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Gender Dysphoria and Disorders of Sex Development pp 205–230Cite as

Medical Treatment for Children with Gender Dysphoria: Conceptual and Ethical Issues

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Part of the book series: Focus on Sexuality Research ((FOSR))

Abstract

There are various treatment approaches available for children and adolescents with gender identity disorder (GID). This chapter offers an overview of these, with a focus on bringing to light their underlying assumption and treatment goals. After such an account, the chapter focuses on the combined approach, which involves early medical treatment for children and adolescents with GID. This treatment has raised and may raise important ethical and legal concerns: this chapter disentangles and analyzes such concerns. The conclusion is not only that there is nothing unethical with providing transgender children and adolescents with early medical treatment but that it may be unethical not to do so.

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Notes

  1. 1.

    Electra is another mythological figure in ancient Greece, which inspired various works, the most famous of which are probably the tragedies Electra by Sophocles and Euripides. Here, Electra plans the murder of her mother’s lover, who killed her father. Sometimes the term “Oedipus complex” is also used for girls.

  2. 2.

    I am grateful to Professor Mike Besser for this specification.

  3. 3.

    In Italy, for example, Articles 328, 591, and 593 of the Penal Code, respectively, Omission or Refusal of Official Acts, Abandonment of the Incapacitated, and Omission of Rescue.

  4. 4.

    Online at http://www.legislation.gov.uk/ukpga/1989/41/section/1. Last accessed 15 November 2011.

  5. 5.

    Bolam v. Friern Hospital Management Committee [1957] 2 All ER 118, [1957] 1 WLR 634.

  6. 6.

    A v. A Health Authority [2002] 1 FCR 481, [2002] Fam 213 at para 43; see also Re A (medical treatment: male sterilisation) [2000] 1 FCR 193; A Hospital NHS Trust v. S and others [2003] Lloyd’s Rep Med 137, (2003) 71 BMLR 188 at para 47.

  7. 7.

    A Hospital NHS Trust v. S and others [2003] Lloyd’s Rep Med 137, (2003) 71 BMLR 188 at para 47.

  8. 8.

    Bolitho v. City and Hackney HA [1998] AC 232 at 242, HL.

  9. 9.

    Re J (A Minor) (Child in Care: Medical Treatment) [1992] 2 All ER 614.

  10. 10.

    Gillick v. West Norfolk and Wisbech Area Health Authority [1985] 3 All ER 402 at 409 e-h per Lord Fraser and at 422 g-j per Lord Scarman; See also R v. D (1984) 2 A11 ER 449.

  11. 11.

    Re S (A Minor) (Consent to Medical Treatment) [1994] 2 FLR 1065; Re E (A Minor) (Wardship: Medical Treatment) [1993] 1 FLR 386.

  12. 12.

    I owe this important observation to Professor Peter Clayton.

  13. 13.

    There might be ethical and pragmatic issues of resource allocation, which could explain why the state might not publicly fund some treatments for transgender people (or for the infertile, or for the intersex, or for the person who is dissatisfied with his/her physical appearance, and so on). However, pragmatic concerns relating to how to allocate resources and how to prioritize people’s needs are not principled reasons to deny medical treatment.

  14. 14.

    This legal right has some limits under English law.

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Acknowledgments

I wish to thank Iain Brassington for reading and commenting on this work.

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Authors and Affiliations

  1. CSEP/iSEI, The School of Law, The University of Manchester, Williamson Building, Oxford Road, Manchester, M13 9PL, UK

    Simona Giordano Ph.D.

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  1. Simona Giordano Ph.D.
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Correspondence to Simona Giordano Ph.D. .

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Editors and Affiliations

  1. Center of Expertise on Gender Dysphoria, Department of Medical Psychology, VU University Medical Center, ...., Amsterdam, 1007 MB, Netherlands

    Baudewijntje P.C. Kreukels

  2. Center of Expertise on Gender Dysphoria, Department of Medical Psychology, VU University Medical Center, Amsterdam, 1007 MB, Netherlands

    Thomas D. Steensma

  3. Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psych, VU University Medical Center, P.O. Box 7057, Amsterdam, 1007 MB, Netherlands

    Annelou L.C. de Vries

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Giordano, S. (2014). Medical Treatment for Children with Gender Dysphoria: Conceptual and Ethical Issues. In: Kreukels, B., Steensma, T., de Vries, A. (eds) Gender Dysphoria and Disorders of Sex Development. Focus on Sexuality Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-7441-8_11

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