Rethinking ‘need’ for clinical support in transgender and gender non‐conforming children without clinical classification: Learning from ‘the paper I almost wrote’

Abstract

There have been ongoing debates as to how, or even whether, we should clinically classify gender diversity in children through clinical classification manuals. So‐called ‘depathologizing’ is argued as being vital to address the stigma that these children are somehow disordered or sick. Yet one argument in favour of continued clinical classification for transgender and gender non‐conforming children is that it better facilitates access to specialist psychological support. I argue that whilst continued clinical classification offers a seemingly pragmatic solution to ensuring access, it does in fact obscure our understanding of the individual needs of these children. In this paper I address fundamental issues that aim to better our understanding of need and thus why a child may benefit from specialist support. I do so by critiquing a paper I nearly wrote, which argued for the ongoing continued classification of gender incongruence in children. Ultimately, I argue that specialist psychological support and care should be driven by the needs of the individual child, as determined by the child and those involved with their care. By bettering our understanding as to why specialist psychological support may be beneficial for some, we move past the focus of such specialist support being provided because of the child’s gender diversity. Methodologically the paper may be unusual, in comparison to traditional normative counter‐argumentative bioethical position papers, but by presenting an argument for depathologization of gender diversity of children in this way there is also an alternative insight into the methods of bioethics.

From clinical to judicial decision-making, and back again in Bell v. Tavistock? Preparing for the legacy of court involvement in gender care for minors

“…cit., 355 [167] (Thackray, Strickland and Murphy JJ). See also 359 [189] example, if parents, or medical professionals are unable to agree'. 103 The majority of the Court observed that in no stage 2 cases had 'contradictory evidence been forthcoming .…”

Taking the Long Way Around: Towards A Depathologized Ethical Framework of Gender-Affirming Care for Trans Youth

“… 33 This is not only problematic in and of itself but also, as Horowicz argues, limits therapeutic approaches, in that diagnostic criteria become individual symptoms to treat, limiting a holistic approach to the youth’s needs. 34 …”

“…33 This is not only problematic in and of itself but also, as Horowicz argues, limits therapeutic approaches, in that diagnostic criteria become individual symptoms to treat, limiting a holistic approach to the youth's needs. 34 Proponents of the pathological model may defend the current framework in that distress and dysphoria are not posited as inherent to trans identity, but rather a result of living within a transphobic society. Such an argument is disingenuous, given the frequent requirement of distress for access to GAC, especially in the case of youth, whose advocates rely heavily on justifications based in suicide prevention and mental illness.…”