A Finnish hospital closely affiliated with a leading figure in far-right anti-trans political circles has been the focus of several years of government reports that have cited neglectful and abusive practices in the mental health care of young people, a review by Assigned Media has found.
Crowding so severe adolescent patients were sleeping on the floor, eavesdropping on patient-family meetings, the use of bedsheets to physically restrain young patients, the failure to properly document restrictions on personal freedom, and a general lack of sufficient resources at the institution, Tampere University Hospital, were cited by three different government oversight agencies over a seven-year period, most recently in April of this year.
The physician directly in charge of patient care at the Helsinki hospital’s adolescent psychiatry unit during much of this time was Riittakerttu Kaltiala. Her personal website describes her current role as Chief Psychiatrist in the hospital’s Department of Adolescent Psychiatry. Though the official criticisms did not specifically involve trans youth, Finnish government agencies expressed broad and persistent concerns about the care of adolescents.
It’s not unusual for regulators in Finland to fault adolescent psychiatry providers for deficient resources, but their critiques of units affiliated with Tampere and Kaltiala stand out for additionally citing concerns about coercive practices, the absence of procedural safeguards, a disregard for patients’ civil rights, and delays in addressing ongoing problems, according to our review. Assigned Media examined dozens of government oversight documents obtained via freedom of information requests, along with contemporaneous news reports.
In 2023, for example, regulators described “meager and deficient documentation” in the use of seclusion and restraint in adolescent wards at Tampere University Hospital, records show. “Some of the restrainment procedures were missing a description of justification altogether,” stated one report reviewed by Assigned Media.
Kaltiala, who has often been the public voice for Tampere University Hospital in media coverage of the criticisms, also stands out in news reports for responses that seem to deflect responsibility, such as casting blame on “societal” issues rather than focusing on the institution’s responsibility to address the concerns being raised. The improper use of restraints, for example, has led to injuries and deaths worldwide, as documented by decades of research and reporting.
The leaders at another Finnish hospital, Oulu University Hospital took a different public tack in addressing regulators’ recent critiques, focusing on their own responsibility. They told the Finnish Broadcasting System they were apologizing to patients and families for falling short, stepping up funding requests and introducing easier-access preventative programs via school counselors and nurses.
Assigned Media reached out to Kaltiala and to Tampere University Hospital to ask about the pattern of safety and privacy issues in their treatment of adolescents. At least one email returned an automated message stating that the office was closed for summer vacation. We will update this story if further responses are forthcoming.
The concerning approach toward the safety and privacy of young patients provides a lens into Kaltiala’s stances on gender-affirming care.
Kaltiala and her colleagues have recently drawn scrutiny for their studies of trans youth. In an April 2026 paper that named Kaltiala as last author (or principal investigator), Ruuska et al claimed that receiving gender-affirming care did not improve the mental health of Finnish adolescents. Although these claims were seized upon by transition care opponents, the paper omitted key details that would seem necessary for evaluating its claims. Patients were assessed two years after their first contact with a gender clinic, for example, rather than after treatment was actually initiated. No information was included about when, if ever, treatment was offered.
A recent letter challenging the paper in the journal where it was published states plainly: “The authors provide no evidence for several central claims.” Anecdotal reports, including accounts of patients published by Assigned Media, suggest assessment at these clinics frequently takes two or more years, meaning the research may have measured outcomes before any treatment had been given in some instances.
Kaltiala has long positioned herself as an influential figure in gender care for young people in Finland, garnering awards from colleagues, but her speaking engagements, published work and public roles appear to have shifted significantly over the last several years, Assigned Media found.
Her presentations, once typically involving low-profile events on topics like forensic and adolescent psychiatry, have become overtly political and her public role has reflected international ambitions.
Kaltiala served as an advisor to Hillary Cass’s highly politicized 2024 project to eradicate gender affirming care for young people in the UK, and as a regular correspondent with Patrick Hunter, a Florida doctor and medical board member who led the effort to impose a gender care ban in that state. She also served as an intermediary between Cass and Hunter. In 2022, Kaltiala was tapped by the Florida Board of Medicine to speak in support of a ban on youth trans care in the state.
Kaltiala’s political positioning has continued to gravitate rightward and her function has been ever more activist. In Europe, she has played a central role in pushing the European Association of Child and Adolescent Psychiatrists, a professional group for EU member nations, to adopt so-called gender critical positions. In July 2025, this association convened a symposium that featured anti-trans campaigners connected to a hate group.
Months later, in October, Kaltiala spoke alongside the anti-trans author Helen Joyce in Australia on a trip where she also gave an interview to the fundamentalist Australian Christian Lobby. In March, she traveled to Chile to give presentations at two Catholic universities, one of which is allied with the Church’s far-right faction Opus Dei. Many of her public speaking engagements have been sponsored by the organization Raiz Humana, which promotes “natural sexuality.”
Most notable, though, is her increasingly close allegiance with the Society for Evidence Based Gender Medicine, which has been designated an anti-LGBTQ hate group. She has been involved in the group’s efforts to influence government policies on trans care in the US and France, and has appeared regularly at its conferences in New York, Paris, Athens and Berlin.
With help from SEGM, she organized a 2023 event for the University of Tampere faculty of medicine that featured two people who would later cobble together the Trump administration’s anti-trans health care “review” – Evgenia Abbruzzese and Kristopher Kaliebe – and the sister of Moti Gorin, who was also an author. Some of those same anti-trans campaigners were given platforms by the EU professional group last summer.
This international campaigning dovetails in some important respects with what oversight records reflect about the care provided at home in Finland. The treatment of adolescents in inpatient mental health settings poses unique challenges, but our review found a harsh and at times punitive top-down approach toward adolescent patients and their families, whether transgender or not.
Billie Jean Sweeney is a freelance journalist and advocate. During her career, she helped lead international news coverage for The New York Times, coverage of New York City for the Associated Press, and press freedom reporting for the Committee to Protect Journalists. At The Hartford Courant, she led an award-winning investigation into the improper use of restraints at U.S.mental health facilities, which led to nationwide reforms.
Evan Urquhart is the founder of Assigned Media.
Esa Kalliomäki is a reporter and researcher based in Finland.
