What Utah Buried and Finland Found

This week on Informed Dissent, Jamie Reed, Cori Cohn, and Lauren Leggieri are joined by guest Dr. Julia Mason to discuss the landmark Finnish cohort study on psychiatric outcomes in gender-referred youth and SEGM's methodological appraisal of the Utah evidence review. Dr. Mason is a board-certified pediatrician, Fellow of the American Academy of Pediatrics, and founding board member of the Society for Evidence-Based Gender Medicine. She has spent years raising concerns about the evidence base underpinning pediatric gender medicine from inside her own profession — including co-authoring peer-reviewed challenges to the Dutch studies in the Journal of Sex and Marital Therapy and introducing multiple resolutions at the AAP Annual Leadership Forum demanding the academy reevaluate its position on pediatric gender transition.The Finnish StudyRuuska, S.-M., Tuisku, K., Holttinen, T., & Kaltiala, R. (2026). Psychiatric Morbidity Among Adolescents and Young Adults Who Contacted Specialised Gender Identity Services in Finland in 1996–2019: A Register Study. Acta Paediatrica. 🔗 https://doi.org/10.1111/apa.70533This is the landmark Finnish national cohort study tracking 2,083 gender-referred adolescents against 16,643 matched population controls for up to 25 years. It is the largest and most methodologically rigorous outcomes study in this field to date. Among adolescents who underwent medical gender reassignment, rates of severe psychiatric illness rose more than sixfold in the years that followed.For a detailed breakdown of what the study found and what happened when it was published, read our two-part series on the LGB Courage Coalition Substack: 🔗 Part I — What the Study Found: 🔗 Part II — What Happened Next: The SEGM Methodological Appraisal of the Utah ReviewSociety for Evidence-Based Gender Medicine. (2026). The “Utah Review” of Hormonal Treatments for Gender-Dysphoric Minors: A Methodological Appraisal. 🔗 https://segm.org/utah-evidence-review-analysisThe Utah Legislature commissioned an independent evidence review of hormonal interventions for gender-dysphoric minors. The resulting 1,051-page document concluded puberty blockers and cross-sex hormones were safe and effective. SEGM’s appraisal found the review excluded the most rigorous international systematic reviews, failed to conduct an evidence synthesis, and was produced by a team with undisclosed conflicts of interest including direct ties to the clinic under evaluation. When standard quality-assessment tools were applied, the result was the lowest possible rating: high risk of bias, critically low confidence.For our own analysis of the Utah Review and what it tells us about how this evidence gets manufactured, read: 🔗 Paid subscribers to the Informed Dissent Substack receive a full detailed breakdown of the week’s stories delivered straight to their inbox every week. Questions, comments, and suggestions welcome in the Substack comment section or at [email protected]. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit informeddissentpodcast.substack.com/subscribe