Bioethical Issues in the Management of Gender Dysphoria

Brown, George R.

doi:10.29046/jjp.006.1.004

Cited by 4 publications

(2 citation statements)

References 10 publications

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“… 37 At the same time, other scholars say that a clinician will not always understand the process the patient goes through, 22 nor may they be able to empathize truly with being transgender in general. 38 Nonetheless it is believed that a clinician should not always consent to the patient’s wishes. 22 In some cases the autonomy of the care seeker and provider may be in conflict.…”

Section: Discussionmentioning

confidence: 99%

Ethical considerations regarding penis transplantation surgery in transgender men—an empirical ethics study

de Haseth,

Gehrels,

Widdershoven

et al. 2023

Sexual Medicine

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Background The ongoing quest to surgically create the (nearly) ideal neophallus in transgender men has led to the continuous development of transgender medicine and the proposed introduction of penis transplantation. However, both technical and ethical issues arise when developing this treatment. Aim We sought to extract ethical considerations among different stakeholder groups regarding penile transplantation surgery in transgender men and to define preliminary clinical recommendations. Methods Three semistructured focus groups, consisting of different stakeholders, were organized to participate in discussions of ethical considerations retrieved from the ethics literature of transplantation and transgender medicine. Analysis of the results was performed according to empirical ethics. Outcomes Study outcomes were the identification of qualitative themes describing ethical considerations pertaining to penile transplantation in transgender men. Results Nineteen people participated in this qualitative study. The main domains that emerged included arguments in favor of and arguments against penile transplantation. Although the participants expressed positive attitudes toward developing this care, with acknowledgement of the current limitations stakeholders of all groups were reluctant to endorse the introduction of penile transplantation for transgender men at this point. Clinical Implications Under the present circumstances, all groups expressed both a wide variety of ethical considerations as well as a tendency to prefer developing alternative treatment options or improving the results of currently available treatments in relation to penile transplantation for transgender men. Strengths and Limitations This study was the first (empirical) study to focus on this topic and included a diversity of stakeholder perspectives. Limitations included the hypothetical nature of the discussion as well as the clinical setting in which the topic has been studied. Conclusion Introducing penile transplantation for transgender men, under the current circumstances, comes with a wide range of ethical considerations, which deal with personal identity, autonomy, medical risks, risk for transgender support and donor willingness, and issues regarding equality. Despite the present hesitancy to use penile transplantation, should the technical side of this treatment option develop, further research in the ethical field of penile transplantation for transgender men is recommended.

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Section: Discussionmentioning

confidence: 99%

Ethical considerations regarding penis transplantation surgery in transgender men—an empirical ethics study

de Haseth,

Gehrels,

Widdershoven

et al. 2023

Sexual Medicine

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“…Ipak, kliničke odluke vezane za indikovanost operacija polnog usklađivanja moraju se donositi u odsustvu definitivnih duževremenskih prospektivih studija efikasnosti ovakvih operacija u poređenju sa nehirurškim modalitetima (vidovima) tretmana. Donošenje stručnih odluka je neophodno, uz punu svest o tome da psihijatri dele "moralnu odgovornost vezanu za tu odluku sa hirurgom koji prihvata ovakvu preporuku" [10].…”

Section: Interdisciplinarnost Pristupaunclassified

Bioethical challenges and contraversis of the interdisciplinary treatment of gender dysphoric persons

Duišin¹,

Barišić²,

Batinić³

et al. 2014

Engrami

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Napomena: Rad je saopšten na simpozijumu Klinike za psihijatriju Kliničkog Centra Srbije "Bioetika i psihijatrija" održanom u Beogradu od 9-10 oktobra, 2014. Kratak sadržajRodna disforija predstavlja složen fenomenološki entitet u brojnim aspektima. Kompleksnosti doprinosi interdisplinirnost tretmana i bioetička pitanja koja iz toga proističu. Jedno od njih je uvremenjenost i obim ponuđenih terapijskih opcija, kao i prava eksperata u ovoj oblasti da ponude i sprovode parcijalni tretman (hormonski/hirurški). Termin "parcijalan" u medicini je u direktnoj koliziciji sa elementarnim načelima bioetike o poštovanju fundamentalnog prava pacijenta da uvek dobije kompletan tretman.Bioetički izazovi odnose se na operativne rekonverzije i pitanje njihove medicinske i bioetičke opravdanosti obzirom da su u nekim slučajevima posledica neprepoznatih motiva i poremećaja u osnovi. Klinički prikazi de-tranzicija i njihovo praćenje doprineli bi klarifikaciji kliničkih pokazatelja i ukazali na ne/opravdanost reverzne tranzicije.Savremeni standardi zajednice i prihvaćena profesionalna etika stručnjaka za mentalno zdravlje propisuju obaveznost tretmana rodno neskladne/disforične dece. Bioetička ispravnost tretmana prepubertetske rodno disforične dece uključuje neophodnost jasne definisanosti, kompletne sigurnosti i pouzdanosti dijagnostičkog postupka. Značajno je pitanje zrelosti i sposobnosti deteta za prilagođavanje telesnim hormonskim promenama. Ovaj uzrast nameće pitanje mogućnosti dobijanja adekvatnog informisanog pristanka koji bi potpuno zadovoljio zakonske kriterijume obaveštenosti i kompetentnosti. Stavovi stručnjaka su podeljeni, od kritičkog koji smatra neprikladnim da roditelji ili lekari nameću deci sopstvene standarde do afirmišućeg koji smatra da su roditelji najprikladnija referentna grupa da daju svoj socijalni vrednosni sud nakon detaljne konsultacije sa lekarima. Zdravstvene profesije uključene u tretman rodno disforičnih osoba imaju jednaku etičku obavezu da garantuju deci srećan i produktivan život putem odgovarajućih medicinskih intervencija ili bilo kojim drugim.U pojedinim oblastima kliničke medicine diskusija o prezervaciji fertilnosti je rutinska, dok je u domenu rodne disforije često kontraverzna za stručnu i širu javnost. Ovakva diskriminacija duboko narušava njihova osnovna bioetička prava, jer je savetovanje i informisanje transrodnih osoba o savremenim moguć-nostima reproduktivne tehnologije neophodno. Roditeljstvo nakon tranzicije ima svoju specifičnost u reverznim roditeljskim identitetima i ulogama, što dodatno čini ovo pitanje kontraverznim.Ključne reči: rodna disforija, bioetika, transrodna deca i adolescenti, promena pola, informisani pristanak, očuvanje fertiliteta.

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Management of Patients with Gender Dysphoria

Benet¹,

Melman²

1997

Male Infertility and Sexual Dysfunction

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Bioethical Issues in the Management of Gender Dysphoria

Cited by 4 publications

References 10 publications

Ethical considerations regarding penis transplantation surgery in transgender men—an empirical ethics study

Ethical considerations regarding penis transplantation surgery in transgender men—an empirical ethics study

Bioethical challenges and contraversis of the interdisciplinary treatment of gender dysphoric persons

Management of Patients with Gender Dysphoria

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