A Finnish study, published in April of 2015 in the journal Child and Adolescent Psychiatry and Mental Health, is one of several that are beginning to document the upsurge in teen girls wanting to “transition.” This study focuses on the high level of comorbid mental health issues that occur along with gender dysphoria.

The number of referrals exceeded expectations in light of epidemiological knowledge. Natal girls were markedly overrepresented among applicants. Severe psychopathology preceding onset of gender dysphoria was common. Autism spectrum problems were very common.

So why does this matter? Well, maybe, just maybe, those other issues need to be addressed. And could they even be the cause of the dysphoria?

In the majority of the applicants, gender dysphoria presented in the context of wider identity confusion, severe psychopathology and considerable challenges in the adolescent development. At this point it is not possible to predict how gender dysphoria in this group will develop: will gender dysphoria in these adolescents cease with the resolution of wider developmental problems, or perhaps consolidate later into transsexual identity, with the completion of the developmental tasks of adolescence.

The researchers conclude:

Adolescents seeking sex reassignment represent a variety of developmental pathways differentiated by the timing of onset of gender dysphoria, psychopathology and developmental difficulties. It is important to be aware of the different groups, or developmental pathways, in gender dysphoric adolescents in order to be able to find appropriate treatment options. In the presence of severe psychopathology and developmental difficulties, medical [sex reassignment] treatments may not be currently advisable. Treatment guidelines need to be reviewed to appreciate the complex situations.

Medical “transition” is seen as the magic bullet. But here’s a thought: What if the other, very common, comorbid disorders are actually the cause of the body dissociation that is now celebrated and promoted as “gender identity”? Why do we rush to hack up healthy young bodies and dose them with powerful hormones, rather than addressing the brain that erroneously thinks it should be attached to a different physical form? Why has it become taboo to pose the obvious hypothesis: Maybe we have it exactly backwards. It’s the brain that is mistaken–not the body.

Questions like these should not be controversial. They should not generate a whole new avalanche of hate mail in my Tumblr inbox. Questions like these should spur thinking, caring people–people who claim to care about suicidal and troubled teens–to investigate deeper; to put the brakes on the headlong rush to drugs and surgery as THE solution to a complex intersection of mental health issues.

Trans activists, take heed.