Puberty Suppression for children and adolescents with gender dysphoria: facilitating ethical reflection and dialogue: Bernadette Wren

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Date(s) - 11/02/2017
10:00 am - 12:30 pm

Oxford - Friends Meeting House


Puberty suppression for children and adolescents with gender dysphoria: facilitating ethical reflection and dialogue

 B.Wren Image

When a child is unhappy with their assigned gender role and feels at odds with aspects of the body that define them as male or female, the questions that arise for parents and clinicians often appear deeply moral, as much as medical or psychological. Whilst families, carers and clinicians coming to the Gender Identity Development Service (GIDS) may share common ethical aims to support and act in the child’s best interests, the ways in which notions of care, autonomy, choice and beneficence are interpreted can diverge significantly, leading to conflict and polarisation which may be described as ethical in character.

In this talk I will focus particularly on the stance of GIDS in relation to puberty suppression. We believe that one important way of supporting these young people to feel more comfortable in their bodies, whilst holding future gender options open to them, is to intervene, in a reversible way, in the developmental trajectory of puberty. I will discuss the ethical concerns bearing on decisions to offer this medical treatment:  finding a developmentally appropriate account of ‘autonomy’, understanding the idea of self-determination in a shifting social landscape, and promoting the capacity for meaningfully knowing ‘who one is’.

I will look at ways of facilitating ethical reflection and dialogue with the aim of empowering clinicians, children, families and carers to explore, share their responses to the ethical landscape in which they are operating and to consider ways in which they can maintain a therapeutic relationship even where there is disagreement and difference.

Bernadette Wren, Clinical Psychologist and Systemic Psychotherapist, is trust-wide Head of Psychology at the Tavistock and Portman NHS Trust. She has degrees in philosophy and psychology and a continuing interest in the relevance of each discipline to the other.  She works clinically with transgender young people and their families in the Trust’s nationally-commissioned Gender Identity Development Service. She is an Honorary Senior Research Associate in the Dept of Clinical, Educational and Health Psychology at UCL.

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