Rising Resident (BCRP) University of Toronto Temerty Faculty of Medicine Toronto, Ontario, Canada
Background: • Numerous jurisdictions (US, Canada, UK) have placed restrictions on youth access to gender-affirming care (GAC) • Advocates have highlighted the tragic outcomes of denying GAC to youth (suicidality, self-harm, depression). These treatments are often described as “lifesaving” • The impetus to rescue trans youth from the suffering they would endure with non-treatment is thus presented as the primary ethical justification for such care • These arguments rely on a pathological model of gender diversity, which upholds settler colonial violence and unjustly curtails the autonomy of trans youth • We review critiques of the pathological model of gender diversity and highlight alternative models that celebrate gender diversity and uphold trans youth autonomy
Objective: • Identify the impacts of pathologized models of advocacy, ethics, and care for GAC amongst trans youth • Synthesize existing alternative models of ethics and GAC provision for youth
Design/Methods: • Literature review conducted, including medical, legal, and critical theoretical research • Emphasis placed on anti-colonial, trans liberatory, and patient-driven literature • Informal interviews completed with trans youth organizations, clinical ethicists
Results: [See images]
Conclusion(s): • A framework that justifies GAC by pathologizing trans youth and lamenting the tragic outcomes of non-treatment, such as suicide and mental illness, is found to be rooted in cisheteropatriarchy, a central feature of settler colonialism • The landslide of legislation attacking the autonomy of trans youth is a continuation of an ongoing process of colonial attempts to control and oppress “deviance,” in service of white cisheteropatriarchal supremacy • We must do the uncomfortable work of rethinking GAC for trans youth, as well as trans medicine more broadly
