A MODEST PROPOSAL FOR RESOLVING THE SEX-CHANGE DEBATE

Recognizing the Competing Rights and Concerns of Minor Children and their Parents and Doctors.

Gender dysphoria incidence rate for males are estimated to be about 1 in 10,000 according to The Diagnostic and Statistical Manual of Mental Disorders.  Despite its rarity, Transgender Activists, the American Medical Association, the ACLU, and Republican legislators in 15 States are engaged in highly-publicized, pitched battles to contest whether it is appropriate to prevent the use of puberty blockers, hormone therapies, and surgeries to alter the sexual development of minor children.

Leading surgeons specializing in the treatment of persons with gender dysphoria have voiced concerns that harmful side effects of puberty blockers, hormone therapies and surgery on minor children have not been considered by many of their colleagues.  They have warned that many transgender healthcare providers were treating kids recklessly because they were not presenting their patients with this evidence of potential side effects like the inability to experience an orgasm or psychological disorders.  Instead, there is pressure to affirm the benefits and downplay the risks. 

In response to these and other concerns, legislators in 14 States considering legislation limiting surgery and hormone therapy to transgender youth.  Arkansas recently became the first State to ban medical treatments for Transgender minors.

In response, “The American Medical Association views these bills as a dangerous legislative intrusion into the practice of medicine and has been working closely with state medical associations to vigorously oppose them. In letters to legislators, the AMA has emphasized that it is “imperative that transgender minors be given the opportunity to explore their gender identity under the safe and supportive care of a physician.”

“This legislation is criminalizing health care for transgender minors.”

ACLU is arguing that “Gender-Affirming Care is Life-Saving Care.”  The opponents of this legislation are taking the offensive under the banner of caring for the well-being of the minor children who need these treatments.

Both sides in this debate have valid points, but instead of seeking consensus, they had resorted to ad hominen attacks.

There is an undeniable risk that a minor child could be experiencing a transitory period of sexual confusion, and that irreversible medical treatments, like the removal of breasts and genitals, would be a grave error. However, there may be situations where delaying the onset of puberty could help delay unwanted physical changes that don’t match the child’s gender identity. Nevertheless, even these puberty blockers do have side effects that can be long-lasting if the child later changed their mind about continuing use of these medications.

The parents and physicians advocating transgender medical interventions for minors don’t have any accountability if the minor child later regrets these medical interventions. Currently, the advocates only discuss the problems of gender-confused youth’s high susceptibility to suicide, and insist that these medical interventions are necessary.

Instead of proscribing treatment for minors, legislators should empower minors with a Surgical Warranty of Satisfaction if these minors later regret the treatments once they attain adulthood.

For example, law makers should enact legislation that enables any person, who received puberty blockers, hormone therapy, or surgeries prior to age 16, to seek damages prior to age 25 from their parents who authorized, and any medical professionals involved in the medical procedures.

These legislators would forgo the ability to make Transgender treatments illegal, a questionable intervention between a physician and the patient’s parents. In exchange, the physicians and parents would have to recognize the minor child’s ability to make an independent decision as an adult if they later regret undergoing the treatment regimen.

If the parents and the medical professionals are confident about their prescriptions for the child, then they should expect the grown adult version of this child to thank them for their interventions.  However, if the child was undergoing confusion and anxiety as a minor and waiting for puberty to occur as they age could undo that confusion, then recommending surgery would have been a mistake.  The persons responsible for these mistakes must be held accountable.

This style of compromise and recognition of the competing rights and concerns is essential for making democracy work. It is also essential for drafting a new Constitution for the United States.