Anne health Susie Greens new clinic

Medical ethics, of course, include consent; but they also adhere by the principle of 'no harm'...and this is where wider ethical issues come into play. How do we decide what constitutes harm. Must harm only be measured by aligning it with the nature of individual desire, or do other factors come into play?

So, for example, when it comes to children, or people below the age of consent; or people of unsound mind etc

Yes, of course you have to have capacity to consent to any medical decision.

Unless you are a child who says 'I'm trans'. Then - anything goes.

You are twisting my words. I said 'bodily autonomy' is not what medical ethics are about. Medical ethics are formed out our social or moral consensus about what is right and wrong. Ethics go beyond individual desire and speak to wider concerns and issues about the nature of life on earth and our responsibilities and relationship to it.

It is. And yet we haven't proscribed travel to Turkey.

Because adults can consent to risky or unwise decisions.

Sorry, are you claiming that there is, or ought to be, a 'verifiable medical reason' to allow abortion?

That is the case de jure in England, Scotland and Wales (not NI), but it is certainly not the case de facto, where abortion is essentially available without the need for a 'verifiable medical reason' up to the prescribed timeframe. The issue with allowing abortion beyond that timeframe is not related to capacity issues and is, in any event, highly contested.

Are you suggesting that if there is a high risk of a woman regretting her choice to have an abortion, she should be assumed to lack the capacity to make that decision?

As to your question re trans affirming healthcare, the premise of your question is wrong.

You were responding to a post specifically about your argument for denying bodily autonomy for women under 30 who seek sterilisation.

And there is, of course, a clinical indication for sterilisation. The most basic of which is that a patience may want a permanent contraceptive that does not rely on abstaining from sex, taking the pill or using an IUD or implant, or cannot be subject to manipulation by a sexual partner.

Your insistence that adult women lack the capacity to make such a decision about their own bodies is, as I say, very telling.

Sorry, your take on medical ethics is a bit bizarre and not grounded in reality.

The ethics by which UK practitioners are bound, and the basis by which they should go about resolving ethical dilemma, is set out by guidance from professional organisations like the BMA and in the legal framework within which they operate.

And bodily autonomy is absolutely a core element of both.

Do I think denying an adult gender affirming medical treatment on the basis that an 18 year old lacks capacity is transphobic? Yes, absolutely it is. And your distinction between 'medical' reasons and 'mental health' grounds is quite telling.

I'm not sure what are referring to in your last sentence. What 'other entirely spurious medical procedures' are you referring to? Sterilisation for purposes other than relating to gender dysphoria - such as permanent contraception? No, denying that is not transphobic. But it is misogynistic.

And we also see lots of people travelling to Turkey, for example, for cosmetic procedures......and the number of times these goes wrong, or people have died, is terrible.

Theer are no clinical indications for trans surgeries. We don't remove people's body parts because they feel traumatised by them. We offer them counselling and therapy. It would be highly unethical to remove a functional body part.

This is on the NHS, of course. The NHS should not be performing such surgeries.There wil always be people who will perform surgeries for money, though,regardless of the ethics..which is why some prominent trans clinicians are not covered by insurance...the risk is entirely on the customer.

Access to abortion is highly regulated and scrutinised to ensure the balance between enduring access to those who need it while protecting life. There is generally a verifiable medical reason to allow it.

Elective sterilisation is viewed differently to medical sterilisation afaik but the decisions are made with the ‘first to no harm’ angle. Elective amputation and x sex hormones is the polar opposite - ‘cause harm first and see if it helps’.

You still haven’t explained why you think it is ok to allow 18 yr olds to elect to have amputation surgery or take drugs likely to sterilise them with no observable clinical reason, no proven improvement in long term outcome, the only change guaranteed is a decline in health and there’s a reasonable risk of total regret?

Medical ethics are shaped by consensual and shared societal codes about what is right or wrong. By that which can be seen as crossing a line and making oneself a god. That is why such issues are so fraught. Because at heart we know that human beings are flawed and make decisions for all sorts of reasons, not all of which have been properly thought through, and yet which have profound human implications not just for the individual, but also for society.

Medical ethics does not prize 'bodily autonomy'. I'd say that is a very individuated, self focused take on it. Medical ethics starts with the assumption that not everything is about us and our individual foibles or desires. That we also have a shared responsibility to the health and maintenance of the group in the long term.

As I suggest, the U.S is very Wild West in this respect, in certain ways, in that people are treated as pharmalogical customers who can make demands on health professionals about their preferences and desires. This is rooted, I feel, in a combination of late stage american capitalism and the cult of the individual.

