Medical, Ethical and Legal issues re Transitioning.

[Ali1cedowntherabbithole]

Have been discussing issues around consent on the Rod Liddle thread (today's oh fuuuuuuuuck moment) and thought it would be worth having a separate thread.

Among the many issues, two stand out to me as a registered nurse.

How can someone - either a child or their parent - give legal consent for a procedure if they are in denial about the potential risks, and unrealistic about the expected outcomes?

Specifically, how can consent be given for genital surgery if the person believes it is possible to "change sex"?

How can someone be deemed to have demonstrated that they have capacity to consent if they are in denial about the potential long term consequences? I'm not referring to someone who acknowledges there may be risks and choose to have treatment in spite of this, I'm thinking about people who are adamant that there are no risks to them.

I'm also thinking through my own professional practice. Would I administer potentially harmful testosterone injections to a child who didn't understand the consequences? Who I didn't believe had given consent? And in the current climate, would there be a backlash if I refused?

MIdgebabe

"Where is the evidence that those girls, now women , have poor life outcomes such that any kind of medicalisation can be supported?"

There is none. Also note that there are zero examples of adult heterosexual females who 'transition' compared with the number of adult heterosexual males who 'transition'.

BMA MEC here: www.bma.org.uk/collective-voice/committees/medical-ethics-committee

Ethics Toolkits here:
www.bma.org.uk/advice/employment/ethics

I think the BMA ethics committee should either provide an ethics toolkit to endorse the practice of medically, surgically, hormonally transitioning children and young people under 25 (which is apparently when the brain reaches adult maturity, assuming natural puberty has been allowed to happen..) and staying when and why they think this is appropriate.

Or they should provide an Ethics toolkit to say that the appropriate treatment for gender dysphoria in children and young people is psychological support (as with other forms of body dysmorphia), and an exploration of whether there are other underlying or surrounding co-morbid issues.

Either way the ethics committee should note that UK doctors should not begin with a generalised starting point of ‘affirmation’, in terms of providing medical, surgical or hormonal treatments as the default- as they are no doubt being put under under pressure to do. This is an inappropriate politicisation of the doctor- patient relationship beyond normal clinical care and this could be very harmful to the patient given what we know about the likelihood of detranisitioning.

I think that the usual ethical and safeguarding rules just get thrown out the window as soon as anyone whispers the word "trans."

I increasingly believe that the whole concept of medical "transition" could be considered unethical, as it's built on a false premise.

Nobody can change sex.

Should doctors be claiming they can "reassign gender"? If they're going to do experimental surgical/hormonal interventions, then at the very least medics should call these things by their proper names and stop using euphemisms. These are extreme forms of permanent body modification (some resulting in sterility) which are being used to treat a poorly-understood psychological condition.

Either way the ethics committee should note that UK doctors should not begin with a generalised starting point of ‘affirmation’, in terms of providing medical, surgical or hormonal treatments as the default- as they are no doubt being put under under pressure to do.

This, this, this.