Medico-Legal Issues In The Treatment Of Young People With Transsexualism

The emergence of claims of biological legitimacy for transsexualism as an intersexual condition, rather than a form of disorder, and the legitimacy of difference generally and associated human, medical and legal rights are engaged here hand in hand with moral and/or religious concerns. This lively mix of issues has effectively isolated young people with transsexualism from the kind of public health funding and professional medical interest enjoyed by other intersexual phenomena. Treatment models, while sharing much symmetry, significantly differ on the issue of the administration of pubertal \'blockers\' as a part of a first diagnostic phase of treatment at Tanner Stage 2 with the onset of puberty. Some expert practitioners refuse such treatment on both medical and ethical grounds and limit treatment prior to 16 years of age to psychiatric practices and counselling; notwithstanding the evidence of the long term loss of quality of life associated with the acquisition of secondary sexual characteristics at puberty at odds with the individual\'s affirmed sex and the associated evidence of risk of self-harm. The presentation will discuss the issues raised for both law and medicine in reconciling the competition between individual, State, religious, interest group, medical and human rights and obligations in respect of the medical treatment of young people with transsexualism; including in the practical context of legal proceedings dealing with both child welfare/parens patriae and Gillick\'s case principles.