Medical gender reassignment in minors–why are we cautious in Finland?

Since 2011, gender identity assessments–sometimes leading to medical gender reassignment (GR) during developmental years–have been available to minors in Finland. However, the profiles of patients referred to gender identity services (GIS) differed from those suggested in international literature at the time. The outcomes of medical interventions were more modest than anticipated, despite internationally optimistic expectations. Meanwhile, the number of young people seeking medical GR increased rapidly. This gap between expectations and observed realities, as documented in our published research, underscored the need for national guidelines, which were issued in 2020. Due to the lack of a strong scientific evidence base for early medical intervention, the guidelines designate psychosocial interventions as the primary approach to treating gender dysphoria (GD) among minors. I will describe these developments and explore future needs in paediatric gender medicine.