Forever young? The ethics of ongoing puberty suppression for non-binary adults

[janterry]

Last edited Wed Jul 29, 2020, 02:05 PM - Edit history (1)

The case of a young person who had been prescribed puberty blockers to forestall puberty. When the person reached the age of majority, they decided they did not want to go through puberty at all - as a way to respect the fact they wanted to be 'non-binary'. The team discusses the ethics of the case and decides it is the appropriate use of medicine.


Abstract (partial)
In this article, we analyse the novel case of Phoenix, a non-binary adult requesting ongoing puberty suppression (OPS) to permanently prevent the development of secondary sex characteristics, as a way of affirming their gender identity. We argue that (1) the aim of OPS is consistent with the proper goals of medicine to promote well-being, and therefore could ethically be offered to non-binary adults in principle; (2) there are additional equity-based reasons to offer OPS to non-binary adults as a group; and (3) the ethical defensibility of facilitating individual requests for OPS from non-binary adults also depends on other relevant considerations, including the balance of potential benefits over harms for that specific patient, and whether the patient’s request is substantially autonomous.

https://jme.bmj.com/content/early/2020/07/24/medethics-2019-106012

[Warpy]

1. We don't know all there is to know about the interplay of hormones

including the sex determining hormones at puberty, so the ethics of doing this in prepubescent children are appalling. Experimenting on them at a crucial development stage is a bad idea. Medicine can safely change these things after puberty without affecting lifespan and overall health. Before puberty, it's a "here there be dragons" situation. We don't know what it will do to children.

FWIW, I knew a trans woman in the mid 60s, she worked as a secretary in another town. This is not a new thing, trans people have always been out there. The difference is that we can do something about it now to ease the pain. It just shouldn't be done as a matter of course in children. There is too much risk of permanent damage.

[janterry]

3. My understanding is that if a patient

stops the suppression (and used the medication throughout normal puberty), the anatomy is permanently altered.

Very worrisome

[hunter]

2. My mind went sideways with puberty -- hallucinations, night terrors, etc.

It's still sideways. I'd liked to have skipped that part. Fortunately there are some effective psych meds now.

As a kid you think that's how puberty is for everyone, and you wonder why you're not coping. And there was a strong cultural bias to keep mental illness hidden, to tough it out. There still is, but it's slightly less prevalent.

Suppressing puberty is nothing new. For example, boys used to be castrated so they could sing in church. Or worse...



It's not "forever young." People who never experience puberty age same the rest of us.

They can be healthier in some ways and not as susceptible to certain diseases, and less healthy in other ways.

Personally I'm not seeing any huge ethical issues here. The problem is a culture that tortures and abuses anyone who is not strictly straight, and not strictly male or female as it is recorded on their original birth certificate.

[janterry]

4. What diseases does Lupron suppress?

n/t