The Ethics of Gender-Affirming Care: An Evaluation of the Research

Abstract

Gender-affirming care has emerged as the dominant model of healthcare for adolescents with gender dysphoria, replacing the historical model of watchful waiting. In gender-affirming care, the healthcare professional affirms the gender with which the patient identifies. Often, with minimal clinical evaluation or investigation into underlying mental health and psychosocial issues, the young person is sent on a path of social transition, puberty blockers, cross-sex hormones, and surgery. This paper addresses the ethics of gender-affirming care through the lens of the ethical principles of beneficence, nonmaleficence, and autonomy. An evaluation of the research and data reveals that gender-affirming care is not an ethical approach to the treatment of adolescents with gender dysphoria. It violates the principle of beneficence because gender transition has not been shown to be beneficial. It violates nonmaleficence because these interventions harm patients. It violates autonomy because, although these interventions are provided at the patient's request, there is inadequate informed consent.