Finnish Study Finds No Drop in Psychiatric Care After Gender Transition

The study examined 2,083 Finnish individuals under 23 who attended specialised gender clinics between 1996 and 2019. Each patient was matched with eight peers from the general population, creating a control group of 16,643 people. By linking national registries, researchers tracked hormone prescriptions, gender‑affirming surgeries and specialist psychiatric visits for up to 25 years, with an average follow‑up of 5.5 years.

Even before their first clinic visit, 45.7 % of the gender‑referred group had received specialist psychiatric care compared with 15.0 % of matched controls. After the clinic visit, the gap widened: 61.7 % of those referred had specialist psychiatric care two or more years later, while controls stayed near 14.6 %.

Higher baseline psychiatric care

The study also examined those who actually received medical gender reassignment. Among them, psychiatric care rates rose sharply after two years: from 21.6 % to 54.5 % for masculinising transitions and from 9.8 % to 60.7 % for feminising transitions. In contrast, those who did not receive medical treatment showed only a modest increase.

Researchers note that the rise might reflect hormone therapy effects, unmet expectations, or underlying severe illness. After adjusting for pre‑clinic psychiatric history, all gender‑referred groups still had higher risk of specialist care, roughly 4.7 to 6.1 times that of male controls and 3.0 to 3.7 times that of female controls.

These findings challenge the idea that medical transition improves mental health for all youth. They underscore the importance of thorough mental‑health assessment before and during transition, and add to the ongoing debate about the evidence base for gender‑affirming care.