I am just back from the first Nordic meeting on transgender health, held in Oslo. Amazing that such meeting did not take place earlier. At certain time when I was doing research on involuntary treatment I participated a lot in Nordic meetings on psychiatric epidemiology and health services research. More recently, focusing clinically and in research on adolescent forensic issues and transgender topics, I have had more contacts with Dutch and British colleagues. It was, however, en excellent idea from the Norwegian experts to arrange a Nordic meeting on transgender health, too. With our fairly similar societies and long common history, not to mention short distances between us, Nordic co-operation in often most fruitful, and easy to establish, too.

In all the Nordic countries, like everywhere in the Western world, all the more people experience gender dysphoria and seek contacts with services desiring medical interventions for gender reassignment. The origins of gender dysphoria, be it mild or extreme, are currently not known. Very likely both biological, psychological and social phenomena play a role in the gender identity issue itself and in the increasing request for services. However, with increasing number of referrals, all the services are also increasingly meeting people who suffer from gender dysphoria in the context of mental disorders that cannot automatically be assumed secondary to gender issues, and complicate or hinder making conclusions on consolidated identity. Particularly among adolescent SR applicants, a share is struggling with large scale identity confusion and long term developmental and mental health difficulties. We recently discussed these topics in an article of ours in the CAPMH http://www.capmh.com/content/9/1/9

Adolescence is a developmental period characterized by identity development. Even if adolescent development, including identity development, is essentially influenced by puberty and its impact on brain maturation with rapid physical and cognitive and clearly slower emotional maturation, it is also and strongly influenced by social relationships and culture around. Identity development has many facets, one of them being gender identity, closely related to but still separate from sexual identity. It is important to allow adolescents to explore identities. As a society, we do not usually have an urge to react on adolescents’ exploring, say, religious or political identities, not to mention cultural commitments such as memberships of subcultures, even if they are sincerely true and important for the adolescent her/himself. Adolescent’s exploring gender and sexual identity sometimes seems to provoke more urge in the society around to classify and categorize them permanently. During adolescence, time may show consolidation but also a change in any facet of identity development. There are young people with consolidated identity not conforming to their biological sex, who benefit of for example hormonal treatments, but also adolescents struggling with gender dysphoria who likely benefit of other interventions during the developmental phase.

A strange coincidence: I travelled to the Nordic gender identity meeting labeled a male… The Norwegian travel agency that arranged the flights had informed the airlines company that I am male, so in all my flight documents there stood Mr. That this would happen exactly when going to a gender identity meeting – a paradox? But indeed, nobody paid any attention.

The autumn’s ballet season has been most rewarding for me. The dance school introduced a new teacher. I feel we all in the class had a need to demonstrate her that we are worth her effort, and on the other hand she has demanded quite a lot from us. Fortunately I had exercised all summer on pointé shoes! Thanks to that I did not completely collapse with the new order… But it is amazing how much one can learn when challenged. I first thought certain changements on pointé shoes are simply beyond my reach forever, but to my great surprise I can do better and better every week. Obviously something matures in the body between the lessons, since I don’t have time for personal extra exercises now. Observing positive developments is rewarding personally and also as a teacher; I enjoy learning so much that having a role in the learning process of others is a great honor for me.