, sits down with her mother and looks around. There are three completely unknown adults in the room, one of whom, a male doctor, leads the conversation. During the conversation, the male doctor turns to the girl and demands that she explains what she thinks about her naked body. When she looks in the mirror, the girl begins to cry and this confuses the staff who cannot understand her reaction. The girl, Milla is 13 years old. Similarly, the staff cannot understand why a girl under the age of 15 feels anxious when asked to speak about her erections, her penis or the way she urinates to unknown adults. Questions like how does it feel to know you'll always really be a boy? How much do you hate yourself because you're a boy? And to what extent do you feel that it is better to be dead than be a boy? Hurt the young girl. According to Miller's mother, the trans poly, which is the the as far as I can tell, the slang term for the gender identity service units in Finland of which there are two. According to Miller's mother, the trans poly had constantly pointed out that blocker treatments and possible hormone replacement therapies would affect the amount of penis tissue available for vaginoplasty and weaken the possible result of surgery. In addition, they had tried to intimidate Miller's mother regarding Miller's possible info fertility, to which the mother had replied that she was aware of the matter. And this really gets me especially since the state still requires trans people to be infertile in connection with their gender recognition.

This is a little edit for the podcast version. As of 2023, Finland no longer requires sterilisation or mandatory infertility the to legally recognise a change in gender. However, the article that I'm quoting from here is from 2021. It's worth noting that Finland was one of the last countries in Europe to change that law.

Miller's mother says that after acquiring puberty blockers from another doctor due to how slow it was at the transpoly the transpolee had made a child welfare report and a criminal complaint against the mother law in even though the blockers were prescribed legally by a Finnish doctor. According to one of the interviewees families, their 13 year old son was encouraged to have sexual experiences. So that quote unquote, you know what you're missing out on if your sexuality changes or is disturbed by the process. Another mother says that the trans poly had interpreted the child's sexual development as delayed when the boy had not had had vaginal penetrative intercourse at age 15. Several interviewees said children had been asked to tell whether they are they masturbate or not and to describe how they masturbate if they do.

Oh, that's disgusting.

Yeah. The children have also been asked by the trans police staff to describe in detail what their naked bodies look like in the mirror as well as asked what kinds of sensations they have in the their naked bodies. Children have undergone unnecessary gynaecological tests and been asked to discuss sexual abuse or violence in their families. The majority of young people in the interviewed families have lived in their true genders for years before applying to a trans poly. Despite this, trans polies often use their birth names and their assigned genders at birth. Families also said they had been questioned by staff throughout the process. For example, one parent says that staff described to them brutally how phalloplasty is ill implemented and how quote unquote, the urethra is stretched to the penis to be built and they almost always have to be repaired and they almost never work properly. The parents said the description felt like intimidation, as if the staff were hinting that Mikko, the parent's son, could not possibly be be transgender as he had not thought about such operations and their consequences in advance. Finally, after a diagnostic process of years, it was decided that Mikko could not be diagnosed because his hobbies were too quote unquote girly and he did not have boys of the same age as friends. Several parents said the transpoly recorded false records in the patient records. For example, the trans boy, Illari's parents, Asco and Helena, say that when they visited the trans outpatient clinic, the child's own account of how he had told them he was a trans boy when he was under school age was changed in the records to a different storey of how the mother, Helena, had told Ilari he was transgender. The mother of the trans boy, Alexei, says that the young person had been criticised for the way he talked about clothes and that the staff expected him to be stereotypical, typically masculine staff criticised the boy's masculinity. A nurse told him, how does it feel to know you'll never be as good as a real man? Many other families confirmed Alexei's storey in their own interviews. Questioning manhood or womanhood and presenting transness as an inadequate version of masculinity or femininity was common. Most parents interviewed believed that the activities of the trans parents polies have caused them and their children long term harm. One of the mothers says the Finnish trans poly system is comparable to torture. It is a system of bureaucrats whose purpose is not to treat trans people but instead to eliminate as many of them as possible. The trans poly is not for transgender people, but for the cissexuals who are afraid of them. According to Helena and Alex Asco, the trans police are not about diagnosing transness but looking for reasons why the child is not transgender. I just want to point out you can't diagnose transness. Everyone, it's not a medical condition. The comments thread even has more of it in there. I hadn't noticed this before. Someone wrote in the comments thread, this is so familiar. I haven't even received a referral yet. But when I ask, the much older doctors started listing sex positions and told me to answer them from positive to neutral or negative.

This is creepy.

It's insane, isn't it?

And completely irrelevant.

