Puberty blockers: can children consent?

[WarriorN]

A review article in The New Bioethics: A Multidisciplinary Journal of Biotechnology and the Body

www.tandfonline.com/doi/full/10.1080/20502877.2022.2088048

I've only skim read it but seems to be a very wide ranging review including Keira Bell.

(Care of @rogdmum on twitter who has read it!)

I've now read it and it's a really good round up of the impacts of PBS and recent cases/ papers raised issues. Mentions Scottish proposals etc.

Written by "Antony Latham is a retired General Practice Physician and is chair of the The Scottish Council on Human Bioethics. He has an MA in Bioethics and Medical Law."

Bumping as this is a really useful article to share with any professionals.

It explores impact on brain development, Gillick competence, teen risk taking, Keira Bell, bone density and the actual diagnosis of GD in children.

I believe the GP has also written for a Scottish paper and is v concerned about what is going on in Scotland.

Bumping again

interesting - it very much supports all the views being discussed on this board, online communities, peer groups, social contagion and isolation, MH issues, puberty

its all such a big unknown with the trans group not prepared to say, let’s allow time to see what is really happening. Their ideology trumps everything else seemingly.

I’m quite interested in the other writings of Dr Anthony Latham on ‘purposive’ evolutionary selection and genetics (eg Hox genes). He’s not an atheist, but he’s very well informed about evolutionary scientific theory, and seeks to promote mutual understanding and tolerance of different theories and approaches. He writes very clear and thorough overviews.

I know he and a co-author had a piece in the Scotsman too about children and ‘puberty blockers’ where they described the abandonment of medical ethical principles by those in charge of Scottish medicine.

Thanks for the link - I’ll definitely read it.

It seems so intuitive to me that children cannot possibly consent, I can't comprehend how anyone can (in good faith) disagree

Thanks for link

We wouldn't let a child decide to eat only sweets. We wouldn't let a child decide to not go to school. We wouldn't let a child decide a whole range of 'negatively impactful on their future self' behaviours. There is no way a child can be gillick competent about this.

"Bioethics and Medical Law" - seems to be key.

No other area of medicine and medical intervention isn't put through the wringer of ethics and law. Whilst some treatment are experimental and also involving children, they're subjected to rigorous proof and record keeping.

All if that is absent in 'Gender medicine.'

@WarriorN thanks so much for the link. I'm going to read it.

I wrote a paper (albeit a legal paper not medical) on children's consent back in the 90s and it's interesting to see how far (or not) we have come.

I've been increasingly seeing this as medical malpractice.

When even adults are saying they've been unable to consent or understand the full implications of surgeries and hormones, how can children?

I posted too soon.
Interestingly at the time I concluded that children needed greater autonomy in the decision-making process during medical treatment.
I hadn't been at the time considering puberty blockers.
I don't feel that children can consent to these however I feel that it is not as black and white as some do.

The other aspect that often gets overlooked in discussions, but should be the starting point, is 'what is a trans child?'

What do we actually mean by this?

He explores the current diagnosis criteria, which is obviously woolly and sexist.

Then you've get articles such as this one, where the whole premise is based on a term, "trans child," that isn't defined.

https://www.frontiersin.org/articles/10.3389/fsoc.2020.00067/full

As more trans children find the confidence to make themselves known in our primary and secondary schools, school teachers and administrators look for guidance on how to best support trans pupils. This article synthesises findings from global literature on trans children in primary and secondary education (K1–12 in the US), extracting key themes and conclusions. It then examines the most recent UK school guidance documents on trans inclusion, assessing which lessons and recommendations from global literature are represented. The article highlights existing good practices in visibility and representation and in protection from violence and harassment. Several areas where additional effort is needed are identified, including action on environmental stress and cisnormativity, addressing barriers to school trans-inclusivity and institutional accountability. A number of important shifts are called for: from adaptation on request to pre-emptive change; from accommodation to a rights-based approach; from pathologisation to trans-positivity. Finally, the article raises expectations on what it means to be an ally for trans children in education.

Slightly off topic but i find the whole area of childrens consent or non consent to medicine in general hard. My autistic 12 year old is involved in his medical care and i often think he isnt able to decide between cheese or peppproni pizza without visual prompts, how is he supposed to decide whether anti-anxiety medicines not indicated for use in children with an increased suicide risk are appropriate.

I need to add that the author of that article has a "trans daughter."

from accommodation to a rights-based approach;

'Accommodating' being gender non conforming (except it's very conforming of the stereotypes of the opposite sex) to saying those sexist stereotypes give rights to access toilets and changing spaces of the opposite sex.

from pathologisation to trans-positivity.

The concept of a trans child is pathologising sexist stereotypes and non conformity. All children should be and are positively treated and have a right to self expression if appropriate. They do not have the right to lie or be lied to.

Children can't even consent to having their photograph publicly displayed.

If we rule that children can consent to lifetime of infertility, a hysterectomy in their 20s ( because even the Tavistock report shows 98 percent go onto CSh) and In cases In Sweden having the spine of A 80 year old at just 15, then how would anyone be able to argue they can't consent to other things.

Having created a cohort of legal adults with the bodies of children , we would quite possibly end up with it being legal to have sex with children.

Yes, this is my opinion too.

Common sense tells you that they can't consent because they are not mature enough to know what they are potentially giving up/closing the door upon.
To pretend otherwise is criminal imho.

You can't "de-pathologise" something while at the same time insisting that it requires serious medical and surgical intervention.

Exactly, and "it's what he/she wanted" is not a valid defence when you are taken to court for not sending your child to school or for feeding them a grossly unhealthy diet. We also don't consider children capable of consenting to sex. Even if they are able to say "yes" and think they understand what they're consenting to, we don't consider it valid consent, because they are children.

This should be no different.