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Priest, Maura. Transgender Children and the Right to Transition: Medical Ethics When Parents Mean Well but Cause Harm
2019, The American Journal of Bioethics. 19 (2): 45-59.
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Added by: Chris Blake-Turner
Abstract: In this article, I argue that (1) transgender adolescents should have the legal right to access puberty-blocking treatment (PBT) without parental approval, and (2) the state has a role to play in publicizing information about gender dysphoria. Not only are transgender children harmed psychologically and physically via lack of access to PBT, but PBT is the established standard of care. Given that we generally think that parental authority should not go so far as to (1) severally and permanently harm a child and (2) prevent a child from access to standard physical care, then it follows that parental authority should not encompass denying gender-dysphoric children access to PBT. Moreover, transgender children without supportive parents cannot be helped without access to health care clinics and counseling to facilitate the transition. Hence there is an additional duty of the state to help facilitate sharing this information with vulnerable teens.

Comment (from this Blueprint): Priest argues that the state should provide puberty-blocking treatment (PBT) for trans youth, even if their parents are not supportive. Priest’s argument is important partly because it avoids the issue of whether adolescents and children can give properly informed consent. This is a point that some of Priest’s critics seem to have missed (see, for example, Laidlaw et al. 2019. “The Right to Best Care for Children Does Not Include the Right to Medical Transition”, and Harris et al. 2019. “Decision Making and the Long-Term Impact of Puberty Blockade in Transgender Children”). Priest’s conclusion is founded instead on a principle of harm avoidance.

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