Unethical to defer treatment
Sex change
operations for adults relatively commonplace. But sex change for children and
adolescents still sparks controversy. The treatment for gender identity
disorder, which has been given to just a handful of prepubescent children
around the world, is to administer puberty suppressant hormones until the child
decides which sex he or she wishes to adopt and whether or not he or she wishes
to have sex change surgery as well.

This has been
criticised as a lack of informed consent by the patient. However, in the
current issue of the British magazine Journal
of Medical Ethics, Dr Simona Giordano, of the Manchester Institute of
Science, Ethics and Innovation, denies this. Such children can make competent
judgements, she says, and there is no evidence at all that there are “hideous
or non-controllable side effects” of puberty suppression.

In fact, Dr
Giordano argues that “suspension of puberty is not only not unethical: if it is
likely to improve the child’s quality of life and even save his
or her life, then it is indeed unethical to defer treatment.” Transgender
children are at risk of violence and suicide because their self-esteem is
constantly threatened. “Endocrinology offers a revolutionary instrument to
help children/adolescents with gender identity disorder,” she claims.

Another common
objection to sex changes is that it is a medical solution to a psychological
and social problem. But Dr Giordano contends that sex change “is responding
with medicine to a serious medical problem that causes enormous distress to the
sufferers and makes them prefer unqualified help, street life and even death,
to life with GID”. ~ Journal of Medical
Ethics, August

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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