Gender reassignment in children: ethical conflicts in surrogate decision making

Area of Science:

• Medical Ethics
• Pediatric Endocrinology

Background:

• Parents serve as surrogate decision-makers for infants.
• Discrepancies between parental wishes and medical recommendations create ethical dilemmas.

Observation:

• This case examines parental refusal of gender reassignment for an XY infant with disorders/differences of sex development (DSD).
• The infant presented with micropenis and nonpalpable testes.

Findings:

• The study explores the ethical conflict when parents' decisions diverge from medical advice regarding infant DSD treatment.
• It questions the boundaries of parental autonomy in medical decision-making for children.

Implications:

• This case highlights the complex ethical considerations in pediatric DSD management.
• It necessitates a thorough examination of beneficence, respect for persons, nonmaleficence, and justice in surrogate decision-making.