News
GHQ tries to document all of the pertinent research studies and news articles regarding the issue of pediatric medical transition for gender dysphoria.
We are adding two links and tagging it to Topic 3, the section on age and the ability to consent to medical treatments.
”Ethical issues arising in the provision of medical interventions for gender diverse children and adolescents” is by Bernadette Wren from the Tavistock clinic in Britain. It is an attempt to balance all of the arguments about how able minors are to consent to the irreversible effects of hormones and surgery.
A letter to BMJ expresses that there are reasons to be concerned about giving minors hormone blockers:
Gonadotrophin releasing hormone (GnRH) agonists are generally given under the premise that they provide “breathing space” for a child or teen to explore their identity without the distress caused by pubertal changes.3 It is becoming clear, however, that once started on GnRH agonists to block puberty almost all children go on to receive cross sex hormones.4 The information given to parents and children that GnRH agonists are completely reversible might therefore be construed as misleading.
“The Medico-Legal ‘Making’ of ‘The Transgender Child’” discusses trans identity and cultural context in terms of the medical ethics of medically altering minors:
Abstract
Thirty years ago, the transgender child would have made no sense to the general public, nor to young people. Today, children and adolescents declare themselves transgender, the National Health Service diagnoses ‘gender dysphoria’, and laws and policy are developed which uphold young people’s ‘choice’ to transition and to authorize stages at which medical intervention is permissible and desirable. The figure of the ‘transgender child’ presumed by medicine and law is not a naturally occurring category of person external to medical diagnosis and legal protection. Medicine and law construct the ‘transgender child’ rather than that the ‘transgender child’ exists independently of medico-legal discourse. The ethical issue of whether the child and young person can ‘consent’ to social and medical transition goes beyond legal assessment of whether a person under16 years has the mental capacity to consent, understand to what s/he is consenting, and can express independent wishes. It shifts to examination of the recent making of ‘the transgender child’ through the complex of power/knowledge/ethics of medicine and the law of which the child can have no knowledge but within which its own desires are both constrained and incited.
References
Brunskull-Evans, H. (2019). The Medico-Legal ‘Making’ of ‘The Transgender Child’. Medical Law Review 27(4), 640- 657. doi.org/10.1093/medlaw/fwz013
Maxwell, J. (2019). Gender dysphoria: a question of informed consent. BMJ (367), 16442. Retrieved from doi.org/10.1136/bmj.l6442
Wren, B. (2019, June 14). issues arising in the provision of medical interventions for gender diverse children and adolescents. ACAMH National Conference. Retrieved from https://www.acamh.org/app/uploads/2015/06/16_05_Dr_Bernadette_Wren.pdf