It is a mistake to focus excessively on the problem that children lack capacity to consent to trans medicalisation. The problem is much more serious than that.

This audio essay explores how the concepts of medical care and consent have been queered by those campaigning for “gender affirmative” healthcare. By clarifying the mindset that leads people to find such treatments plausible, we can more effectively argue against them and disabuse those who have been hoodwinked by smoke and mirror tactics as words like “consent” and “healthcare” have multiple meanings so that the absurd is made to appear plausible.

Now trans healthcare, being “healthcare”, must be paid for by your health insurance and you cannot discriminate against trans people by having their “healthcare” not get paid for.

And secondly, it being necessary “healthcare”, you can then loosen up on the requirements for consent by being allowed to be paternalistic and deciding on behalf of a vulnerable patient like somebody who's mentally ill or a child that you know what's in their best interest. Because you understand that this patient is trans because you are the expert.

You can see into their soul.

So paternalistically you will then approve of the child having healthcare done to them for which they do not have the capacity to consent, to which they actually have not consented.

You consent on behalf of them, and you do it in the name of personal autonomy.

Sources on Informed Consent and Medical Necessity in Body-Altering Healthcare

When patients lack capacity, others decide for them in their best interests

* https://www.cqc.org.uk/guidance-providers/learning-safety-incidents/issue-12-capacity-and-consent

* https://code-medical-ethics.ama-assn.org/ethics-opinions/decisions-adult-patients-who-lack-capacity

Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults by Stephen B. Levine, E. Abbruzzese &Julia W. Mason

Summarises the issues to do with consent.

It is common for gender-affirmative specialists to erroneously believe that gender-affirmative interventions are a standard of care

Five scientific observations question and refute the assumption that an individual’s experience of incongruence of sex and gender identity is best addressed by supporting the newly assumed gender identity with psychosocial and medical interventions

AMA to states: Stop interfering in health care of transgender children

Empirical evidence has demonstrated that trans and non-binary gender identities are normal variations of human identity and expression. For gender diverse individuals, standards of care and accepted medically necessary services that affirm gender or treat gender dysphoria may include mental health counseling, non-medical social transition, gender-affirming hormone therapy, and/or gender-affirming surgeries. Clinical guidelines established by professional medical organizations for the care of minors promote these supportive interventions based on the current evidence and that enable young people to explore and live the gender that they choose. Every major medical association in the United States recognizes the medical necessity of transition-related care for improving the physical and mental health of transgender people.

Misinformation Obscures Standards Guiding Gender-Affirming Care for Trans Youth

This article defends gender affirming care by pointing out that there is careful assessment to make sure that children have capacity. The Endocrine Society claims most adolescents have capacity by age 16.

Different Aspects of Informed Consent in Aesthetic Surgeries by Nasrin Nejadsarvari and Ali Ebrahimi

About informed consent for aesthetic surgeries. Consent is impossible if patients have psychiatric problems. Surgery may make psychiatric problems worse. Misinformed consent can lead to legal liability for malpractice.

Note: Gender doctors treat the psychological distress of patients as analogous to the distress of an accident victim who is mis-figured and requires reparative surgery to restore their appearance and therefore help their mental health.

Example: https://saberplasticsurgery.com/gender-affirming-breast-removal/

Advertises surgery as helping with gender dysphoria and feeling “comfortable in your skin”. Top surgery is “medically necessary”.

New advertising guidelines for cosmetic surgery in Australia: https://aestheticmedicalpractitioner.com.au/features/cosmetic-practice/new-cosmetic-surgery-advertising-guidelines/

Gender affirmation surgery is not considered cosmetic surgery, and the cosmetic surgery advertising guidelines ‘do not apply to non- surgical cosmetic procedures’.

Cosmetic surgery must not be advertised in a way that exploits the vulnerabilities or insecurities of individuals to increase demand for cosmetic surgery

* testimonials are not allowed

Gender Confirmation Surgery: Cosmetic or Reconstructive Procedure? Alexis Laungani, MDcorresponding author* and Pierre Brassard, MD, FRCS(C)

For the sole purpose of dichotomy, the transgender patient could be considered as having a birth defect by not having a body envelope corresponding to their true gender. Gender confirmation (also called sex reassignment) with hormones, mental therapy, and surgical transition, has been shown to relieve symptoms of gender dysphoria and to provide patients with a regained socialization in their true gender, as opposed to their gender assigned at birth.

Body modification – when consent is not a defence

This is a longstanding legal principle. Where actual bodily harm or above is inflicted upon a person with no good reason, in public or private, the consent of the victim is irrelevant. Whether there is a “good reason” is a matter for the courts to decide.

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