And keep in mind, this is a quirk of the Finnish system. To even get referred to the trans poly, you have to go through the local healthcare system that doesn't specialise in transness in any way whatsoever. They're supposed to interrogate you before you even get there. And they're supposed to. They're the ones that look for the co occurring mental health conditions and if you have them, then you're fresh out of luck. You can't get.

You're ineligible. Yeah, right.

So. And someone else comments. Yeah, familiar stuff. I was 14. The specialist got angry when I announced that some of his questions were outrageous. He said, I can't really become a real man. There was also a claim that if I inform the school that I'm a boy before the diagnosis, it's an identity crime. During the diagnosis I found out that I'm just a girl who can't stand that boys don't want to play with me anymore. I heard how I would regret changing my name and I would regret trying to make my body more masculine. I complained to the hospital about this and they didn't see anything wrong with these comments or actions.

Oh, wow. Well, you're listening to transmission on 4 triple Z. We're doing some pretty heavy stuff today, chatting about quote unquote gender affirming care for trans young people in Finland, what their models of quote unquote care are and not care.

So yeah, I'm just gonna go back into just a bit more of young people's testimonies. So this comes from a different article. This is Assigned Media. Again, I mentioned them earlier. Evan Urquhart, who appears to be writing with someone from finland, Esser Kalyamaki, 2024. So again, link in the show notes at the gender clinic, Mikhail says there was no kindness, no recognition of the stress the intensely personal questioning might cause in a young teen. One line of questioning was particularly hard, harder even than questions about about his chest. The nurse wanted to know if he touched his genitals and how he touched them, if he did. I told the nurse I did not touch myself, so she said I should. She said I should touch myself, come back and tell her how I did it, mikhail said.

What?

She said, that was my homework.

Oh my gosh.

Don't forget your homework, he remembers her saying. As the appointment came to an end, Mikhail returned to visit the clinic every month or so for several years. The same questions were repeated at every visit with little change. He was not offered counselling or other support, just repeated questioning about his body, his sexuality, his friendships and many other things. His storey is similar to that of the other young trans people assign media spoke with five in all who described their experiences as minors at the gender clinics at Tampere and Helsinki. He and all the other youth clinic patients we spoke to described feeling that the process was designed to break them and encourage them to give up rather than help them in managing their gender dysphoria during the years the process took. Then, when he was 18, he made an appointment with a psychiatrist outside the gender clinic to be assessed for adhd. When that doctor reported that he'd found some markers for depression, Mikhail's heart sank. He'd heard storeys from other Finnish trans people online about patients being rejected if they were in anything but perfect mental health. Now he feared these markers of depression would be all the reason the clinic needed to send him away. A few weeks later, his worst fears came true. Although the clinic had never diagnosed, treated or recommended any kind of treatment for depression during the years that he'd been seen, the doctor at the clinic now told him they felt his mind was not clear enough to start transitioning, and they brought the process to an end. Sent off with nothing but a recommendation that he start therapy, Mikhail was left to fend for himself. Losing the hope of treatment after a mental health diagnosis was a common theme across every person we spoke with, not just those who sought help as young people, but also those who sought to transition in Finland as adults. Trans Finns who had no mental health diagnoses counted themselves lucky and told us about friends whose transitions had been refused because they struggled with their mental health. Others who suspected they might benefit from treatment for depression or anxiety spoke of delaying seeking help out of the fear that obtaining help for those issues would result in losing their transition chance. So this is another reason why the latest Kaltiala study, the latest Ruska et al study that came out this year is suspect. Because mightn't young people have been just waiting till after they obtain gender affirming medical treatment to seek mental health support? Mightn't that be the reason why their

visits to psychiatrists but also like who's rocking up to get gender affirming care going. I'm so happy to be here.

So I might. Well I will mention this young trans girl said I was asked about masturbation in one form or another in all but two visits and it has continued to this day. I knew I couldn't refuse the question, so I tried to keep the answer short so it would meet their needs and share as little information as possible. Everything I said was interpreted in the worst way. Eventually I learned I had to lie to them. I had to think of every word I said. It became hard for me to eat before the visits. They gave me so much anxiety that even just being in the lobby made me anxious. So I'm going to leave the Finnish young people there. Sorry, I'm just getting to me.

Yeah. This is awful.

Yeah. What I want to say though is that none of this is in the least surprising though.

And so this is the gender affirming care model that everyone's supposed to adopt, is that.

That's right.

Right.

