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[Ethical implications of supporting trans or questioning children and adolescents: Articulation with reproductive
Nicolas Mendes1, Laure Woestlandt2, Clément Moreau3
1Service de psychiatrie de l'enfant et de l'adolescent, Groupe hospitalier Pitié-Salpêtrière, AP-HP. Sorbonne université, 47 bd de l'Hôpital, 75013, Paris, France - Plateforme Trajectoires jeunes trans d'Île-de-France, enfants, adolescents et jeunes adultes - Équipe d'accueil CLIPSYD (clinique psychanalyse développement) EA 4430, Connaissance, langage, modélisation (ED 139), université Paris Ouest-Nanterre-La Défense, 92000 Nanterre, France - Service d'histologieembryologie, cytogénétique, biologie de la reproduction/CECOS (centre d'étude et de conservation du sperme), Hôpitaux universitaires Paris Seine-Saint-Denis, site Jean Verdier, 93143 Bondy Cedex, France.
Abstract:
Supporting children and adolescents who are trans or who are questioning cannot be done without an ethical reflection on one's own practice as a health professional. It is important to consider the young person as a whole, including reproductive health issues. This article proposes, through the principles of Beauchamps and Childress, an ethical reflection on the issues of beneficence - not maleficence, and of autonomy and justice for adolescents, young adults, and future trans or questioning parents. For adolescents, concerning the possibilities of medical treatment of gender affirmation, we need to propose information in terms of impact on fertility and, if necessary, proposals for the possibilities of preserving their reproductive capacities. These issues require to question the state of scientific knowledge in terms of parenthood of trans people and questioning. We propose here a state of knowledge of these realities, put in perspectives of the axes of ethical reflections inherent to guidance. In fine, it appears that the major ethical stake concerns the child to be born. Finally, it is necessary to consider the quality of life of the future parents and the impact of their medical follow-up.
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