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Abstract
Ethical concerns have been raised about routine practice in paediatric gender clinics. We discuss informed consent and the risk of iatrogenesis in the prescribing of gonadotropin-releasing hormone analogues (GnRHas) and cross sex hormones to children and adolescents respectively. We place those clinical concerns in a wider societal context and invite consideration of two further relevant ethical domains: competing rights-based claims about male and female personhood; and freedom of expression about those claims. When reflecting on the assessment and medicalization of children and adolescents presenting at gender clinics, the matters of informed consent and iatrogenic risk should be the most pressing for clinicians. However, this is not just a matter of medical ethics, it also implies the need for a full ethical debate on competing notions of personhood and the defence of freedom of expression about transgender and its implications within contemporary democracies.
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Disclosure statement
No potential conflict of interest was reported by the author(s).
Notes on contributors
Dr David Pilgrim is Visiting Professor of Clinical Psychology, University of Southampton. His books include Critical Realism for Psychologists (Routledge, 2020) and Child Sexual Abuse: Moral Panic or State of Denial? (Routledge, 2018).
Dr Kirsty Entwistle is a Clinical Psychologist working in Independent Practice. She is registered with the UK Health and Care Professions Council (HCPC) and is a member of the Ordem dos Psicólogos Portugueses (OPP).
Correction Statement
This article has been republished with minor changes. These changes do not impact the academic content of the article.