Children and Gender: Ethical issues in clinical management of transgender and gender diverse youth, from early years to late adolescence

Abstract

This book investigates the moral concerns raised by current clinical options available for transgender and gender diverse children and adolescents. From the time young children express gender incongruent preferences and attitudes, up to the time in which older adolescents might apply for medical or surgical treatment, moral questions are likely to be asked: should children be enabled to express themselves freely inside and outside the domestic environment? What are the implications of the choices that parents might make early on? How should clinicians respond to distress around sexual anatomy? Is it ethical to suspend pubertal development? What level of evidence should we seek for medications to be used in paediatric care? What are the risks and benefits of various forms of hormonal treatment? Is it ethical to defer surgical interventions till adulthood? The book provides a detailed ethical analysis of these and many other questions that are likely to arise at various stages of a person’s life and proposes a moral formula to answer these questions, as well as others, that are likely to arise in a fast-changing landscape. It combines a detailed ethical analysis with an accurate clinical description of gender development and available clinical pathways.