Gender-affirming surgery for transgender Adolescents: Ethical and legal considerations

Simona Giordano, Edmund Horowicz

Research output: Contribution to journalArticlepeer-review

Abstract

In this paper, we consider the ethico-legal issues surrounding gender-affirming surgeries in minors, with a specific focus on English law. First, we outline and discuss the current clinical guidelines on genital surgery for minors with gender incongruence/dysphoria. Second, we consider the recent legal developments following R (on the application of) Quincy Bell and A v Tavistock and Portman NHS Trust and others, and we discuss how these might impact the ability of doctors to agree to surgical procedures when their patients are still minors. Finally, we explain why the removal of the adulthood threshold is justified. However, we argue that surgical interventions should remain differentiated from fully reversible interventions, and that clear guidance on eligibility criteria for genital surgery is needed from clinical guidelines, which, in consideration of the legal, professional and regulatory framework in which clinicians work, can provide needed reassurance regarding when it is in the best interests of competent young people to be considered suitable candidates for genital surgery.

Original languageEnglish
Article number102295
JournalBest Practice and Research: Clinical Obstetrics and Gynaecology
Volume86
Early online date16 Dec 2022
DOIs
Publication statusPublished - 2 Feb 2023

Keywords

  • Battery
  • Bell v Tavistock
  • Ethical issues
  • Genital surgery
  • Negligence
  • Transgender minors

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