EPISODE 62 - Pioneers Series - Adolescent Identity: Riittakerttu Kaltiala

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Quick Notes:
Riittakerttu Kaltiala, MD, PhD, BSc, is professor of adolescent psychiatry in Tampere University and chief psychiatrist in the Department of Adolescent Psychiatry in Tampere University Hospital. She is specialist in psychiatry, adolescent psychiatry and forensic psychiatry. She has been clinically involved in carrying out research on adolescent gender identity issues since 2011 when one of the two nationally centralized gender identity services for minors was opened in Finland, in Tampere University Hospital.
Riitta tells us about the shift around 2010 in Finland in which health policy makers, politicians, activists, and human rights groups pushed for inclusion of adolescent and child services for gender transition. The adolescent psychiatrists scrambled to accommodate these new demands but recognized that identity consolidation is known to take more time and they had concerns about such early interventions. Nevertheless, they began developing a program for childhood gender services based on the literature in other countries such as the UK and netherlands. They were astonished and quite confused when the populations arriving at their services reflected a very different demographic in age, sex, and presentation of other comorbid psychiatric issues. They saw a shift again around 2015 which continued to confound the clinicians. Riitta tells us about reading the littman ROGD research which accurately documented what she and colleagues were seeing
Links:
Dr Kaltiala’s Website:
riittakerttu.fi/
Adolescent GD Current Perspectives:
www.ncbi.nlm.nih.gov/pmc/arti...
Lisa Marchiano - Outbreak:
www.tandfonline.com/doi/full/...
GD and ASD: A Narrative Review
pubmed.ncbi.nlm.nih.gov/26753...
Extended Notes
● Riitta talks about how she got into psychiatry and got to work in this field.
● When did Riitta first come across gender identity? She shares the backstory.
● Riitta talks about how it was decided in Finland in 2009 that children and adolescents also needed gender medical intervention. What was the motivation behind this?
● It is during adolescence that young people seek and experiment with their identity. However, it is normal for them to change or evolve in 2-3 years. It is part of the process of stabilizing their identity.
● It’s hard to expect in adolescent psychiatry during the early phases of adolescent development that the person would already be ready with any aspect of identity.
● In the beginning, most of society did not have an idea about gender identity issues so it was not discussed much including the medical field as only a small group had started to study it.
● Riitta shares the unexpected phenomena she experienced about puberty blockers of gender identity when she first learned about it.
● Social media and peer discussions usually precede gender distress cases in the US and UK. Riitta shares what data they collected in this case for Finland.
● People who came to their services had severe psychiatric problems and history and were suffering mental disorders. This was one of the issues that inspired Riitta to further her research.
● In the first years, professionals such as teachers, child welfare, psychiatrists, etc., who were around the young person when they started to express their gender dysphoria felt insecure and uncertain about their competence on how to help them.
● As contact with peers is very important for healthy adolescents, they have observed a lot of young people who displayed non-confirming gender behaviors isolated themselves as they were discriminated against and bullied.
● What was the follow up like from these services back in 2011? Where are those adolescents now and how are they doing?
● Despite changes hormonal treatments were producing was satisfying for the adolescent, it did little to relieve other psychiatric symptoms. Simply changing gender will not resolve all these problems.
● Although a lot of professionals have failed helplessly in the past, this has completely changed in Finland. People working with adolescents nowadays are more well equipped and competent.
● What does Riitta think about the concept of Rapid Onset Gender Dysphoria?
● Riitta shares that peer influence is valid as it is natural with adolescents to be susceptible to their peer groups. Similar to kids confirming their ideals in music and other interests, it can also happen with gender identity.
● It’s good that young people are able to express themselves however they feel like but making medical interventions for the healthy body must have a stronger consideration.
● Riitta talks about how highly autistic children may lack the flexibility to deal with ambiguity as they tend to obsess and fixate on things. Is it playing a big role in their gender dysphoria?
This podcast is sponsored by ReIME and Genspect. Visit Rethinkime.org and Genspect.org.
For more about our show: Linktr.ee/WiderLensPod

Опубликовано:

9 фев 2022

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Комментарии : 21

@terfteeps 2 года назад

I want to come and work in Finland!! Finally I hear a voice I agree with about adolescence 👏👏👏

@Call-Me-Sam 2 года назад

It's a strange world we live in where it takes years of studies and " scientific " research to point out the obvious . An important question is, as a culture, how did we get to a place where we ever believed transitioning young people was even sane . The context is primary. Social engineering. Great episode, very interesting.

