Norway has gone from having a demand of 4 people a year who want to undergo gender transition treatment, between 1975 and 1990, to having between 400 and 600 patients a year, in 2018-2021.
The greatest growth in demand has occurred among adolescents and young adults who, being women, identify with the male sex. These striking data have been provided by the National Research Commission for the Norwegian Health and Care Service (UKOM). This is an independent state company tasked with analyzing serious incidents or other malfunctions in Norwegian health and care services. On March 9, the Commission published a report on the safety of minors with dysphoria, warning of the lack of «scientific evidence» for gender reassignment treatments in minors. They explain that research on the treatment is «deficient» and the long-term effects «are not well known.» In addition, they note the instability of minors’ gender incongruity, since they are not «fully developed bodily, mentally, sexually, or socially.»
Risks to patient safety
Not only is there a pattern in relation to a greater demand by women compared to men, but it has been seen that 75% of minors who are diagnosed have a high prevalence of mental illnesses or cognitive disorders (ADHD/autism or Tourette’s syndrome) prior to the diagnosis of dysphoria.
The report criticizes that the national professional guidelines for the treatment of gender affirmation in minors with dysphoria do not have specific requirements for their evaluation and initiation of therapy. This translates into a risk to patient safety, lacking the principle of prudence. Likewise, they warn of the long list of secondary effects underlying this practice, such as the appearance of liver disease, negative psychological reactions in the case of treatment from man to woman, increased thrombotic risk or arterial hypertension; and conversely, from women to men, increased red blood cells, scarring, edema, or infertility resulting from both surgical procedures and hormonal treatment.
Safety of treatments
The reason for the study that gave rise to the aforementioned report is related to the numerous notifications to the Commission by relatives of minors, who question the safety of the treatments offered to children and adolescents diagnosed with dysphoria.
One of the recommendations put forth by the aforementioned commission is the revision of the guidelines that establish a safe framework for treatment, in addition to strengthening the knowledge base. They recommend defining the treatment as experimental, and treating it as such when offering it to children with dysphoria.
The UKOM therefore declares the need to expand the level of evidence on the approach to gender dysphoria and propose and organize the services offered based on this knowledge.
Bioethical assessment
As published in the Bioethics Observatory in previous articles, in recent years there has been an exponential increase in people initially declared to be transsexuals who show their regret after starting the sex reassignment process. The accumulation of data on the side effects associated with these treatments, their inability to resolve the underlying problems that frequently underlie dysphoria, and the persistence, especially in the long term, of the serious problems associated with dysphoria processes In many cases, together with the irreversibility of these interventions on many occasions, it has promoted that in the countries in which these interventions began many years ago, they have rethought their related health policies, drastically modifying the procedures by which these cases are addressed. leading to more prudent and conservative positions pending the availability of new evidence on the suitability or otherwise of the proposals applied in gender transition processes.
