Campus Reform | ASU prof: Parents should lose ‘veto power’ over 'most transition-related pediatric care'

ASU prof: Parents should lose ‘veto power’ over 'most transition-related pediatric care'

An academic paper argues that parents should lose 'veto power' over their children’s gender transitions, even if they are deeply harmful to physical health.

The professor also argues that 'prioritising physical over psychological health' for self-identified non-binary patients is 'ethically dubious.'

An academic paper argues that parents should lose “veto power” over their children’s gender transition proceedings.

Maura Priest — a philosophy professor at Arizona State University — wrote a response in the Journal of Medical Ethics to another paper from Melbourne Law School researcher Lauren Notini, which argues that ongoing puberty suppression “is consistent with the proper goals of medicine to promote well-being, and therefore could ethically be offered to non-binary adults in principle.” Priest agrees with the authors’ conclusion, but claims that medical opinion should not override LGBT testimony when it comes to making decisions around the gender transition process.

“If the medical community is to take LGBT testimony seriously (as they should) then it is no longer the job of physicians to do their own weighing of the costs and benefits of transition-related care," Priest wrote. "Assuming the patient is informed and competent, then only the patient can make this assessment, because only the patient has access to the true weight of transition-related benefits.”

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Furthermore, Priest argued that “taking LGBT patient testimony seriously also means that parents should lose veto power over most transition-related paediatric care.”

Notini’s article stated that a hypothetical patient — in this case, an eighteen-year-old female named Phoenix who identifies as “gender non-binary” — should still be approved for hormone treatment despite the risk of lowering her bone density. In particular, Phoenix would have a “very low absolute risk of fracture.”

Priest’s response considered a second hypothetical “non-binary patient” named Chicago, who fully understands that a hypothetical ongoing puberty suppression treatment has a “90% risk of osteoporosis” — a disease which, according to the Mayo Clinic, causes bone to become “so brittle that a fall or even mild stresses such as bending over or coughing can cause a fracture.”

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Because “medical experts have dismissed, downplayed and doubted, LGBT testimony, all of which manifests blatant disrespect,” Priest asserted that Chicago should be approved for treatment without question. She added that any doctor second-guessing the recommendation may be “prioritising [sic] physical over psychological health” — a move that is “ethically dubious.”

“Chicago contends that OPS’s identity-affirming benefits justifies the serious risk of osteoporosis,” wrote Priest. “This preference might seem unusual, but we must remember that both values and experience can impact suffering.”

“Heteronormativity has long fueled LGBT medical mistreatment,” she continued. “To avoid going back down that path, medicine must leave room for diverse and atypical health prioritisations.”

Another obstacle to “justice” in such a case is “guardian veto power” whenever “such power means one trans child is denied the care that another receives.”

Campus Reform provided Priest with another hypothetical: whether a doctor should meet a patient’s request to quiet voices inside his head by drilling a hole in his cranium. Priest responded that any doctor who affirms such a request “would be acting negligently and unethically,” as “putting psychological health on the same level as physical health does not mean that we should just blindly accept anything a patient would say.” In this particular case: “Hearing voices is a well-established symptom of schizophrenia, and it is well established that when persons are schizophrenic and experiencing symptoms they are NOT acting autonomously.”

Priest offered, however, that she maintains “a different stance on a situation in which a person experiences body integrity disorder, a long-recognized disorder in which a person strongly desires to have an arm or leg removed.” 

“I will take the controversial position in this instance,” she said. “I think that when a patient is evaluated as otherwise psychologically capable that physicians do indeed act ethically by removing the limbs at the patient's request.”

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