@upnorth2421 8 месяцев назад

Kaltiala and her team have been really important to us in Finland. Our new trans-legislation would have been much worse without them. Her science-based and calm yet empathic and warm stance towards both gender dysphoric teens and larger public is admirable.

@happynjoyousnfree 2 года назад

I love the insights about adolescence from someone who is an actual expert with this age group. It helps make sense of the current social contagion of "trans." I've been seeing this push to abolish all talk of gender and transitioning, but then how on earth is a parent supposed to communicate with a young person who is so wrapped up in this language? I love what Genspect and this channel are doing to help guide the conversation in a healthier direction.

@janmariolle 2 года назад

Thank you for his wonderful discussion. It is so refreshing to learn that there are countries following a conservative and scientific based approach. Because these treatments are irreversible, a child deserves every chance to mature while exploring their identity. I especially appreciated the wisdom of the comments regarding fertility and how our desire for children evolves as we move through our lives.

@markkavanagh7377 2 года назад

I think the tragedy for teens is that if they go down this road but realise it was wrong for them, they don't know who they are to go back to it as a mature person can, who has had some life experience.

@adlernewman 2 года назад

I have to be quite firm. It is insane to accept what a child or an adolescent says on face value. Yes, there might be some sex dissonance (gender is a ridiculous concept) in some children because of their family circumstances, difficulty with teenage maturation, autism or other mental health issues, but it absolutely doesn't point towards a trans identity. A trans identity is not a thing. It is always a symptom of other trauma or mental health problems. Grooming and gaslighting confused children into a false identity is child abuse, full stop. I am glad this lady has an open mind to acknowledge that.

@nastja33 Год назад

Brilliant. In Australia we've just had an article published in a mainstream newspaper questioning Queensland gender clinic's sloppy approach and why they have the highest rate of cross sex hormone prescriptions in the country. Queensland Children's Hospital responded by saying, among other things, that they follow WPATH's standards of care. Un-fkn-believable. This contrasted with Riitakerttu's account of clinicians tearing their hair out, questioning why patients aren't matching up with the Dutch research...we have a massive scandal here in Australia that hospitals continue to ignore

@akashicturtle1827 2 года назад

An impressive interviewee. A lot of stuff I hear about the youth trans craze is getting pretty repetitive, but Dr. Kaltiala definitely offers some fresh information based on her direct expertise. I would like to hear more from non-anglo cultures.

@paulondawula1011 2 года назад

Well done again!

@shadow.banned Год назад

Listened to this one the other day.

@muppelmuh1445 6 месяцев назад

Being on the spectrum (but too old to have encountered gender BS during my adolescence) my explanation why so many autistic young people present at clinics is as follows: In adolescence social codes turn very very complicated. Weirdly enough though it gets a lot easier if you are a girl to hang with the boys and if you are a boy to hang with the girls. Being the odd one out the very intricate complicated social hierarchies and codes don't apply to you, the group exempts you. If you are the boy who hangs out with the girls all the bitchy power struggles won't touch you. Being a girl and hanging with the boys their social hierarchy struggles and competitiveness won't touch you. They don't see you as a boy hence you are exempt. For someone who doesn't speak social very well being the odd one out is maybe the only way to have friends at all. But being on the spectrum you may mistake this effect for actually being a girl/a boy- especially in today's climate. Look. People on the spectrum often have friends from the other sex, other age groups or even hugely different cultures. It's just a way to fly stealth. The easiest life for me was to be a foreigner in another country with a strong accent. If I am weird then it's because I am a foreigner - not because I am actually weird. People cut you more slack. They don't turn nasty and mean because they have a very obvious explanation for my being weird. I think the fact that so many autistic young people present with gender issues is rooted in these 2 things. 1) you get on so well with the opposite sex 2)you need a validation that is widely accepted and alright for your being different. Trans is cool AND accepted AND you get attention AND everybody understands you being different and it's just a package that solves so many of your social problems. Whats a little physical pain against finally "fitting in" as in finding the niche in which normal people respect you instead of ostracize and bully you. Edited to add: in an adolescent or child this wouldn't be a conscious reasoning. I am in my mid 40s. I wouldn't have been able to even put words to any of this back when I was a teenager. I wasn't even realizing why I was was so happy living in another country, I only understood in retrospect. People on the spectrum aren't exactly good at knowing how they feel when they feel it.

