Ethical issues in Gender Reassignment Surgery by Ariana Nakhla

[ By on December 18, 2016 ]

While the United States has developed the laws and language to protect transgender individuals, there still lies debate about the ethics of reassignment surgery and the administration of hormones. Many individuals question which forms of transition are the safest, what age is appropriate to begin transitioning, and how to cater to those who don’t have access to the medical resources necessary for transition. While there are no clear answers to any of these concerns from ethical or medical perspectives, it is clear that in order to uphold the rights of transgender individuals, hormone therapy at the very least should be accessible across the nation.

According to a study conducted by the AMA Journal of Ethics, 26.7% of transgender individuals who responded to a survey reported being denied hormone therapy at clinics. This precedent of treatment denial leads to transgender individuals to be hesitant to go to clinics, and to treatment being primarily  administered in large health clinics in major cities. This lack of universal access to transgender care leads to a large population of transgender individuals, often those who identify as people of color or are of a lower economic status, without access to the necessary treatment.

Having access to the necessary transgender care is ethical mainly because it supports the rights of an individual to make decisions about their gender identity, and it is the duty of all other citizens, including medical practitioners, to honor this decision. From a deontological perspective, accessible transgender care should always be made available in order to honor the decisions one makes about their identity. Medical, psychological, and social support is available to individuals of all identities, thus it should not be the choice of an institution to deny a transgender individual care. Questions that I still have about the subject, however, are about if age should truly play a role in choosing to administer hormone therapy, and if gender dysphoria can be medically confirmed or relies more on the decision of a patient to seek the necessary treatment.

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4 Comments on “Ethical issues in Gender Reassignment Surgery by Ariana Nakhla”

  1. KNF

    Kelley Nicholson-Flynn

    [ January 03, 2017 at 1:06 pm ]

    Reply from Jordan Officer:
    This topic is incredibly interesting, especially because it’s such a pressing issue today as mindsets towards transgender rights are changing and hopefully moving forward. One point I find interesting is bringing age into the question because depending on a child’s age, they may or may not know exactly how they want to handle their body. If a child for instance is young and wants to undergo hormone therapy, then what unknown harm should they be aware of?

    There are numerous known and unknown risks of undergoing hormone therapy early on in ones life as opposed to later in one’s life, but how much is unknown, and how much should it interfere with one’s desire to take this step in becoming comfortable with who they are? One unknown risk we can discuss is that medications that essentially “block” puberty, do not have enough research done on them to prove or disprove that using them for a long period of time is harmful.

  2. KNF

    Something that would support/strengthen this: what approximate percentage of individuals who have access to hormone therapy pursue gender reassignment surgery? My first-hand knowledge/experience with many transfolk is that the cost of hormone therapy may be manageable, however the cost of surgery may not be manageable, and many seem quite satisfied with access to hormone therapy. I posit this question because having a sense of how access to hormone therapy addresses the psychological need of the user would support the ‘pro’ side of this argument.

    Second question: _is_ clinical access the _main_ factor that prevents hormone access or are there are chief factors? If there are other ‘major’ factors, how might one argue the ‘pro’ side in resolving each of those factors?

    Thank you for posting this to the blog and inviting inquiry!

  3. KNF

    The issue of appropriate transition age is important to explore further. Some would say the older the child gets, the more able they are to make an informed decision. Others would argue that individuals who want to transition usually know from an early age, indeed, knowing from an early age can be a key criterion mental health professionals consider a sign the individual has a valid case. They would also argue the longer the individual is made to delay transitioning, the more they are likely to develop discomfort in their own body, low self-esteem, depression, suicidal ideation and other mental health issues. Exploring this more deeply would be useful to your argument.

  4. KNF

    Emily Schorr Lesnick

    [ January 25, 2017 at 8:15 pm ]

    Thank you for this post, Ariana. I know the show “Transparent” recently explored the health risks associated with GRS, especially for older trans people. A question I have is: when do the risks of surgery outweigh the risks of not going through with gender affirming surgery?

Hi Stranger, reply with your thoughts:

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