Open AccessThe Bioethical Dilemma of Gender-Affirming Therapy in Children and Adolescents
Author(s) -
Monique Robles
Publication year - 2021
Publication title -
linacre quarterly/the linacre quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.148
H-Index - 9
eISSN - 2050-8549
pISSN - 0024-3639
DOI - 10.1177/0024363921989475
Subject(s) - bioethics , gender dysphoria , psychological intervention , dilemma , autonomy , transgender , ethical dilemma , mental health , population , distress , medicine , quality of life (healthcare) , psychiatry , gender identity disorder , psychology , psychotherapist , clinical psychology , gender identity , social psychology , philosophy , genetics , environmental health , epistemology , political science , psychoanalysis , law , biology
Since the establishment of the first transgender clinic in the United States in 2007, over sixty clinics associated with children's hospitals have opened across the nation and are seeing very young children and adolescents with a diagnosis of gender dysphoria (GD). Once known as gender identity disorder, GD has been redefined by the latest version of the Diagnostic and Statistical Manual of Mental Disorders , fifth edition ( DSM -5) not as a mental illness but as the distress experienced by individuals related to their biological sex. The widely accepted practice of gender-affirming therapy (GAT) to treat a vulnerable population despite the associated health risks, the lack of supportive scientific evidence for the pharmacological and surgical interventions, along with the unqualified claim that these interventions will decrease the rate of suicide in these individuals presents a significant bioethical dilemma. The growing trend of GD not only impacts the individuals diagnosed but also society, culture, and the integrity of the profession of medicine. This article utilizes the five-box method, an ethical decision-making framework, to address the implications of the proposed treatment. Once applied, it becomes clear that the hormonal and surgical approaches used are not scientifically or ethically justified. The patient's autonomy and preferences should be respected, yet constrained, if there exists a considerable risk to the well-being of the individual without proven benefits. The quality of life of those receiving this treatment has not been shown to be significantly improved long term, and the mental, physical, and spiritual health of individuals with GD is not thoroughly addressed in these clinics. The important social and contextual factors, on both microcosmic and macrocosmic scales, are minimized in favor of promoting an ideology. Ultimately, Catholic moral teaching reveals that this widely recommended treatment violates the body-soul union, disregards the principle of totality and integrity, and debases the dignity of humanity.