Which is where I also see the whole trans movement being located. It really is an aptheosis of all things American. Be whoever you want to be; your best self; your true self; all that self referential stuff. and of course, in this sort of culture trans surgeries are re-framed as being 'health care'. When really it is not about bodily health or integrity....it is about knowingly damaging a functional and healthy body - in pursuit of the impossible. And doing this to children, too.

You might have missed my question:

Are you genuinely suggesting that it’s ‘transphobic’ not to allow an 18 year old ‘bodily autonomy’ to sterilise themselves and have healthy body parts amputated for no medical reason and entirely shaky mental health grounds? And to allow other 18 year olds full bodily autonomy for other entirely spurious medical procedures?

That doesn't address the question.

Yes, of course you have to have capacity to consent to any medical decision. In the case of sterilisation, those risks include the risk that the patient may change their mind about not wanting children (or not wanting more children if they already have children).

Provided that someone has the capacity to understand that that is a risk, they should not be denied treatment that is otherwise clinically indicated.

Do you think Stephen Whittle also invented knowing he was trans as a kid because of a 'kink'?

Agree fully.

Which is why the approach advocated here that women under 30 should be denied a sterilisation which is clinically indicated for the desired outcome (i.e. permanent contraception that does not come with the issues associated with abstinence, IUDs, pharmacological contraception or condoms), is actually against medical ethics.

Medical ethics prize bodily autonomy. The clinician's role is to determine if a treatment is clinically indicated, and whether capacity exists or not. And when it comes to capacity, 'a person is not to be treated as unable to make a decision merely because [s]he makes an unwise decision'.

The defining factor seems to be whether someone makes 'an identity' out of something. The advent of identity politics has seen people feel they have to buy into a whole suit of opinions or feelings about all sorts of things and try to solidy an identity and make it a fixed feature. Then join forces with an identity community or family.

Identity, though is not a fixed thing. It is a central integrating force but one which is fluid and changes with time and experience. Bringing new components in, and releasing others

The only fixed reference points are: male or female: place of birth: parents. These are the only things that you cannot change or which do not morph over time. All else is social/emotional.

There are lots of gay people who do not 'identify as' gay. They simply are, and all it says about them is that they have a strong tendency only to be attracted to people of the same sex. It says nothing else about them or about their views on anything.

Of course abortion is a perpetually contentious issue for a multitude of reasons, even if we do have fairly settled laws in the U.K.

There is always a risk with all forms of surgery and you have to consent to these possible risks beforehand. Though infertility is not a major or guaranteed risk of early stage abortion at all.

All I have said is that we know that many trans adults describe knowing they were trans as a child.
The only blanket statements here are people erroneously claiming that there are no trans children.

There are no trans children. These stories are invented by adult cross-dressers & AGPs to justify their kink. A very common story is of wearing their sister's or mother's knickers because they are "trans" but it's definitely not a sexual thing of course.

And, of course, abortion has legal limits for a reason of ethics.

What? You think that if abortion led to infertility, that would be grounds for denying women under 30 - who is fully aware of that risk and is willing to take it - access to an abortion?

All of that could be claimed about gay people when the concept of homosexuality as an orientation and identity emerged in the late 19th C. Prior to that, homosexuality was seen as an act, and the emerging thinking was essentially a 'framing' around that act. To some extent that distinction is still relevant - the term MSM is used to describe men who have sex with men but don't identify as gay or bi, for example.

So something being a 'framing' for a state of being is not a reason it cannot be understood at an early age. You're right that the framing of transgender is relatively new, and that framing gives clarity to the feelings of trans people that previous generations did not always have; just as the emergence of gay and lesbian identities have come to help gay and lesbian kids to understand what it is they are experiencing, and so the age at which we see people coming out as gay or bi has tended to fall as a result.

As with trans kids, this gave rise to a moral panic that kids were being indoctrinated to become gay, ignoring the much more obvious point that kids who were always gay felt more comfortable being openly themselves in a society that had the right framing and social conditions around it.

If abortion were likely to lead to infertility or osteoporosis, or impact brain development, it’s likely that the rules would be different.

We have medical ethics for a reason..........to stop the free for all, wild west of american style pharmacology.

There is a very real and qualitative difference between being gay ( same sex attracted) and 'being trans'.

That difference lies in the fact that everyone is either male or female and that nobody can actually change sex. People who are same sex attracted are not making impossible claims. They are simply stating that they are attracted to members of their own sex.

'Trans' people remain either male or female/the sex that they are, but they may choose to dress or present in a manner typically associated with the opposite sex ( or they may not)"Trans' is simply a framing device for those that want to express cross sex roles, performances or presentations. It does not make a man a woman, or a male person into a female person.