If informed consent is one of the pillars of clinical bioethics, puberty blockers fail the test, according to a leading psychiatrist and constitutional lawyer writing in the magazine Commentary. Paul McHugh, an emeritus professor of psychiatry at Johns Hopkins, and Gerard Bradley, of Notre Dame, argue that neither young people nor their parents can possibly understand what they are missing by delaying puberty, one of the most mysterious aspects of human physiology.
Their immediate purpose is to support a recently passed law in Arkansas which bans “gender transition services” for people under 18 because they are too young to give their informed consent. The law has been struck down by a federal appeals court. Seventeen other states wrote in support of the law claiming that legislation is needed because “The medical establishment has abandoned the field to the political zeitgeist”.
The article in Commentary covers too much ground to summarise adequately, but McHugh and Bradley target two failings involved in transgender medicine for children and teenagers.
The first is “recklessness”. Puberty, they contend, is mysterious and little understood. Tinkering with a young person’s physiology is dangerous.
In other animals, all that they shall be is in place at puberty. For us, puberty amounts to a kind of second birth; it is the start of our becoming contributing members to our times. To block puberty and then artificially redirect its course is to tamper with a vital human developmental matter with no reason for confidence in what will emerge beyond a lifetime preoccupied with medico-surgical interventions to maintain the illusion that one’s sex has changed.
The second is “thoughtlessness”. Consent must be informed; people must understand the consequences of their actions. But a prepubescent person can hardly grasp what a life of sterility, childlessness and perpetual medication involves.
They predict that a single successful case against transgender treatment – like the UK’s Bell v. Tavistock –will cause the experiment with transgender medicine to crumble.
With the appearance in the United States of even one well-publicized case such as Kelsey’s, with its obvious potential for a major lawsuit, the transgender misadventure will come to a close. A public outcry will start, insurance companies will cease malpractice support as lawsuits emerge, and reputations of doctors and health systems will sink.
The damage to the victims will nonetheless be irreparable and (as Abigail Shrier’s 2020 book on this subject has it) irreversible. Their sense of betrayal will be matched by the shame of everyone capable of feeling it.
Michael Cook is editor of BioEdge
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