Teenage transgender row splits Sweden as dysphoria diagnoses soar by 1,500%

[Jorge Mayer]

https://www.theguardian.com/society/2020/feb/22/ssweden-teenage-transgender-row-dysphoria-diagnoses-soar

New health report and TV debates highlight backlash against gender reassignment

Sat 22 Feb 2020 15.15 GMT

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.

Lukas Romson, an equality consultant and one of the country’s leading
trans activists, is prepared for the worst. “There will be no serious
trans activists in the show, because none of us trusts Malou at all,”
he says. “I’m afraid she’ll just use us.”

But the fact that a mainstream programme is devoting so much time to
the issue demonstrates just how much the debate has shifted in Sweden
over the past year. “It’s been a very big change and very sudden,”
Romson adds. “Everyone – but especially young people – feels worse
because of what they perceive as the media’s hatred of them.”

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.

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.

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.

At the same time, Filter magazine profiled the case of Jennifer Ring,
a 32-year-old trans woman who hanged herself four years after her
surgery. An expert on psychosis who was shown her medical journal by
her father, Avi Ring, was quoted as saying that she had shown clear
signs of psychosis at the time she first sought treatment for gender
dysphoria.

Indeed, the first clinic she approached refused to treat her, citing
signs of schizotypal symptoms and lack of a history of gender
dysphoria. But the team at Karolinska went ahead. “Karolinska don’t
stop anyone; virtually 100% get sex reassignment,” says Ring.

Sweden’s authorities are starting to respond. Shortly before the bill
that would have lowered the sex reassignment minimum age was due to be
debated in parliament in September, it was shelved, and the Board of
Health and Welfare was ordered to reassess the evidence. Its report is
due on 31 March.

Sametti, a former trans man who now identifies as a woman, regretted
the treatment.

After being interviewed on Uppdrag Granskning, Sweden’s health
minister, Lena Hallengren, asked the programme to include a text
addendum to remind viewers that it had been her predecessor, and not
her, who had drafted the controversial law.

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.

For Romson this is a worrying turn of events. He blames Gender
Identity Challenge Scandinavia (Genid), a parents’ group set up by
Ring, a retired professor of neurophysiology, the Swedish toxicologist
Karin Svens and the Norwegian teacher Marit Rønstad, for the change in
the debate, contrasting these “so-called concerned parents”, some of
whom he points out have adult transgender children who should be
allowed to speak and decide for themselves, with “real parents” who
affirm their children’s chosen identities. Svens was the only Swedish
parent to speak openly on Uppdrag Granskning about how her trans son
announced he was a boy when he was 17, started going to Karolinska’s
adult clinic when he turned 18, and now identifies as male. When asked
about Jennifer Ring, he says that friends of hers have told him she
found it difficult that her family were unwilling to accept her as a
trans woman.

“When I started questioning this some years ago, I thought I was
alone,” says Svens. “They tried to scare me by repeatedly implying
that there is a high risk of suicide, especially if the parents don’t
agree. Now more and more parents have found the courage to question
what the doctors say.”

The recent report from the Board of Health and Welfare also found that
32.4 percent of 13 to 17-year-olds with gender dysphoria registered at
birth as women also had diagnoses for anxiety disorder, 28.9 percent
had depression, 19.4 percent had ADHD, and 15.2 percent had autism.

Trans people often explain the higher levels of depression and anxiety
by pointing to the difficult experience living in a body that clashes
with their gender identity, particularly when many in society, often
including parents and friends, do not accept their identity.

One of the most surprising changes has been the growing divisions
between trans activists. While Romson warns that children will have
even more anxiety because of the change in the debate, Aleksa
Lundberg, a trans woman and longstanding activist, is backing the call
for more research.

Last October she apologised for not having been sufficiently open
about the depression she had felt after her operation. “I would
probably not undergo corrective surgery if I had the same choice
today,” she wrote. “And I want to apologise to those who perhaps
needed to hear that story earlier.”

This article was amended on 27 February 2020 to clarify that when
Lukas Romson referred to “so-called concerned parents” he was noting
that some have adult transgender children who should be able to choose
their own gender identities. Romson’s job title has also been
included.