Children and Gender Ethical issues in clinical management of transgender and gender diverse youth, from early years to late adolescence

Simona Giordano investigates the moral concerns raised by current clinical options available for transgender and gender diverse children and adolescents. From the time young children express gender incongruent preferences and attitudes, up to the time in which older adolescents might apply for medical or surgical treatment, moral questions are likely to be asked: should children be enabled to express themselves freely inside and outside the domestic environment? What are the implications of the choices that parents might make early on? How should clinicians respond to distress around sexual anatomy? Is it ethical to suspend pubertal development? What level of evidence should we seek for medications to be used in paediatric care? What are the risks and benefits of various forms of hormonal treatment? Is it ethical to defer surgical interventions till adulthood? Giordano provides a detailed ethical analysis of these and many other questions that are likely to arise at various stages of a person's life and proposes a moral formula to answer these questions, as well as others, that are likely to arise in a fast-changing landscape. Children and Gender combines a detailed ethical analysis with an accurate clinical description of gender development and available clinical pathways.

Simona Giordano, Professor of Bioethics, University of Manchester

Simona Giordano is Professor of Bioethics at the University of Manchester. Giordano graduated cum laude in Philosophy at the University La Sapienza in Rome (1995) and moved to England in 1997, to begin a PhD under the supervision of Prof. John Harris, on the ethics of treatment of people with mental illness, with a special focus on eating disorders. Giordano has lived in Manchester and worked at the Centre for Social Ethics and Policy ever since. Giordano began working on gender diversity in children in 2005 and has published widely on the topic. Giordano is currently serving on the Ethics Committee of the World Professional Association for Transgender Health.

Preface
Acknowledgments
1. The Current landscape
2. Gender incongruence and gender dysphoria in children and adolescents: clinical descriptions, psychosexual outcome studies, aetiology
3. Gender development
4. Gender incongruence as a condition related to sexual health
5. Clinical guidance on the management of gender diverse youth: an historical account
6. The early stages of clinical management: Should children transition socially?
7. The first stage of medical treatment: puberty suppression
8. Risks and benefits of puberty suppression
9. Are trans children guinea pigs? The fear of unethical experimentation
10. Can valid consent to medical treatment be given by gender diverse minors?
11. What should the role of the family and the court be?
12. Is it ethical to use puberty blockers in the treatment of gender dysphoria?
13. Ethical issues in the provision of cross-sex hormones
14. Gender-affirming surgery: ethical issues around age of access