Finland and Sweden both recently issued new guidelines for gender dysphoric youth. I knew what the guidelines said—puberty blockers & hormones only in exceptional cases after intensive evaluation, leading with therapy—but I didn't know why. So I found out. lisaselindavis.substack.com/p/letter-from-…

Sweden's guidelines said "the risks of puberty suppressing treatment with GnRH-analogues and gender-affirming hormonal treatment currently outweigh the possible benefits, and that the treatments should be offered only in exceptional cases.”lisaselindavis.substack.com/p/letter-from-…

Finland's guidelines said “The first-line intervention for gender variance during childhood and adolescent years is psychosocial support and, as necessary, gender-explorative therapy and treatment for comorbid psychiatric disorders.”

And Finland's said: “In light of available evidence, gender reassignment of minors is an experimental practice.” Gender reassignment medical interventions “must be done with a great deal of caution, and no irreversible treatment should be initiated."lisaselindavis.substack.com/p/letter-from-…

Both Sweden & Finland's approaches were very different from @WPATH's and from what most American medical associations recommended. Why? Because the cohort showing up for treatment were radically different from the cohort on whom the treatments were based. lisaselindavis.substack.com/p/letter-from-…

Instead of mostly male kids with lifelong, childhood-onset dysphoria and without other serious mental health issues, Finland and Sweden saw an influx of teen girls with longterm psychiatric issues but adolescent onset gender dysphoria, which had rarely been seen until then.

Finally, both countries started to see detransitioners, and realized that the 1% detransition rate did not apply to the kids seeking treatment. They realized it was more common than they'd previously thought and that they needed longterm follow-up. lisaselindavis.substack.com/p/letter-from-…

Both Sweden and Finland ordered nonpartisan evidence reviews of the research and science, and found it did not support the affirmative model of care. They now emphasize risk and unknowns and emphasize the importance of therapy, follow-up and research. lisaselindavis.substack.com/p/letter-from-…

In America, there's been only one nonpartisan evidence review (in Florida). The AAP hasn't requested one, despite some pediatricians advocating for it. With our profit-driven healthcare system, it's harder to interrupt. Those who try are labeled bigots. lisaselindavis.substack.com/p/letter-from-…