@widerlenspod 6 месяцев назад

This is a powerful insight. Thank you for sharing. We hope to delve a lot deeper into the autism conncetion in 2024.

@muppelmuh1445 6 месяцев назад

@@widerlenspod well, the above and the obvious. The obvious is that people on the spectrum do feel very different. And they spend a lot of time ruminating what's wrong with them. If they don't have a diagnosis I can totally see them explaining this feeling with being trans because trans explains the feeling different since kind of always. And if they in addition get on better with the opposite sex (see above) then how can it not be trans? And even with a diagnosis I can imagine them clinging to the trans explanation because it's easier on the mind because there are treatments for being trans and once transitioned all would be good, right. But there is no treatment for autism. No pills. No therapy. The therapy that you could get doesn't help autism at the core it only helps you to mask better. It's a lot easier on the mind to chose the issue that's wrong with you that promises relief and treatment. That's the obvious connection. Personally I remember puberty as years of depression, knowing deep down that I am different but not knowing why and no matter how hard I tried I always fell short. It is so important in that age to have peers, to have friends and there is nothing you leave untried to get friends and to fit in and to bend and mask and you always fall short. For me this was the motivation to start smoking because that was cool. (I am older, now it's uncool) . To me that was the incentive to start shoplifting because I could give away the stuff and be popular. And to skip school with "friends". And somehow these friends always managed to talk their way out of getting caught and saying sorry and I got caught and got full disciplinary measures like getting expelled from school. Anyway, what I also remember from puberty is the feeling that my body isn't part of me, just a machine that I needed to function but not part of me. I didn't obsess about my sex or gender, but it was years of feeling a total disconnect from my body. Not understanding when it needed feeding, not understanding where I was in space and being very clumsy, not understanding when my body needed anything or was tired. A total disconnect and yet my was the only thing I got judged by from peers. In puberty body and appearance gets so so important and I felt so ugly and as if my body wasn't a part of me. And all I wanted was to fly stealth, not being attractive to neither boys nor girls and just no sex. Androgenous. That I would have liked. Because you aren't capable of dealing with this sex thing at all. If someone had told me that the reason I feel that way was because I am on the wrong gendered body I would have latched on. Maybe that's why I am so interested in this topic. I also remember in my late teens thinking that I can't continue living with this disconnect and that I had to find a way to live in my body and integrate it somehow. Reclaim it and own it. For me the way I chose was to quit reading fiction which I had done since age 4 and instead use my body in years of physical work on farms with animals and outside. And yes, it did help. But had someone offered me trans as a way out.... I would have latched on. And you do think that you have nothing to lose and I would not have listened to warnings. At all.

@sueinraleigh3091 Год назад

This is the only investigation I trust on adolescent gender Id.

@saraha7124 2 года назад

What I found most interesting about this was the lack of gender confused male teenagers in Finland. As I understand it, in the US and UK, whilst the major demographic is girls, there is also a rising cohort of young males, as Angus Fox has detailed. I wonder if this is because something within Finnish society is different with regard to masculinity? Anyone care to speculate?

@suvkat 21 день назад

As a finn I guess it has something to do with our culture. It is more common to appreciate more masculine than feminine traits so I bet it plays at least some part of this phenomenon.