“Mika” hesitates if she dares to tell her story. What has happened to her, she says, is such a sensitive topic in the trans world. It is about how she was diagnosed with gender dysphoria in 2017, and how she underwent a gender correction.
- What I learned from the care was that there is basically no one to regret, she says.
Then "Mika" was sure that the treatment was the right path for her - that she was a guy, born in the wrong body.
- I really saw it as my biggest obstacle in my life was that my body did not reflect who I am. If I get resolved that bit, then many other things will be much easier.
"Mika" got testosterone and noticed how the body changed. At first, it felt good, she says. But that didn't solve the problems, she still felt bad. She eventually began searching the net and found people who "detransitioned", that is, undone her gender correction.
And "Mika" realized that she was one of them.
- Now, in retrospect, I think it is quite sickly to say how this process goes. There is so little support for everything.
Explosive increaseThe diagnosis of gender dysphoria describes the suffering that occurs when the body and the perceived sex do not match. Previously, there were few people diagnosed in Sweden, but a new and growing patient group has begun to come to the country's receptions: Young girls who feel they are boys and want to undergo a gender correction.
In 2008, 28 girls aged 10–19 received care for gender dysphoria, the National Board of Health statistics show.
In 2017, 536 girls in the same age group were enrolled.
The treatment is internationally accepted, both healthcare and trans people testify to how it has reduced people's suffering. But Mission Review has been in contact with staff at gender identity clinics both in Sweden and in other countries warning that you do not know what to do when it comes to gender corrections of the new group of patients.
Anne Waehre is a senior physician at the Norwegian Sex Survey for Children at Rikshospitalet. There you see the same increase as in Sweden - and she calls the care of just teenage girls "experimental".
- In this group, there may be people we have not previously seen and who we are unsure of the benefit of the treatment, she says and continues:
- You do not know in the long run how they will feel, you have no research on how things are going.
"They are depressed"The biggest reception for gender-affirming treatment, or gender correction, also known as, for children, is with the Kid team at Karolinska University Hospital. Per-Anders Rydelius is a consultant and professor of children and adolescent psychiatry.
- Today we have had about 650 cases since its inception. It has been interesting because at the beginning it was maybe five, ten a year. But in the last few years there has been a huge accumulation of new referrals. Almost 200 per year.
Per-Anders Rydelius does not agree with Anne Waehre that the care is experimental.
- It follows a model of investigation that has been tested. Of course, the investigation model may need to be modified in different ways. But the majority of those who are investigated and treated, they are still satisfied.
The new group of patients has some common denominators.
More than half of teenage girls have other psychiatric diagnoses. They suffer, for example, from self-harm behavior, autism and anorexia - and many tell about other traumas.
Parents testify about concernBut a group of parents who Mission Review have been in contact with testify about how their daughters were offered nothing but gender correction when they sought help for gender dysphoria.
They want to tell anonymously because the children are minors.
- We do not feel that care offers anything other than hormone therapy and planning for surgery. To operate on our child. And give yes, help our child change the sex, ”says Sofie, the mother of a teenage girl.
Several of the parents also testify that the issue of gender identity came suddenly and unexpectedly into the lives of their teenagers. It is a phenomenon so common that it has gained an international name: Rapid onset of gender dysphoria.
- Our daughter has been bad for many years. Things have been brave for her in school, with friends and maybe in the family. In many ways in life. Now it seemed as if she had suddenly found an explanation for why it was so brave, that it is another gender identity simply, ”says Jens.
Those who think they suffer from gender dysphoria can seek help through, for example, a youth reception - but you can also write a referral on the Internet yourself. Then it can take months of waiting to get to a sex reception. At Karolinska University Hospital, which has the country's largest sex reception, it is stated that the investigation time for young people is about half a year, but that time varies.
When diagnosed, treatment begins, and hormones can be prescribed. Teens who undergo sexually affirming treatment receive strong preparations, first given a stop hormone that stops puberty.
Same doses of the medicine used in chemical castration of adult men. The prescription, which is recommended for a maximum of three years, increases in the age group 15-19 years.
- We know that we castrate and we have a heart effect. And we know that there is a risk to the skeleton and that it will have a mental impact, says Karl Mikael Kälkner, clinical investigator at the Swedish Medicines Agency who approves and controls drugs.
But here it is bodies that are fully healthy, but where you prescribe such powerful drugs. What, then, has to be useful at the other end?
- I think it's about showing that the individual feels better to take that risk.
Doctors believe that the body returns to normal development after cessation of medication, but there is no research into what is happening in the long term.
"It's a lot you don't know"According to health care, the number of people who regret a gender correction is few. A Swedish study shows that there are only 15 people in the years 1972–2010.
But the large increase in the new patient group of teenage girls started around 2012. Thus, there is no research on them. Assignment Review has been in contact with two people who have regretted, in closed Facebook groups there are dozens of other Swedes who testify to the same thing.
At the Lund Stream reception in Västra Götaland, several people have returned to the reception in recent years.
- Patients who regret not standing on the barricades. They are suffering, and they are not proud of this. Without it, there is a crisis at the highest level, says Lennart Fällberg, head of care unit.
The fact that patients regret affects the staff who make decisions about diagnosis and treatment, says Lennart Fällberg.
- That's a lot you don't know. This is what creates what we call ethical stress. That we do not have sufficient evidence of what we do.
The lack of science and knowledge is reflected in the care document. In a research application to the Ethics Review Board, which Assignment Review has taken part in, it says that today, surgery, gender correction, without quality assurance or follow-up.
For the person transitioning from female to male sex, medication must continue throughout life. The physical changes, which happen, among other things, with the help of the hormone testosterone, are forever.
- If you start taking testosterone, you will be patient for the rest of your life. You have to come to the hospital, you have to follow up with blood tests, that is a very serious treatment, says Anna Waehre at the Norwegian National Hospital.
“Mika” is angry that gender corrections are being carried out without proper research on people like her, who belong to the new group of patients.
- My generation of mostly young girls who are just a little different, stand out from the typical girl or women role, we are a great experiment in this. We are test rabbits, something that there is not enough science behind. Where is medicine done in this way, where do you play with people's lives?
The Tran Train and teenage girls report can be seen already on SVT Play - or Wednesday, April 3, 20:00 at SVT1.
Correction: In an earlier version of this article, it was stated that the investigation of gender dysphoria often takes around six months. It is correct that Karolinska University Hospital states that the time for young people is around half a year - but even there the time may vary.