Young people who identified as transgender suffered from worse mental health both before and after meeting with specialists, a new study has found.
Children and others younger than 23 in Finland with gender dysphoria—or the belief that one’s gender identity differs from one’s sex—had higher rates of psychiatric problems before intervention, compared with matched controls, Finnish researchers said in the paper, published on April 4 by the journal Acta Paediatrica.
Nearly half, or 45.7 percent, of the youth referred for gender conflict had psychiatric morbidity, versus just 15 percent of the control group.
Researchers followed up with the individuals who identified as transgender for up to two years after referral for intervention. During that time, 61.7 percent of the group had psychiatric issues, compared with 14.6 percent of the controls.
Among the subset of adolescents who underwent surgery, prevalence of psychiatric problems rose to 60.7 percent from 9.8 percent in males and to 54.5 percent from 21.6 percent in females.
“Severe psychiatric morbidity is common among gender-referred adolescents,” researchers concluded in their study report.
The researchers used data from the national Finnish information system to analyze psychiatric health among children who went to gender identity clinics in Finland from 1996 through 2019. The follow-up period started at the first appointment with gender identity specialists and lasted until June 2022, when researchers compiled the dataset.
They drew controls from the same national system.
The researchers ended up with 2,083 individuals aged 22 or younger. They were matched with 16,643 controls.
“When prior psychiatric morbidity was controlled for, the gender-referred adolescents had a 5- to 6-fold increased need for specialist-level psychiatric treatment two years or more after the index date compared to the male controls, and 3- to 4-fold greater risk compared to the female controls,” the researchers wrote.
“This does not support the suggested improvement in mental health after medical [gender reassignment] initiated during developmental years, and in light of the present findings, severe psychiatric disorders do not appear primarily attributable to [gender dysphoria].”
Doctors should be aware that interventions may lead to the deterioration of mental health in some patients, the researchers said.
Study co-author Sami-Matti Ruuska, a researcher with Tampere University, did not respond to a request for comment.
In the United States, federal health officials in 2025 recommended that minors suffering from gender dysphoria receive therapy, rather than be subject to interventions such as puberty blockers or breast removal. They said that some of the interventions could result in psychiatric problems.
Listed limitations of the new study included a lack of more detailed information on why the youth used psychiatric services.
The study was funded by the Jenny and Antti Wihuri Foundation, a nonprofit in Finland. Conflicts of interest included at least one researcher receiving support from the Finnish Society for Child and Adolescent Psychiatry.