Ethical Considerations and Implications for Transgender Medicine
In Western society gender and sexuality are believed to be binary and there is little room for variance. As the decades progress, more and more sociologists, scientists, and therapists are acknowledging that gender and sexuality are largely a social construct. With this new understanding, physicians are forced to grapple with how to treat gender-variant patients both physically and emotionally. As many patients seek to match their bodies with their minds, at times risky surgical and hormonal treatments must be prescribed. The physician is forced to weigh the risks and benefits to the patient and oftentimes it is the physician's decision that will determine if the transgender patient will complete the medical part of his, her, or hirtransition, allowing the individual to continue living his or her life in a body congruent with his or her gender expression. The psychiatrist’s recommendation for SRS and hormonal treatment is imperative in the process and this paper will examine the ethical implications of the essential causal diagnosis of Gender Identity Disorder (GID) and the recommendation of surgical treatment in order for patients to fit into the Western gender binary. A brief examination of co-morbidity of mental disorders and their affect on consent and provider views on competence and capacity are also warranted. Adolescent transgendered patients under the age of eighteen experience more difficulties with the sex reassignment process due to emerging autonomy and complications with adolescent assent, consent, and parental permission.The physician's consent has more weight in the absence of parental permission and in many cases transgender foster children and homeless teens must rely on recommendations from physician and mental health professionals.A discussion of the use of puberty-blockers in