Bioethics News

Doing the right thing by transgender kids is not easy

A US$5.7 million study of the long-term outcomes of medical treatment for transgender youth begins recruiting in May. But knotty ethical questions remain unanswered.

The study will be located at four academic medical centres with dedicated transgender youth clinics and will include 280 young people with gender dysphoria in two age groups.

Younger children in early puberty will receive hormone blockers, called GnRH agonists, to suspend the process of puberty – preventing the development of undesired secondary sex characteristics.

Older adolescents will begin use of masculinizing or feminizing cross-sex hormones that allow them to go through the “right” puberty – consistent with their gender of identification.

Feelings about the ethics of gender dysphoria run high, although little is really known about the condition. “People are making declarations of knowledge that are their belief systems, that aren’t also backed up by empirical research,” Jack Drescher, a psychiatrist at the William Alanson White Institute in New York City, told Nature. In this case, a number of ethicists regard hormone treatment itself as unethical, while those directing the study assume that it is.

Some studies say that 80% of children under with gender dysphoria abandon the idea by the time they enter puberty. However, it appears that children who identify as transgender in adolescence seldom change. Therefore, denying them the ability to transition is unethical, bioethicist Simona Giordano of the University of Manchester, UK, told Nature. “Not treating adolescents is not being neutral,” she says. “It means exposing children to a lot of harm.”

However controversial Giordano’s view is, even more controversial is how to treat younger children.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.