Norway’s most influential trans activist physician has officially lost his ability to practice “gender medicine” after his last-ditch appeal to reverse the revocation was denied. Esben “Esther Pirelli” Benestad, 74, was first struck off completely by the Norwegian Health Authority (NHA) in 2022, and has been fighting the decision since. Last year, he won an easing of his restrictions, but will still no longer be allowed to prescribe cross-sex hormones.
Benestad, who was born male but identifies as a “woman,” prompted backlash after privately supplying minors with puberty-halting drugs and cross-sex hormones without proper approval. His medical license was restricted last year following the third formal investigation into his practice.
Benestad, who was previously investigated twice by the NHA for disregarding recommended safe practice policies in his medical treatment of minors at his Grimstad clinic, was declared by the NHA in 2023 to be “unfit to practice responsibly due to a substantial lack of professional insight, irresponsible activity, and substantial breaches of duty.”
When first ordering the investigation in 2022, the State Administrator in Agder concluded that there had been a breach of the health legislation’s requirements for duty to provide information to health authorities and a lack of sufficient record keeping.
As a result of the investigation, Benestad’s medical license was revoked. However, in June 2023, health authorities softened their ruling and instead restricted only Benestad’s permission to prescribe hormones, while also requiring him to practice medicine under supervision.
In the 42-page report issued by the NHA last year and reviewed by Reduxx, inspectors highlighted Benestad’s tendency to neglect both the opinions of colleagues and nationally recommended protocols.
“The National Health Inspectorate has also assessed that you do not follow the Norwegian Health Authority’s national guidance in your treatment of patients with gender incongruence. We consider it worrying that you justify this by saying that no one else has enough expertise or resources to provide this treatment, or that they advocate a method of treatment that you do not agree with.”
On Friday, Benestad was told by the court that the Health Authority’s decision was valid, and the state was acquitted of any wrongdoing.
Speaking with Norwegian outlet VG, Benestad called the decision “absurd.”
Responding to the news that he would not have his full medical license restored, the self-accredited sexologist replied, “I have 40 years of experience in recognizing these people… It is very sad, but unfortunately not surprising. This affects parts of the population who are already discriminated against.”
The investigation which saw his medical license restricted was the third formal inquiry into Benestad’s laissez-faire attitude towards what is euphemistically called “gender-affirming care.”
Benestad had previously been scrutinized for giving puberty-halting drugs to adolescents under questionable circumstances, and for falsifying medical diagnoses in order to recommend underage girls for double mastectomies.
In 2008 Benestad was reported to national health authorities for misconduct related to three of his female patients which he had referred for mastectomies in order to affirm a chosen ‘gender identity’. In the process, Benestad fabricated diagnoses of health conditions in order to bypass medical guidelines.
The treatment of “gender incongruence” is overseen by Oslo University Hospital, or Rikshospitalet, which requires that a psychiatric assessment be undertaken prior to the implementation of medical intervention. Despite this regulation, Benestad had been repeatedly providing hormones and puberty-halting drugs to patients who were refused the medications following an assessment by professionals at Rikshospitalet.
During a November 2009 interview, the clinician discussed the incidents which prompted concern from the national health authorities. “I have had many somatic women patients who want to have their breasts removed but they don’t want neither testosterone nor genital surgery. I was able to assist three such people to remove their breasts but then I was accused of malpractice,” he said.
In 2010, the Norwegian Board of Health issued a warning which, while it did not name Benestad specifically, detailed the exact scenario media reported he had been investigated for. According to the letter, a doctor specializing in the area of transsexualism had told health services that three female patients had certain neck conditions which would be alleviated by double mastectomies.
Describing another case in which he prescribed puberty blockers to a nine-year old boy, Benestad explained that his celebrity status enabled him to find young patients. “Parents of kids who don’t perform gender the way ‘they should’ often call me because they have seen me on television. The first kid I ever met was nine years old. She was a somatic boy, she had a penis but felt like a girl,” he explained.
“I worked with her and her family, with her school and with everyone that could be disturbed by her. At the time I was aware of work being done in The Netherlands that taught me that you can postpone puberty in cases like hers, to give kids more time to establish what gender they identify with more. I did that, but I was turned in by the G.I.D. Clinic psychiatrist who said that this was the wrong medical treatment and that additionally I had another malpractice case pending with the Norwegian health authority.”
