Could Gender Self-determination be a Medical Right?
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Published
Aug 29, 2024
Abstract
It is crucial to evaluate the potential risks and repercussions of advocating for gender self-determination as a medical right. The concept of permitting individuals to determine their own gender without proper assessment or counseling raises concerns about patient safety and well-being, despite the fact that autonomy and self-determination are essential in healthcare decision-making. Gender dysphoria, a recognized psychiatric condition, necessitates a comprehensive evaluation by trained professionals to guarantee the most suitable diagnosis and treatment. Negative physical and psychological consequences may arise from permitting individuals to make irreversible decisions, such as hormone therapy or surgery, without adequate supervision. Furthermore, medical guidelines are in place to guarantee that patients receive evidence-based care that is consistent with the most effective transgender health practices. Consequently, it is pivotal for healthcare providers to exercise caution when it comes to gender self-determination and to prioritize the comprehensive care of transgender individuals by providing comprehensive support services, rather than relying solely on individual autonomy.
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Keywords
Biological Gender, Social Gender, Medical Right, Autonomy, Gender Dysphoria
References
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12. Weinhardt LS, Stevens P, Xie H, Wesp LM, John SA, Apchemengich I, Kioko D, Chavez-Korell S, Cochran KM, Watjen JM, Lambrou NH. Transgender and gender nonconforming youths’ public facilities use and psychological well-being: A mixed-method study. Transgend Health 2017; 2(1):140-150. DOI: https://doi.org/10.1089/trgh.2017.0020
13. Francis J, Sachan P, Waters Z, Trapp G, Pearce N, Burns S, Lin A, Cross D. Gender-neutral toilets: A qualitative exploration of inclusive school environments for sexuality and gender diverse youth in Western Australia. Int J Environ Res Public Health 2022; 19(16):10089. DOI: https://doi.org/10.3390/ijerph191610089
14. Mezzalira S, Scandurra C, Mezza F, Miscioscia M, Innamorati M, Bochicchio V. Gender felt pressure, affective domains, and mental health outcomes among transgender and gender diverse (TGD) children and adolescents: A systematic review with developmental and clinical implications. Int J Environ Res Public Health 2022; 20(1):785. DOI: https://doi.org/10.3390/ijerph20010785
15. Tordoff DM, Wanta JW, Collin A, Stepney C, Inwards-Breland DJ, Ahrens K. Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care. JAMA Netw Open 2022; 5(2):e220978. DOI: https://doi.org/10.1001/jamanetworkopen.2022.0978. Erratum in: JAMA Netw Open 2022; 5(7):e2229031. DOI: https://doi.org/10.1001/jamanetworkopen.2022.29031
16. Alcind or ML, Alvarez-Calupitan S, Appleby RA. Poor mental health in the transgender and non-binary youths and its influence on healthcare practices and outcomes. Evid Based Nurs 2022; 2022:ebnurs-2021-103473. DOI: https://doi.org/10.1136/ebnurs-2021-103473
17. Anderson RE, Tarasoff LA, VanKim N, Flanders C. Differences in rape acknowledgment and mental health outcomes across transgender, nonbinary, and cisgender bisexual youth. J Interpers Violence 2021; 36(13-14):NP7717-NP7739. DOI: https://doi.org/10.1177/0886260519829763
18. Kraschel KL, Chen A, Turban JL, Cohen IG. Legislation restricting gender-affirming care for transgender youth: Politics eclipse healthcare. Cell Rep Med 2022; 3(8):100719. DOI: https://doi.org/10.1016/j.xcrm.2022.100719
19. White Hughto JM, Rose AJ, Pachankis JE, Reisner SL. Barriers to gender transition-related healthcare: Identifying underserved transgender adults in Massachusetts. Transgend Health 2017; 2(1):107-118. DOI: https://doi.org/10.1089/trgh.2017.0014
20. Safer JD, Coleman E, Feldman J, Garofalo R, Hembree W, Radix A, Sevelius J. Barriers to healthcare for transgender individuals. Curr Opin Endocrinol Diabetes Obes 2016; 23(2):168-171. DOI: https://doi.org/10.1097/MED.0000000000000227
21. Pullen Sansfaçon A, Medico D, Suerich-Gulick F, Temple Newhook J. “I knew that I wasn’t cis, I knew that, but I didn’t know exactly”: Gender identity development, expression and affirmation in youth who access gender affirming medical care. Int J Transgend Health 2020; 21(3):307-320. DOI: https://doi.org/10.1080/26895269.2020.1756551
