Recently a Swedish documentary called Uppdrag granskning (translated as “The Trans Train”) was released about the increasing numbers of youths medically transitioning to live as the opposite sex or as a non-binary identity.
A description on a Swedish website reads as follows:
The increase of teenage girls with gender dysphoria worry parents and health care staff in several countries - because of the lack of research on the new group of patients. What if the irreversible decision to undergo a gender correction is a mistake?
The increase in young trans-identified female is the current trend in many western countries, where generally about 2/3 of the youths seeking gender clinic services are females.
Here is a chart from Sweden demonstrating the increases of referrals (both sexes). This pattern is seen in the Netherlands, the United States, Britain, Canada, New Zealand, Finland, Germany and elsewhere.
We explore the topic “Why are so many females coming out as trans/non-binary” and possible reasons why this is happening, such as mental health issues, social contagion, and internalized homo/bisexual guilt. The Swedish health professionals are observing the pattern with these females that many of them have serious co-morbid conditions. The relationship between mental health and gender dysphoria is complicated. In some cases the mental health issues arise because the dysphoria isn’t treated or the person is treated poorly for being trans. However, it also appears that mental health problems may contribute to causing the gender dysphoria, is masked by trans-identification, or at least has a complicated integral relationship with the gender dysphoria.
There were some interviews with people who regret having transitioned. They believe they were affirmed too easily and did not receive proper care from doctors or mental health professionals, who claimed transition was the only way to cure gender dysphoria.
This documentary confirms, like in the United States, that they are operating on minors in Sweden (they state at fourteen years old). Mastectomies are being performed on females as young as 13 and vaginoplasty on minors under the age of 18 in the United States.
A clinician sums up the moral dilemma they feel they are in when the interviewers asks, “Can a 14-year-old really understand the consequences of such a decision?”
If it is a very young person, then we make a particularly careful assessment.
But you’re quite right that there is a dual ethical problem. The unethicalness of not helping to ease their suffering, and also there’s the unethicalness in that the patient may change their mind 15 years down the line.
The Swedish Pediatric Society indicates it does not support the “let the child lead” approach of affirmative model mental health professionals and doctors. Their position is the child can’t alone give consent to life-long body alterations.
The physical and psychological maturation process of children and adolescents is individual, but for most people, it involves searching for and experimenting with their identities; this is natural and needs to be done with nuanced support by the child's relatives. Society's rules need to balance children´s own rights against the necessity to protect them. Giving children the right to independently make life-changing decisions at an age when they cannot be expected to understand the consequences of those decisions, lacks scientific evidence and is contrary to established medical practice.
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