This sort of aggressive interrogation of children's sexual behaviour and endless waiting while you interrogate them about everything under the sun to try and make sure that their identity is legitimate is what's recommended in the Therapy first clinical guidelines which we've spoken about here on the. In the show we did on conversion therapy. So Therapy first is an offshoot of segim and we know that Kaltiela is close with segim. Now, Therapy first clinical guidelines have been taken offline recently, but luckily I downloaded them. Here's what Therapy first recommends that therapists talk to young people about. What is the history of their romantic and sexual relationships? How do they see their sexual orientation? Have they had any sexual experiences and what was their nature? Do they masturbate? What kinds of sexual fantasies do they have? If anything, when was their first sexual experience? How do they feel about sexuality and sexual content? Are they interested in sexual contact or do they find it frightening or abhorrent? If they are sexually active, what do they prefer? Who do they prefer to have sexual contact with? And is this consistent with their stated sexual orientation? What kinds of sexual activities do they prefer? Brackets. Brackets being active, passive dominant, submissive kinks, etc. Keep in mind there is no lower age limit that I could find on this.

Oh my God.

How did family and peers respond to their sexual orientation? Is there any internalised homophobia? Have they had any adverse sexual experiences including non consensual contact, abuse or sexual assault? The CASs review actually goes further than that. The CAS review claims that pornography might be a possible cause of transness. And to support this, it links to a paper. Again, I've mentioned this before, it's Nadrowski's A New Flight From Womanhood. Now, the paper itself, which is just an opinion piece, it states outright that there is no evidence for the theory that porn causes transness. But it's still worth looking into. And it recommends asking young trans men in particular about the type of pornography consumed, Age of of proponents, sex of proponents, pornographic scripts, meaning do they show gang bangs, facial ejaculation, double penetration, rough oral sex, bdsm, coercion or rape? Again, no lower age limit that I could find.

Open Doors Youth Service is a South East Queensland support service for lesbian, gay, bisexual, transgender and or intersex youth aged 12 to 24 and their families. Open Doors believes that all young people have the right to explore, experience and express their gender and sexuality in safe and supportive environments and offers a range of programmes and counselling services, as well as support services for parents of LGBTI youth and community education and training. For more information, visit their website at www.opendoors.net.au. sponsors are 4zzz.

You're listening to transmission on 4zzz and where we've got 10 minutes.

Okay, I'm gonna try and cram this in. I just wanted to point out there's an Australian study on mental health outcomes for trans people that came out this year, Saxby et al. I'll link it in. The show notes. It shows something very different from the Finnish study. It shows that mental health care use does increase a little bit around the time of trans gender affirming hormone treatment initiation, but then it declines substantially over time. Altogether, gender affirming hormone treatment may help address unmet mental health needs and contribute to longer term reductions in mental health care use and associated costs among trans people. This study had an absolutely massive sample size. It also had a sibling study that you all would have noticed that looked at mental health treatment following gender affirming sight. Now, I just wanted to point out quickly that study did not show, as some pro trans advocates claimed, that gender affirming surgery pays for itself within three years through reduced mental health costs. It showed that it would pay for the current Medicare rebates on surgery within three years, which, as we all know, are a fraction of the actual cost. But that's still good, right? Yeah, so I'll link to that one too. So, and I wanted to just bring my opinion in here because I actually think this whole discussion about whether or not gender affirming medical treatment reliably produces improvements in mental health for young people is kind of a bit misguided, you know, so we keep hearing that the evidence is low certainty that, you know. So we hear over and over again that the evidence for puberty blockers is low certainty. Why? Because puberty blockers don't reliably increase mental health, improve mental health or reduce gender dysphoria. Now I want to ask, why would puberty blockers improve mental health or decrease gender dysphoria? Unless it's about artificial scarcity and discriminatory healthcare practises that are making it hard to get puberty blockers. And so that means when a young person finally is prescribed them, they feel a great sense of relief and that improves their mental health. But puberty blockers, they just pause you where you are in your development, they don't change your body at all.

Yeah, you're in limit.

They don't make you more aligned with your gender identity, they don't make you feel more affirmed, they don't do any of that. And they have a few minor side effects as well, which wouldn't help your mental health as well. They pause you in a part of your development while your other friends are going through their endogenous puberties. And so if you have to stay on them for quite a while, that could be depressing. We should not expect mental health improvements for prescribing someone puberty blockers. It's completely absurd. The only possible reason I can think of why their mental health would improve is that they would feel relieved that they managed to negotiate a transphobic system and get hold of these friggin drugs.

Right, yeah.

