The issue of access to gender affirming care is far too important to be discussed using sweeping generalizations and one-sided perspectives. Uppdrag Granskning has aired a TV program that questions care. In our view, this program was more nuanced than the one that aired last spring, which created much concern with a sensationalistic viewpoint and random facts. But again, as in the first program, important perspectives and voices that could illuminate the issue in order to create the basis of a meaningful discussion, were missing.
We are organisations that meet target groups with mental ill-health who are in need of gender affirming care or other support on a daily basis. It’s our mission to safeguard trans people’s, and especially young trans people’s, rights and access to good care and different health promoting efforts. As a part of that work, we of course welcome an objective and respectful debate.
It’s not factual to, like Uppdrag Granskning, question the risk of suicide among young trans people. We know that mental ill-health is common among trans people. We know that mental ill-health and earlier attempts at suicide are the strongest risk factors for suicide. After working for many years with the target group we know that people with gender dysphoria that attempt suicide say that the waiting time for care has played a central role. In Sweden there are no statistics of how many people with gender dysphoria take their lives, how many who do it waiting for care, or what the reason is. It’s partly because statistics don’t factor in trans experience, and partly because the reasons for suicide are difficult to report in a correct way. But we do know that many trans persons have suicidal thoughts and attempt suicide.
It’s also not correct or fair of Uppdrag Granskning to leave out young trans people’s own voices and stories. Instead, youth is portrayed as dependent victims that can’t speak for themselves. Children and youth have the right to necessary healthcare, and children and youth may sometimes need necessary care without the consent of a legal guardian. This isn’t unique to gender affirming care. Being young means that you can’t be part of the decision making about your own care with your own doctor. Genital surgery can be necessary from a medical perspective in a few cases for people under 18 years of age, but it’s equally as important to not have to undergo unwanted or unnecessary surgery; a right that we have been fighting for. The care should be tailored to the individual’s needs.
The issue of mental ill-health among youth that have thoughts about their gender identity and gender dysphoria is not only an issue about gender affirming care, even though it’s central and has been in focus. It’s just as much about safe spaces, social support, community, affirmation and the space to reflect upon and mirror oneself in the experiences of others. In the future, we hope that the discussions can revolve around how we can make things better for young people with mental ill-health. How we can get more resources for a good trans care, create more meeting spaces and increase the level of knowledge within schools, healthcare and within important activities for young trans people. It can make a real difference.
Sandra Ehne, president of RFSL
Jêran Rostam, president of RFSL Ungdom