Gender Dysphoria: Unwanted Sex Characteristics & Gender Roles - Essay Sample

Introduction

Gender dysphoria is a condition where an individual's assigned gender at birth and the gender they identify themselves with are contrasting. As a result, such individuals are often extremely uncomfortable with their sex, sex characteristics, and gender roles. Gender dysphoria (GD) can manifest and be observed during childhood and adolescence development both before and after puberty. In children with gender dysphoria, puberty results in the development of undesirable sexual characteristics that causes psychological distress and if the child undergoes puberty in their perceived incorrect gender, their psychological state may deteriorate leading to depression, and suicidal thoughts. Because of these risks, healthcare practitioners and family members of children and adolescents with GD advocate for psychological and medical interventions to address the disorder. However, treatment of GD has raised various ethical concerns. The essay will show that the current GD treatment is based on insufficient evidence, that the claims of being fully reversible are also based on inadequate literature thus invalid, the risks of the treatment are based on adult studies and that they go against the principles of beneficence and non-maleficence. Thus although the primary objective of medical practitioners is to alleviate the distress of children and adolescents with GD, the use of under-researched and inconclusive GD treatment is not ethically justifiable.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Order now

Medicine based on evidence is established on the concept that the care of patients should involve the thorough, clear and well thought-out utilization of best evidence. From an ethical point of view, evidence-based medicine allows for the evaluation of beneficial healthcare methods and potentially harmful methods thus allowing healthcare practitioners to make informed decisions. Thus, if a particular form of treatment is backed by sufficient evidence and is determined to have a positive effect on the patient without causing further emotional, psychological or physical distress, that course of treatment is considered ethical, beneficial and justified. However, in the context of gender dysphoria treatment in children and adolescents, there is a lack of adequate evidence to adequately declare them as ethical and beneficial to the patients.

In a case where a patient in psychological and emotional distress requests for treatment that is not guaranteed to relive his or her distress, is experimental and the patient does not have the mental capacity to make consent, a practitioner would delay the treatment until sufficient research on the risks and benefits and sound evidence-based literature of the treatment is evaluated before proceeding with the treatment. Subsequently, it is ethically concerning to provide or recommend treatment which involves a child undergoing treatment without the existence of literature on the processes that cause, result from or are associated with the disorder. For that reason, treatments for gender dysphoria should be considered experimental and cannot ethically justify the risks exposed to the patients. Furthermore, gender dysphoria treatments are interventions that do not cure an ailing body, rather involves the mutilation of healthy body organs.

A major argument for the use of puberty blockers in the treatment of GD in children and adolescents is the claim that they are fully reversible; however, this assertion is not valid as it is not supported by evidence. Research present on the effects of puberty blockers is not conclusive on whether primary sex characteristics suppressed by the blockers can fully resume once a patient stops taking them. Also, the adoption of puberty blockers is claimed to give the child adequate time to decide while reducing the patients suffering and improving their quality of life. These drugs to some extent are also thought of as a diagnostic tool as they improve the understanding of the persistence, nature, and degree of the patient's discomfort. However, this argument is not entirely valid as the majority of children and adolescents that take the puberty blockers go on to the second stage of high dose cross-sex hormones. On the other hand, a larger percentage of children diagnosed with gender dysphoria, not on puberty blockers do not remain gender dysphoric in their adolescence while those on puberty blockers end up becoming homosexuals later in life (Bizic, et al., 2018). Such evidence would suggest that treatment does not, in fact, give children the time to decide, rather it makes the choice for them without addressing the underlying causes of the gender identity disorder that do not involve the use of irreversible interventions.

Furthermore, the suppression of puberty prevents the internal feminization or masculinization of the brain causing children undergoing treatment to be nonconforming. Recommendations in the treatment of GD involve the patient impersonating their desired gender while also taking blockers, which unavoidably forces the already confused child or adolescent to take on the role of their non-biological gender. Such neurological repercussions prevent the patient from identifying as being their biological sex and could further lead to suffering and confusion in the event the child is unable to correctly impersonate their desired gender. Consequently, a treatment protocol that suppresses puberty and facilitates the unavoidable results of transgender identification that needs constant and lifelong use of synthetic and potentially harmful hormones cannot be claimed to be fully reversible thus the use of such a treatment cannot be ethically justified.

Another ethical implication comes from the risk of harm to patients who proceed to cross-sex hormones. Similarly, there is insufficient literature on the risks of these hormones to children and adolescents as all the potential risks to children from the cross-sex hormones are based on studies of adults. Additionally, in adult studies, although most of the studies have been inconclusive, the literature does reveal the potential for long term risk associated with these hormones (Bizic, et al., 2018). Accordingly, children and adolescents that transition from puberty blockers to cross-sex hormones will need these hormones for a longer duration compared to their adult counterparts. Consequently, as they will be exposed to the hormones for longer, they are more likely to experience the adverse long term effects than the adult.

When administering treatment to children and adolescents with GD in managing their emotional and psychological distress, it is important to note the ethical considerations of risks in determining the morality of administering the treatment. Although we understand that the treatment is established to provide relief and improve the psychological welfare of the child, it is important to assess if good intentions correlate with the greater good of the child. While ensuring children and adolescents with GD get adequate medical care is the primary objective, how it is achieved is also of great importance. In ethics, beneficence is the moral responsibility to act for the benefit of others in helping to advance legitimate and vital interests by removing and preventing potential harms.

Thus although an argument can be made that the current GD treatment for children and adolescents removes the harm of continued psychological and emotional distress, there lacks adequate evidence to prove that this form of treatment is the safest and best for achieving the end result. Hence the use of treatments that have proven adverse side effects while there are other evidence-based treatment options that have been successful at alleviating distress and do not have adverse effects on the patient is not ethical. Furthermore, healthcare practitioners also have the moral obligation to non- maleficence. Administering a treatment that has been proven to possess harmful risks that have the potential to cause harm to the child or adolescent receiving it does not fulfill the moral responsibility to do no harm as it further does the patient the injustice of disregarding dealing with the core issues causing the psychological and emotional distress in children and adolescents with GD.

Ultimately, the ethical implication evaluated above elucidates an in-depth comprehension of administering puberty suppressing and cross-sex hormones in the treatment of gender dysphoria in children and adolescents and whether such as course of action is ethically justifiable. However, from the evaluation, it is clear that while the primary objective of medical practitioners is to ensure children and adolescents receive adequate treatment and care, the current treatment options are not ethically sound. They are not based on adequate evidence from research and they possess adverse risks that can potentially harm the patients. Thus, as there exist alternative forms of treatment that have lack the adverse risks associated with the current treatment options, the use of under-researched and inconclusive treatment to manage gender dysphoria in children and adolescents is nit ethically justifiable and need to be re-evaluated.

References

Bizic, M. R., Jeftovic, M., Pusica, S., Stojanovic, B., Duisin, D., Vujovic, S., . . . Djordjevic, M. L. (2018). Gender Dysphoria: Bioethical Aspects of Medical Treatment. BioMed Research International, 1-6. doi:10.1155/2018/9652305