Sven Roman, MD is a specialist in Child and Adolescent Psychiatry
The number of cases of gender dysphoria has increased explosively in recent years, especially among young people. I am appalled at the drastic, irrevocable and unscientific treatment. This may be our country’s biggest healthcare scandal ever.
On September 5, 17 parents of children with gender dysphoria wrote an op-ed in the Swedish newspaper Dagens Nyheter on the epidemic of gender dysphoria among children and young adults (18 to 25 years). They describe an epidemic in which social contacts play a major role.
In psychiatry, it is common for epidemics to spread socially. Some other examples are eating disorders and self-harm behavior.
Through internet, the social spread has been made easier and thus has increased. It started with contacts via sms. The increase became exponential through the rise of social media. The trend grew additionally with smart phones.
When eating disorders and self-harm behavior began to increase, the health care provider community tried its best when it came to treatment. I will exemplify how we approached self-harm behavior, that started to appear in the early 1990s.
Initially, we forced these young people into treatment, and kept them under constant surveillance with the aim to reduce self-harm. The result was quite the opposite.
The youth felt monitored as if they were in prison, their levels of anxiety increased, the self-harm behavior escalated and the blood was literally splashing. There were many restraining belt interventions and forced medication.
But we learned. We realized there was a great spread of contamination and we tried to avoid hospitalization in closed wards.
After a decade, research has shown promising results through psychotherapy. Today, practices across the country are treating self-harm behavior with scientifically rooted psychotherapy. Often, patients stop injuring themselves within three months.
From 2014, the six gender dysphoria reception centers for children has seen an avalanche of referrels. In 2013, Stockholm received 24 referrals. In the years 2016 to 2018, 197 to 239 referrals came annually, this is an eight to ten-fold increase in three years, according to an article in Swedish newspaper Expressen.
There is a corresponding increase in all the reception centers in the country. Thousands of children and young adults are likely to have received sex-corrective treatment over the past five years.
Unlike the epidemic of self-harm behavior, care providers are not exploring to find the right treatment. Instead, on a broad front, drastic treatment with high doses of sex hormones and breast and genital surgery is introduced. This despite the lack of any scientific evidence for these treatments for children, and probably not for young adults either.
Research shows that at least 75 percent of patients with gender dysphoria have other psychiatric problems. In the group of children and young adults, autism, eating disorders, self-harm behavior and abuse are common. For all these conditions there is evidence-based treatment. Given such, gender dysphoria often disappears, as it is usually secondary to these conditions.
The brain undergoes major changes during adolescence. Development takes place from the posterior part of the brain and moves forward. The last part of the brain to mature is the front lobe. This is where the capacity for holistic thinking, empathy and judgment lies. The brain is only fully developed at 25 to 30 years of age.
Since gender dysphoria often is secondary to psychiatric conditions for which there is evidence-based treatment and gender-corrective therapy for adolescents lacks scientific support, all gender-corrective therapy for patients younger than 25 years should be discontinued.
There needs to be an independent investigation into the probably biggest health scandal in our country’s history.