During the same interview, Benestad boasted that he could not be put in jail, saying, “I have to face the health authorities not the legal authorities. They would not send me to jail. They would have problems finding what jail to put me in anyway.” Laughing, he joked that any prison cell built for him would need “a nice wardrobe and lots of big mirrors.”
In 2021 it was revealed that Benestad had circumvented national protocols in his treatment of a teenager who went on to die by suicide. While on puberty blockers, the teen was also privately being administered hormones by Benestad, thereby undermining the NBTK’s policy banning cross-sex hormones for minors under the age of 16.
Over the years Benestad has made numerous alarming statements in defense of pathological sexual behaviors, and has appeared to display sympathy for pedophilia.
Prior to working with children and individuals in the capacity of medical transition, Benestad was treating child sexual abusers, whom he has referred to as “pedosexuals,” while insisting that pedophilia is a common human trait.
“We’ve all been pedosexuals once,” Benestad told VG in 1998, and cited “prevailing taboo notions” around pedophilia as a cause for child sexual abuse.
The medical practitioner has, over the course of his career, dedicated a significant amount of energy towards destigmatizing pathological sexual fetishes, focusing on sadomasochism and transvestic cross-dressing in particular.
In 2017, along with his spouse and co-professor, Elsa Almås, founder of the Norwegian Association for Clinical Sexology (NFKS) he co-authored an article in the Journal of Sexual Medicine titled, Autogynephilia and Autoandrophilia Revisited, which argues that the sexual arousal men experience through transvestic cross-dressing should be normalized.
In December 2021, Benestad was criticized after requiring his sexology students at the University of Agder to participate in a BDSM fetish club as part of their research. Tonje Kristin Jensen, a student at the University of Agder, told the Norwegian Broadcasting Corporation that she decided to forego a study trip in Oslo after receiving a letter providing a required dress code that included fetish gear on the theme of “lacquer and rubber.”
In a 2002 documentary produced by his son, Even Benestad, the nationally-recognized trans activist admitted to stealing his mother’s underwear for masturbatory purposes.
“The first time I put on a dress, I was around eight years old. I tried the dress on and it felt right. I always chose to stay home. I tried on all my mother’s clothes. Over time the cross-dressing became erotic in nature. I had my first orgasm in such a situation. I had trouble getting mom’s underwear clean. I washed it, used the iron to dry it and put it back in place,” he said.
Until his license was restricted last year, Benestad was listed as a member of the World Professional Association for Transgender Health (WPATH). The gender clinician has also spoken at and attended conferences hosted by WPATH and has exerted influence on their policies.
Benestad was present at a WPATH conference held in June of 2009 where academics involved in a pedophilic and sadomasochistic fetish forum presented a concept of a “eunuch” gender identity. The concept would later be incorporated into the most recent WPATH Standards of Care guidance, and the WPATH conference and presentation by academics involved with the fetish forum appears to have influenced Benestad’s own interest in the subject.
Just five months later the WPATH conference, he brought up the topic during an interview, and would continue to reference the ‘eunuch gender’ thereafter. In an academic paper published in 2010, “From gender dysphoria to gender euphoria: An assisted journey,” Benestad cites the Eunuch Archive forum, which hosts castration fetish erotica – of which the most popular stories involve violent, forcible castration of children, primarily boys.
In a 2016 video, aimed at young viewers and aired by national broadcasting service NRK, Benestad discusses his belief in seven different ‘genders,’ naming one such category as ‘eunuch.’
“Eunuch gender… They have male bodies. But they want to remove their testicles,” he asserted.
Despite the restriction on his medical license and repeated investigations into his practices, Benestad continues to lecture students through the Department of Psychosocial Health at the University of Agder. In December 2023, he presented a lecture on “Gender Excitement.”
Additionally, both Benestad and his partner Elsa Almås are currently listed as members of the Advisory Committee for multinational sexology activist group the World Association for Sexual Health (WAS). WAS, formerly known as the World Association for Sexology, of which WPATH is a member organization, influences the World Health Organization (WHO).
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