Anne health Susie Greens new clinic

[Hoardasurass]

So not happy with the puberty blockers ban in the UK and frustrated by Wes Streeting closing her planned loophole she found a new one and has been arranging for parents to take their kids abroad to get prescriptions of puberty blockers injections and testosterone for under 16s. The government has said its going to stop the practice but hasn't said how.

Gift token for the telegraph article

https://www.telegraph.co.uk/gift/d5a10834b446c428

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.

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.

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.

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, 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.

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

Because adults can consent to risky or unwise decisions.

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.

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.

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

Bodily autonomy in this instance relates to consent to treatment. Although, of course, the treatment must have a clinical foundation in the first place, or else it is unethical. 'Consent' doesn't mean that a medical practitioner can do anything to my body that I ask of them. Autonomy also means the right to refuse a treatment that has been recommended for clinical reasons.

No. I support the very long established Gillick principle for trans and non-trans people alike.

It is folk like you who demand differential assessments of capacity when trans healthcare is involved.

But there is a clinical foundation to someone who cannot tolerate an IUD due to pain, doesn’t want the side effects of pharmacological contraception and doesn’t want to be reliant on her sexual partners compliance required of condoms to seek the only available form of contraception that meets her needs.

Claiming that a woman cannot consent to that form of contraception is massively paternalistic. Which is to say nothing of your grounding of medical ethics in a societal interests space, which is of course the standard approach to every attempt to force women to do with their bodies that which they do not wish to do.

I don't know. She did have mental issues & several suicide attempts before being given testosterone as a teenager. It's the males who transition as adults who are the cross dressers & AGPs all getting a sexual kick out of playing at being a woman.

If I decided at 35 that I did want children, that does not render my 25 year old self incapable of consenting to a sterilisation in full recognition that I may later regret that decision.

So you recognise that people can change their minds yet you still think that 18 year olds, some with very poor mental health for a variety of reasons should be allowed to make life changing decisions and elect to amputate their breasts or remove their penis and have to live with the consequences of getting it wrong?

Are you aware that the brain doesn’t fully develop, particularly around more complex decision making/risk taking until around age 25?

That seems like an utterly brutal view that would permanently harm vulnerable people and then say “tough, it was your decision”. I’d that this you intend it to come across?

Ritchie Herron was vulnerable when he was encouraged and rushed into extreme surgery. He is now incontinent and without a penis. Are you trying to say that it’s ok that Ritchie and Keira were medically harmed so that others take their own risks? Are you suggesting that it’s tough luck for them?

Do you think that there should be any protections for people to prevent self inflicted medical harm or should anyone be enabled to commission whatever procedures they want on the NHS?

But there is a clinical foundation to someone who cannot tolerate an IUD due to pain,

Yes, and presumably through bitter experience, doctors are still very mindful that despite the protestations of some women, they will end up wanting children and determine that the mental fallout of sterilisation does not tip the balance of justification. In some individual cases, it may feel unjust but the doctors are doing their best to reduce harm based on prior knowledge.

Whereas there is ZERO clinical need for so called ‘affirming’ surgeries and treatments and plenty of evidence that they make mental health WORSE. Yet you advocate for 18 year olds to be allowed to do this and live with the consequences of their decisions.

As I said, I don’t think you have any understanding of 18 year olds and their decision making abilities.

Gillick principles were established for a very specific and limited reasons. ‘Trans’ does not fall into any of that.

No we’re not. I’d be happier if the same standards of caution were applied to young people with ’gender dysphoria’ as to women wishing to be sterilised (and men wanting a vasectomy).

So called ‘affirming surgeries and procedures’ are not in the same ball park (or the same planet) as hormone contraception and the reasoning for allowing young girls to access contraception is completely different.

Gillick principles:

"Children under the age of 16 can consent to their own treatment if they're believed to have enough intelligence, competence and understanding to fully appreciate what's involved in their treatment."

The reason that 'gender affirming care' would not meet this criteria is not the patient's trans identity, but that the child is too young to understand the long term impact of the treatment.

Separately, there is no evidence that the treatment is beneficial, while there is evidence that it does harm.

I'm not sure of your point about contraception?

You seem to be assuming that a woman must always push for total autonomy and independence to have integrity ? Whereas on certain levels and to a certain extent the very nature of the female body and its biological function negates the idea of total bodily autonomy. The interior nature of the female sex organ plus the very fact of pregnancy, childbirth and childcare very definitely ties women into a sense of themselves as integral beings that is not entirely rooted in autonomy, exteriority or separateness. Which is why some of the more strident demands for abortion can come across as being very distasteful:

" Parasites have no rights" for example, or " My body, my choice"

There are ethical questions around abortion, and which is why the termination of a pregnancy can be such a painful and/or difficult choice. Autonomy is not the be all and end all. We do have responsibilities towards others, towards the collective and so on. We are all inter-dependent on the co-operation of, and input from, others.

Why would you bring children or people below the age of consent (I’m not clear why you’d separate the two since by definition all of the latter are also the former) or people of an unsound mind into your argument about denying health care to women in their twenties on the basis of capacity?

Is that really where you place adult women in the spectrum of capacity? Similar to children and people of ‘unsound mind’? That line of argument sounds familiar…

This is nonsense, as established by the courts. You folk are fond of relying on court judgements right?

You still can’t seem to get your head around what capacity to consent actually means.

It does not mean that a patient must have certainty that they are making the right decision or certainty that they will never regret it.

It means that they are capable of understanding the procedure, understanding the risks and benefits, and of making an informed and free decision. Your insistence that a 29 year old woman lacks this capacity is incredibly patriarchal.

This post makes no sense. I never said anything about independence. The point is that it should always be a woman’s choice if she wants children or not and if she doesn’t then it should be her choice as to the best means of avoiding having children.

All this talk about obligations to society and some almost mystical nonsense about the very idea of women negating full autonomy is patriarchal nonsense. It is straight out of the playbook of every person who has ever sought to limit women’s reproductive freedom. Insisting that to be a woman necessary means you give up the right to decide what happens to your own body for some greater good has all sorts of terrifying implications.

Autonomy; separatness, individuation..... whatever you want to call it.......

I'm not disputing personal choice, although, of course, ideas about personal choice are in many respects very much liberal, western constructs. I have said that the very nature of female biology, in certain ways, negates ideas of separateness and bodily autonomy. And ultimately, none of us is really separate and autonomous. Male or Female. We all make decisions and choices within the context of certain sets of social conditions, cultures, family of origin and so on - over which we have no input and no control and which we didn't choose.

Maybe this is too subtle an argument or a perception for you to grasp.

You cannot seem to get your head around alternative perspectives.