22. Graham P. Transgender children and young people: How the evidence can point the way forward. BJPsych Bull 2023; 47(2):98-104. DOI: https://doi.org/10.1192/bjb.2022.3
23. Cislaghi B, Heise L. Gender norms and social norms: Differences, similarities and why they matter in prevention science. Sociol Health Illn 2020; 42(2):407-422. DOI: https://doi.org/10.1111/1467-9566.13008
24. Stewart R, Wright B, Smith L, Roberts S, Russell N. Gendered stereotypes and norms: A systematic review of interventions designed to shift attitudes and behaviour. Heliyon 2021; 7(4):e06660. DOI: https://doi.org/10.1016/j.heliyon.2021.e06660
25. Litvin K, Grandner GW, Phillips E, Sherburne L, Craig HC, Phan KA, Patel AN, Dickin KL. How do social and behavioral change interventions respond to social norms to improve women’s diets in low- and middle-income countries? A scoping review. Curr Dev Nutr 2024; 8(6):103772. DOI: https://doi.org/10.1016/j.cdnut.2024.103772
2. Garg G, Elshimy G, Marwaha R. Gender Dysphoria. [Updated 2023 Jul 11]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Available at: https://www.ncbi.nlm.nih.gov/books/NBK532313/
3. Gerritse K, Hartman LA, Bremmer MA, Kreukels BPC, Molewijk BC. Decision-making approaches in transgender healthcare: Conceptual analysis and ethical implications. Med Health Care Philos 2021; 24(4):687-699. DOI: https://doi.org/10.1007/s11019-021-10023-6
4. Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, Fraser L, Goodman M, Green J, Hancock AB, Johnson TW, Karasic DH, Knudson GA, Leibowitz SF, Meyer-Bahlburg HFL, Monstrey SJ, Motmans J, Nahata L, Nieder TO, Reisner SL, Richards C, Schechter LS, Tangpricha V, Tishelman AC, Van Trotsenburg MAA, Winter S, Ducheny K, Adams NJ, Adrián TM, Allen LR, Azul D, Bagga H, Başar K, Bathory DS, Belinky JJ, Berg DR, Berli JU, Bluebond-Langner RO, Bouman MB, Bowers ML, Brassard PJ, Byrne J, Capitán L, Cargill CJ, Carswell JM, Chang SC, Chelvakumar G, Corneil T, Dalke KB, De Cuypere G, de Vries E, Den Heijer M, Devor AH, Dhejne C, D’Marco A, Edmiston EK, Edwards-Leeper L, Ehrbar R, Ehrensaft D, Eisfeld J, Elaut E, Erickson-Schroth L, Feldman JL, Fisher AD, Garcia MM, Gijs L, Green SE, Hall BP, Hardy TLD, Irwig MS, Jacobs LA, Janssen AC, Johnson K, Klink DT, Kreukels BPC, Kuper LE, Kvach EJ, Malouf MA, Massey R, Mazur T, McLachlan C, Morrison SD, Mosser SW, Neira PM, Nygren U, Oates JM, Obedin-Maliver J, Pagkalos G, Patton J, Phanuphak N, Rachlin K, Reed T, Rider GN, Ristori J, Robbins-Cherry S, Roberts SA, Rodriguez-Wallberg KA, Rosenthal SM, Sabir K, Safer JD, Scheim AI, Seal LJ, Sehoole TJ, Spencer K, St Amand C, Steensma TD, Strang JF, Taylor GB, Tilleman K, T’Sjoen GG, Vala LN, Van Mello NM, Veale JF, Vencill JA, Vincent B, Wesp LM, West MA, Arcelus J. Standards of care for the health of transgender and gender diverse people, Version 8. Int J Transgend Health 2022; 23(Suppl 1):S1-S259. DOI: https://doi.org/10.1080/26895269.2022.2100644
5. Reczek R, Smith EB. How LGBTQ adults maintain ties with rejecting parents: Theorizing “conflict work” as family work. J Marriage Fam 2021; 83(4):1134-1153. DOI: https://doi.org/10.1111/jomf.12765
6. Malpas J, Pellicane MJ, Glaeser E. Family-based interventions with transgender and gender expansive youth: Systematic review and best practice recommendations. Transgend Health 2022; 7(1):7-29. DOI: https://doi.org/10.1089/trgh.2020.0165
7. Ghiasi Z, Khazaei F, Khosravi M, Rezaee N. Physical and psychosocial challenges of people with gender dysphoria: A content analysis study. BMC Public Health 2024; 24(1):16. DOI: https://doi.org/10.1186/s12889-023-17537-z
8. Divan V, Cortez C, Smelyanskaya M, Keatley J. Transgender social inclusion and equality: A pivotal path to development. J Int AIDS Soc 2016; 19(3 Suppl 2):20803. DOI: https://doi.org/10.7448/IAS.19.3.20803
9. Cooper K, Russell A, Mandy W, Butler C. The phenomenology of gender dysphoria in adults: A systematic review and meta-synthesis. Clin Psychol Rev 2020; 80:101875. DOI: https://doi.org/10.1016/j.cpr.2020.101875
10. Anzani A, Biella M, Scandurra C, Prunas A. Desire for genital surgery in trans masculine individuals: The role of internalized transphobia, transnormativity and trans positive identity. Int J Environ Res Public Health 2022; 19(15):8916. DOI: https://doi.org/10.3390/ijerph19158916