Now I'll even go further and this will be a bit more controversial, but why should we even be looking in improvements in mental health for gender affirming hormone treatment for hrt? Like again, if a young person has gone on puberty blockers in a timely fashion and then they're prescribed hormone treatment in a timely fashion and they don't have to fight anyone to get these prescriptions, then. Look, do we ask cisgender kids to feel happier after going through puberty? Do we look at puberty as improving mental health in cisgender kids? I've never heard of that. So why should we look for improvements in mental health in a trans person who goes through puberty? Which is basically what's going to happen when they go on hormone treatment, they're going to go through puberty. Like the reason why we get significant mental health improvements in adult trans people is because we had to go through our endogenous puberties, we had irreversible changes from them and then finally we get on hormone treatment later in our lives. Of course it's going to improve our mental health. We're so relieved to finally be on the right road after taking this wrong turn. Now, even then, though, there are going to be things, minority stress. You know, we may have problems passing, quote, unquote, I hate that term. You know, we might. We may still feel dysphoria because there are parts of our endogenous puberty that we can't reverse effectively. But yeah, you hear what I'm saying.

And the perceptions of others, right?

Yeah, totally. And yeah, especially. And this also applies for young people like the young people in Finland. How do we know how transphobic or otherwise Finnish society is? If you think about it, Kaltiyala and her crew are making these young people wait for years to get a diagnosis so they can get the drugs that they need. Meanwhile they go through their endogenous puberties. So they're basically transitioning as adults or close to it when it's too late for puberty blockers and when gender forming hormone treatments are not going to reverse all of the secondary sex characteristics. And keep in mind that Kaltiela's latest study goes up to 23 years old. So these young people who may have transitioned at 22, for all we know in this study, they may be going through the same minority stress issues that adults go through when we transition and we can't pass pass and people heckle us in the street and so on. So why are we looking for mental health improvements? The one question that we should be asking these young people years from now is are you glad that you transitioned? And all we want is for them to say yes, end of storey. Just to be clear, the purpose of

gender affirming medical treatment for young people is not to improve mental health. It is to inoculate against the likely catastrophic decline in mental health that will happen if these young people are not allowed to affirm their genders and live as they want to.

Postscript Kaltiala is in the news in Finland. This comes from yle, the Finnish equivalent of the abc, the most respected mainstream news service in the country. And this relates to the EVA unit at the Tampere University Hospital. So this is where the Gender Clinic is located, but this is not in the Gender Clinic. This is in what's called the EVA unit or the Psychiatric Treatment and Research Unit for Adolescent Intensive Care. So this is where the very disturbed young people with psychiatric difficulties go. An Ombudsman's inspection revealed illegal practises in the EVA unit. Now, these illegal practises include restriction of young people, people's freedom of movement without a formal decision, body searches carried out without a formal decision. Sheets, bed sheets used to tie up children and young people. Normally in that situation, restraints would be used, but in the EVA unit, young people were sometimes restricted by a bed sheet tied across their chest and attached to the bed frame. Conversations between young people and their families have been listened to via microphones in the unit's family room. Kaltiala says that families and young people have been aware of this, but the Ombudsman says staff do not have the right to listen to those conversations, regardless of whether young people and families are aware or have given consent. The Ombudsman stressed that any measures that lead to the deprivation of a young person's liberty must be viewed with restraint and must be recorded in the patient's records. So, gosh, One last thing I wanted to say. There's often an argument, and I've got into it myself, about whether or not people like Rita Kurtu Kautiala are acting in good faith or bad faith. And I've often accused her of bad faith. You know what? It doesn't even matter. It doesn't matter if she has good intentions. It's irrelevant. So. Oh, and the argument about so called progressive Nordic countries. Go and Google the rise of the Swedish right. The rise of the Finnish right. Link to an article in The Guardian from 2024 titled I Moved to Finland believing it was a progressive dream. It hasn't turned out that way. Welcome to life under the most right wing Finnish government in generations. So people don't let anyone come at you with that progressive Nordic countries claim. They say it all the time. As soon as they say that, you know that they've been reading the Segum website. Yes, I'll end with this. A comment that I saw on Reddit in a Finnish discussion of Finnish Finnish young people. They said, nowadays gender identity is explored and transition is experienced on a stage with such bright lights that it is bound to leave behind traumas in itself.

Well, there you have it. Listener update from BET on what's going on in Finland. Thank you so much. As well to listener Phil for texting in and for saying always love when BET's on the show. All of us cis people should listen to this knowledge. So thanks, Phil. Please look after yourself out there. If you need support, you can always contact lifeline and there's also Q Life as well, which is a great online

to all the trans young people out there. I will never stop fighting for you all, and I know a whole lot of the rest of us will not either.

Thanks for listening to Transmission. Catch us every Monday live on 4 Triple Z from 10am or listen to our podcast on the community radio plus applause.