Giving informed consent on hormone replacement therapy

2002 ◽  
Vol 2 (2) ◽  
pp. 47-51 ◽  
Author(s):  
Susan L. Hendrix
Keyword(s):  
Hormone Replacement Therapy ◽  
Informed Consent ◽  
Replacement Therapy ◽  
Hormone Replacement

scholarly journals Gatekeeping hormone replacement therapy for transgender patients is dehumanising

2019 ◽  
Vol 45 (7) ◽  
pp. 480-482 ◽  
Author(s):  
Florence Ashley
Keyword(s):  
Mental Health ◽  
Hormone Replacement Therapy ◽  
Informed Consent ◽  
Health Professional ◽  
Replacement Therapy ◽  
Clinical Care ◽  
Hormone Replacement ◽  
Double Standard ◽  
Referral Letter ◽  
Trans People

Although informed consent models for prescribing hormone replacement therapy are becoming increasingly prevalent, many physicians continue to require an assessment and referral letter from a mental health professional prior to prescription. Drawing on personal and communal experience, the author argues that assessment and referral requirements are dehumanising and unethical, foregrounding the ways in which these requirements evidence a mistrust of trans people, suppress the diversity of their experiences and sustain an unjustified double standard in contrast to other forms of clinical care. Physicians should abandon this unethical requirement in favour of an informed consent approach to transgender care.

Reply to ‘Hormone replacement therapy: informed consent without assessment?’

2019 ◽  
Vol 45 (12) ◽  
pp. 826-827 ◽  
Author(s):  
Florence Ashley
Keyword(s):  
Hormone Replacement Therapy ◽  
Informed Consent ◽  
Medical Ethics ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Well Being ◽  
Protective Role ◽  
Depression And Anxiety ◽  
Mental Well Being ◽  
Assessment Requirements

In a previous article, I argued that assessment requirements for transgender hormone replacement therapy (HRT) are unethical and dehumanising. A recent response published by the Journal of Medical Ethics criticises this proposal. In this reply, I advance that their response misunderstood core parts of my argument and fails to provide independent support for assessment requirements. Though transition-related care may have similarities with cosmetic surgeries, this does not suffice to establish a need for assessments, and nor do the high rates of depression and anxiety justify assessments, especially given the protective role HRT plays towards mental well-being.

Hormone replacement therapy: informed consent without assessment?

2019 ◽  
Vol 45 (12) ◽  
pp. 824-825 ◽  
Author(s):  
Toni C Saad ◽  
Bruce Philip Blackshaw ◽  
Daniel Rodger
Keyword(s):  
Mental Health ◽  
Hormone Replacement Therapy ◽  
Informed Consent ◽  
Health Professional ◽  
Replacement Therapy ◽  
Mental Health Professional ◽  
Cosmetic Surgery ◽  
Hormone Replacement ◽  
Psychiatric Morbidity ◽  
Consent To Medical Treatment

Florence Ashley has argued that requiring patients with gender dysphoria to undergo an assessment and referral from a mental health professional before undergoing hormone replacement therapy (HRT) is unethical and may represent an unconscious hostility towards transgender people. We respond, first, by showing that Ashley has conflated the self-reporting of symptoms with self-diagnosis, and that this is not consistent with the standard model of informed consent to medical treatment. Second, we note that the model of informed consent involved in cosmetic surgery resembles the model Ashley defends, and that psychological assessment and referral is recognised as an important aspect of such a model. Third, we suggest that the increased prevalence of psychiatric morbidity in the transgender population arguably supports the requirement of assessment and referral from a mental health professional prior to undergoing HRT.

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