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Medically assisted gender affirmation: when children and parents disagree
Samuel Dubin1, Megan Lane2, Shane Morrison3
1New York University, New York, New York, USA.
Journal of Medical Ethics
|January 2, 2020
Summary
When parents and transgender youth disagree on gender-affirming medical care, legal and ethical frameworks can support the minor's autonomy. This research explores options prioritizing the adolescent's developing decision-making capacity.
Area of Science:
- Medical Ethics
- Adolescent Health
- Pediatric Endocrinology
Background:
- Current institutional guidelines inadequately address parental disagreement regarding gender-affirming medical care for transgender minors.
- Disagreements between transgender youth and their parents present complex ethical dilemmas in pediatric and adolescent healthcare.
Purpose of the Study:
- To explore ethical dilemmas and potential solutions when transgender minors and parents disagree on gender-affirming medical care.
- To prioritize the developing autonomy of transgender youth in medical decision-making processes.
Main Methods:
- Ethical analysis integrating paediatric, adolescent, and transgender health research.
- Review of legal doctrines, including mature minor doctrine and state intervention for neglect.
- Examination of literature on risks and benefits of gender-affirming therapy.
Main Results:
- Identified three potential avenues for care amidst parental disagreement: legal carve-outs, mature minor doctrine, and state intervention.
- Highlighted the importance of respecting transgender youth's developing autonomy in medical decisions.
Conclusions:
- Existing legal and ethical frameworks can be leveraged to support transgender youth's access to gender-affirming care despite parental objections.
- Prioritizing adolescent autonomy is crucial in navigating complex medical decisions for transgender and gender diverse youth.
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