Arizona State prof calls for end to parental veto over puberty blockers

The author of an article in the Journal of Medical Ethics argues that 'LGBT testimony' ranks higher than informed medical opinion and that only a patient, no matter how young, should be able to decide whether to pursue treatment.
Wed Jul 14, 2021 - 7:19 pm EST
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TEMPE, Arizona, July 14, 2021 (LifeSiteNews) — A philosophy professor at Arizona State University has published a paper in which she says it isn’t fair that some children don’t get puberty blockers because their parents are against it.  

In a recent issue of the Journal of Medical Ethics, Dr. Maura Priest responded to a lengthier essay about the ethics of giving or refusing puberty blockers to a “non-binary” adult for as long as “they” [she] wants them despite the risk of harming “their” [her] physical health. Noting that the parents of the hypothetical patient, “Phoenix”, had consented to “their” [her] medication, Priest said the article had presented a “related ethical challenge.” 

“Thanks to guardian consent, as a youth Phoenix had received paediatric PS [prescriptions] making OPS [ongoing puberty suppression] possible,” Priest stated in “LGBT Testimony and the Limits of Trust.”  

“However, some guardians of non-binary patients withhold this consent and then androgynous [sic] puberty is inevitable,” she continued. 

“The aligning of the parental stars can thus determine whether adulthood begins with either, (1) a confidence-inducing, gender-affirming body or (2) a confidence-undermining body that intensifies gender dysphoria.”  

The choices Priest presents are overly narrow. In fact, only a minority of children who experience gender dysphoria continue to do so in adolescence or adulthood. According to Dr Lawrence S. Mayer, a professor of statistics and biostatistics at Arizona State University, there is no evidence that all children should be encouraged to become transgender, given hormone treatments or surgery.   

In the original paper “Forever young: the ethics of ongoing puberty suppression (OPS) for non-binary adults,” the fictional Phoenix is 11 when “they” [she] is first distressed by the early signs of puberty and given puberty blockers. However, in her own response “LGBT testimony and the limits of trust,” Priest goes on to speak of “teens,” saying that all “non-binary” teens who want them deserve puberty blockers. 

“Two non-binary teens desiring comparable treatments are like cases, hence just demands like treatment,” she stated.  

“Guardian veto power over identity-affirming care thus results in injustice whenever such power means one trans child [sic] is denied the care that another receives.”  

Priest went on to say that parents’ right to say no to their children receiving puberty blockers violates the principles: the duty not to hurt someone, a person’s right to self-determination, and the duty to act for the benefit of others.  

“This veto power also conflicts with the principles of non-maleficence, autonomy, and beneficence. Autonomy is infringed because medical options are forever closed off to those who (through no choice nor fault) miss PS [prescriptions] in adolescence. Frustrating a trans person’s desire to affirm identity is harmful, that is, in tension with non-maleficence. Lastly, parents’ veto power over PS keeps many identity-affirming benefits out of reach, thus failing compliance with beneficence.”  

In this discussion of a distressed 11-year-old's reaction to developing a sexually mature body, Priest rates “LGBT testimony” higher than informed medical opinion.  

“[I]t is no longer the job of physicians to do their own weighing of the costs and benefits of transition-related care,” she wrote. 

“Assuming the patient is also informed and competent, then only the patient can make this assessment.” 

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However, this should not be assumed in children about to enter puberty. The High Court of Justice for England and Wales determined that prepubescent children, and, indeed, all children under 16 do not have the capacity to consent to transgender transition. The court decided that it was “highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers” and added that it was “doubtful” that children age 14 or 15 could properly and understand and appreciate the gravity of the process.  

Priest’s stance seems to have been informed by her solidarity with the LGBT community as a whole and resentment for the way the medical community has viewed people with “LGBT identities,” particularly that those identities were “illnesses best treated and cured.” She worries that medical experts will trust in “LGBT testimony” only when they deem it reasonable.  

The assistant professor posited another “non-binary” patient, this time named Chicago, and for the sake of argument, that OPS carried a 90 percent risk of osteoporosis. Priest argued that, even though Chicago has a 90 percent risk of developing osteoporosis, if Chicago understands that and “still insists that OPS is necessary for their [sic] wellness,” it would not be okay to give Phoenix (who has less of a risk) the drugs, but not Chicago. 

“Increased risk itself is not enough to justify disparate treatment,” Priest stated. 

“Risk must be weighed against reward, and enough of the latter can overcome the former.”  

In her view, it is “ethically dubious” to prioritize “physical over psychological health … in assuming that osteoporosis is worse than gender dysphoria.” Priest also believes that “skepticism” toward Chicago’s “testimony” is also problematic. She did not give a hypothetical age for Chicago or any guidelines for determining at what age “LGBT testimony” can be considered a suitable cause for physically harmful medical treatment.  

Priest also believes that doctors have nothing to lose or gain when it comes to giving people potentially harmful medical treatment. Regarding OPS for “non-binary” people, Priest wrote, “Patients, not physicians, have something to both lose and gain.” There is no suggestion in the articles that doctors have consciences, only grievances stemming from “medicine’s history with LGBT patients.”  LGBT “testimony”, i.e. subjective wants, trump medical expertise. 

“[A] clash between a patient’s and physician’s cost/benefit analysis in itself implies that the latter understands the patient better than the patient does themselves,” she wrote. 

“Given medicine’s history with LGBT patients, this is not only implausible, but arrogant and ethically suspect.” 

Priest’s previous publications include an article entitled “Transgender Children and the Right to Transition: Medical Ethics When Parents Mean Well but Cause Harm.” 

Arizona mother-of-five Loretta Myler had some tart words for the idea that parents should not have the right to veto puberty blockers for their children.  

“If parents are nothing more than incubators and babysitters for the state, then we should get paid by the state to have children and keep them alive," she told LifeSiteNews. 

Myler, who has a M.A. in Theology from the University of Toronto, also stated that Priest is a substandard teacher of philosophy. 

“Philosophy understands the progression of human self-understanding,” she said.  

“An 11-year-old does not have the kind of sexual awareness that would allow for decisions that will forever change his or her anatomy.” 

Myler, whose eldest is 14, added her opinion that if a child is confused about sexual identity, it’s because he or she has received confusing information at too young an age. 

“Kids are not just blank slates, and I do not trust an 11-year-old who has to be reminded to wipe his bottom …  in some cases to choose anything, much less their sexual identity.”  

Best-selling author and columnist Rod Dreher was horrified by just the abstract to “LGBT testimony and the limits of trust,” which clearly states that “parents should lose veto power over most transition-related paediatric care.”  

“Got that?” Dreher asked in The American Conservative on Monday.   

“Maura Priest, the philosopher writing here, says that Love Will Not Win unless parents have no right to say whether or not their children can be injected with sex hormones, have their breasts removed, be treated with psychotherapy to convince them that they are the opposite sex, and so forth.” 

Dreher noted that Priest had argued in a similar fashion in a 2019 bioethics seminar.  

“[S]he claims, for example, that children should be seized from parents for sex changes on the same principle that allows the state to force blood transfusions on the children of Jehovah’s Witnesses, over parental objections," he wrote.  

Author and bioethicist Wesley Smith of the National Review stated in 2019 that he thought Priest’s ideas against the parental veto were “utterly nuts” and “should alarm the hell out of everyone.” 

  gender dysphoria, hormone treatment, journal of medical ethics, lawrence s. mayer, lgbt, maura priest, non-binary, puberty blockers, transgender, university of arizona

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