11. National Academies of Sciences, Engineering, and Medicine; Division of Behavioral and Social Sciences and Education; Committee on National Statistics; Committee on Measuring Sex, Gender Identity, and Sexual Orientation; Becker T, Chin M, Bates N, editors. Measuring Sex, Gender Identity, and Sexual Orientation. Washington (DC): National Academies Press (US); 2022 Mar 9. 1, Introduction and Background. Available at: https://www.ncbi.nlm.nih.gov/books/NBK581050/
12. Weinhardt LS, Stevens P, Xie H, Wesp LM, John SA, Apchemengich I, Kioko D, Chavez-Korell S, Cochran KM, Watjen JM, Lambrou NH. Transgender and gender nonconforming youths’ public facilities use and psychological well-being: A mixed-method study. Transgend Health 2017; 2(1):140-150. DOI: https://doi.org/10.1089/trgh.2017.0020
13. Francis J, Sachan P, Waters Z, Trapp G, Pearce N, Burns S, Lin A, Cross D. Gender-neutral toilets: A qualitative exploration of inclusive school environments for sexuality and gender diverse youth in Western Australia. Int J Environ Res Public Health 2022; 19(16):10089. DOI: https://doi.org/10.3390/ijerph191610089
14. Mezzalira S, Scandurra C, Mezza F, Miscioscia M, Innamorati M, Bochicchio V. Gender felt pressure, affective domains, and mental health outcomes among transgender and gender diverse (TGD) children and adolescents: A systematic review with developmental and clinical implications. Int J Environ Res Public Health 2022; 20(1):785. DOI: https://doi.org/10.3390/ijerph20010785
15. Tordoff DM, Wanta JW, Collin A, Stepney C, Inwards-Breland DJ, Ahrens K. Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care. JAMA Netw Open 2022; 5(2):e220978. DOI: https://doi.org/10.1001/jamanetworkopen.2022.0978. Erratum in: JAMA Netw Open 2022; 5(7):e2229031. DOI: https://doi.org/10.1001/jamanetworkopen.2022.29031
16. Alcind or ML, Alvarez-Calupitan S, Appleby RA. Poor mental health in the transgender and non-binary youths and its influence on healthcare practices and outcomes. Evid Based Nurs 2022; 2022:ebnurs-2021-103473. DOI: https://doi.org/10.1136/ebnurs-2021-103473
17. Anderson RE, Tarasoff LA, VanKim N, Flanders C. Differences in rape acknowledgment and mental health outcomes across transgender, nonbinary, and cisgender bisexual youth. J Interpers Violence 2021; 36(13-14):NP7717-NP7739. DOI: https://doi.org/10.1177/0886260519829763
18. Kraschel KL, Chen A, Turban JL, Cohen IG. Legislation restricting gender-affirming care for transgender youth: Politics eclipse healthcare. Cell Rep Med 2022; 3(8):100719. DOI: https://doi.org/10.1016/j.xcrm.2022.100719
19. White Hughto JM, Rose AJ, Pachankis JE, Reisner SL. Barriers to gender transition-related healthcare: Identifying underserved transgender adults in Massachusetts. Transgend Health 2017; 2(1):107-118. DOI: https://doi.org/10.1089/trgh.2017.0014
20. Safer JD, Coleman E, Feldman J, Garofalo R, Hembree W, Radix A, Sevelius J. Barriers to healthcare for transgender individuals. Curr Opin Endocrinol Diabetes Obes 2016; 23(2):168-171. DOI: https://doi.org/10.1097/MED.0000000000000227
21. Pullen Sansfaçon A, Medico D, Suerich-Gulick F, Temple Newhook J. “I knew that I wasn’t cis, I knew that, but I didn’t know exactly”: Gender identity development, expression and affirmation in youth who access gender affirming medical care. Int J Transgend Health 2020; 21(3):307-320. DOI: https://doi.org/10.1080/26895269.2020.1756551
22. Graham P. Transgender children and young people: How the evidence can point the way forward. BJPsych Bull 2023; 47(2):98-104. DOI: https://doi.org/10.1192/bjb.2022.3
23. Cislaghi B, Heise L. Gender norms and social norms: Differences, similarities and why they matter in prevention science. Sociol Health Illn 2020; 42(2):407-422. DOI: https://doi.org/10.1111/1467-9566.13008
24. Stewart R, Wright B, Smith L, Roberts S, Russell N. Gendered stereotypes and norms: A systematic review of interventions designed to shift attitudes and behaviour. Heliyon 2021; 7(4):e06660. DOI: https://doi.org/10.1016/j.heliyon.2021.e06660
25. Litvin K, Grandner GW, Phillips E, Sherburne L, Craig HC, Phan KA, Patel AN, Dickin KL. How do social and behavioral change interventions respond to social norms to improve women’s diets in low- and middle-income countries? A scoping review. Curr Dev Nutr 2024; 8(6):103772. DOI: https://doi.org/10.1016/j.cdnut.2024.103772
How to Cite
Barros, M. G. de. (2024). Could Gender Self-determination be a Medical Right?. Science Insights, 45(2), 1453–1456. https://doi.org/10.15354/si.24.pe137
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