Respecting the free will, authenticity and autonomy of transgender youth

Abstract

Transgender and gender diverse (TGD) youth are currently being targeted by global anti-trans legislation that would prevent their access to gender-affirming care even by healthcare providers willing to deliver it and who understand the importance of this support. It has been suggested in some studies that transness in young people is a result of peer contagion. As such their free will, authenticity and autonomy could be brought into question when accessing gender-affirming care. It is important to explore the relevance of these concepts concerning the provision of gender-affirming care to TGD youth by nurses and other healthcare professionals. Nurses should challenge the notion held by some that these young people are not capable of knowing themselves or the level of treatment they require. They can do this by practising gender-affirming care determined by aspirational ethical values of beneficence, non-maleficence, autonomy and justice.

Critically Appraising the Cass Report: Methodological Flaws and Unsupported Claims

“…Recognising and supporting the authenticity and competence of transgender young people is an important aspect of the provision of high-quality care. 54 However, the Cass Report emphasises their distress, rather than their treatment wishes: the report describes them as "children with gender dysphoria and/or gender-related distress" (p.52) and then emphasises the resolution of this distress as the main goal of interventions. Framed in this way, GAC becomes one of several treatment options for a quasi-psychiatric condition, rather than the authentic preference of competent individuals (note that Gillick competence is still applicable, without special limits, to under-16s seeking GAC, after the Court of Appeal quashed the High Court judgement that set restrictions specifically for GAC).…”