1. United States
2. Mich.
3. Letter

A new study from Finnish psychiatrist Riittakerttu Kaltiala is circulating in anti-trans policy circles and being used to argue that gender-affirming care harms youth mental health. Don't be misled by it. The study is fatally flawed, and its headline finding — that psychiatric treatment rates jumped from 9.8% to 60.7% among trans girls who received care — is a direct artifact of how Finland's gender clinics work, not evidence of harm. Finland's gender care pathway is housed inside adolescent psychiatry departments. Patients are monitored every three to six months in close cooperation with psychiatric units. Every downstream referral those check-ins generate — even one that clears the patient entirely — registers identically in the study's database to a psychiatric hospitalization. The study's own authors admit they "could not analyse patients' reasons for using psychiatric services." That's not a minor limitation. It means they cannot distinguish routine monitoring from genuine crisis, and they drew causal conclusions anyway. This is textbook surveillance bias. Kaltiala has received honoraria from an organization the Southern Poverty Law Center designates as an anti-LGBTQ+ hate group, testified in support of Florida's ban on transgender care, and presided over clinics where patients reported invasive sexual questioning of minors and systematic deadnaming. This study landed in a journal with an impact factor of 2.1 — well below JAMA Pediatrics or Pediatrics — for a reason. Please do not let manufactured science drive policy that will directly harm transgender youth in our community.