A recent study examining the rise in referrals to Norway’s National Center for Gender Incongruence (NCGI) has come under scrutiny, with researchers raising concerns about the validity of its findings. The study, published in July 2024, claimed a “sharp” increase in referrals between 2000 and 2022, particularly among those assigned female at birth. But experts have questioned its methodology, ethical approval, and statistical interpretations.
One of the primary concerns is the lack of clarity regarding ethical approval. The study states that it was approved by the Data Protection Officer at Oslo University Hospital, but this does not constitute formal ethical approval in Norway. In medical and health-related research, approval must come from regional ethics committees, which has led critics to demand immediate clarification on this matter.
The study’s handling of data has also been criticised. Researchers argue that the authors did not properly account for key statistical factors, including the influence of societal attitudes over time. The study treats different generations as if they experienced the same cultural environment, which could distort findings. Additionally, the data covers a period that includes significant policy changes and shifting social attitudes, yet these factors were not sufficiently considered in the analysis.
Another issue raised is the potential impact of the Covid pandemic on referral rates. The study noted a dip in referrals during 2020 and 2021, attributing it to reduced healthcare capacity. But critics argue that this period should be analysed differently, as many referrals may have been delayed rather than reflecting an actual drop in demand. This delay could have contributed to an artificial increase in referrals in subsequent years, skewing the study’s conclusions about the rate of change.
Beyond these methodological concerns, the study has been accused of misrepresenting the scale of referrals. While it describes a dramatic rise, critics argue that the reported figures remain well below known population estimates for gender-diverse individuals. This discrepancy raises questions about whether the study has overstated its findings, particularly when compared with broader demographic trends. The portrayal of increased healthcare access as a cause for alarm has also been challenged, with some arguing that it reflects a positive shift in accessibility rather than an epidemic of new cases.
Further doubts have been cast over the study’s statistical models. Critics highlight a lack of transparency in key aspects, such as why certain data points were treated differently and why some statistical techniques were chosen over others. They argue that more appropriate methods, such as adjustments for generational differences and pandemic effects, could have provided a clearer picture. The absence of crucial model details, including explanatory power and assumptions, weakens the reliability of the study’s conclusions.
These concerns suggest that the study may not provide an accurate representation of trends in gender incongruence referrals in Norway. With questions surrounding its ethical approval, data handling, and statistical models, researchers are calling for greater scrutiny of its claims before they are used to inform public discourse or policy decisions.
