Ashley, Florence. Gatekeeping Hormone Replacement Therapy for Transgender Patients is Dehumanising
2019, The Journal of Medical Ethics. 45: 480-482.
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Added by: Chris Blake-TurnerAbstract:
Although informed consent models for prescribing hormone replacement therapy are becoming increasingly prevalent, many physicians continue to require an assessment and referral letter from a mental health professional prior to prescription. Drawing on personal and communal experience, the author argues that assessment and referral requirements are dehumanising and unethical, foregrounding the ways in which these requirements evidence a mistrust of trans people, suppress the diversity of their experiences and sustain an unjustified double standard in contrast to other forms of clinical care. Physicians should abandon this unethical requirement in favour of an informed consent approach to transgender care.Zagzebski, Linda Trinkaus. Epistemic Authority: A Theory of Trust, Authority, and Autonomy in Belief2012, Oxford: Oxford University Press.-
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Added by: Chris Blake-Turner, Contributed by: Wayne Riggs
Publisher's Note: In this book Zagzebski gives an extended argument that the self-reflective person is committed to belief on authority. Epistemic authority is compatible with autonomy, but epistemic self-reliance is incoherent. She argues that epistemic and emotional self-trust are rational and inescapable, that consistent self-trust commits us to trust in others, and that among those we are committed to trusting are some whom we ought to treat as epistemic authorities, modeled on the well-known principles of authority of Joseph Raz. These principles apply to authority in the moral and religious domainsComment:
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Comment (from this Blueprint): Ashley draws on their own experiences as a trans person, as well as that of the trans community more broadly, to argue against assessment and referral requirements for hormone-replacement therapy (HRT). Ashley argues instead for an informed consent model, on which providers of HRT are not gatekeepers of transness, but facilitators of thoughtful decision-making.