Ethical Concerns About Emerging Treatment Paradigms for Gender Dysphoria

The increasing incidence of requests for medical services to support gender transition for children, adolescents, and adults has consequences for society, governmental institutions, schools, families, health-care professionals, and, of course, patients. The sociological momentum to recognize and accommodate to trans phenomena has posed ethical dilemmas for endocrinologists, mental health professionals, and sexual specialists as they experience within themselves the clash between respect for patient autonomy, beneficence, nonmaleficence, and informed consent. The larger ethical clashes are cultural and therefore political. There is a distinct difference between pronouncements that represent human rights ideals and the reality of clinical observations. Some interpret this clash as a moral issue. This article delves into these tensions and reminds apologists from both passionate camps that clinical science has a rich tradition of resolving controversy through careful follow-up, which is not yet well developed in this arena.