Childhood gender dysphoria – the legal and ethical issues

GIDC was formalized in the third revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 and primarily referenced gender non-conforming behaviors. GIDC remained in the DSM from 1980 to 2013, when it was replaced with the diagnosis of “gender dysphoria” in the fifth revision (DSM-5), in an effort to diminish the stigma attached to gender variance while maintaining a diagnostic route to gender affirming medical interventions such as hormone therapy and surgery.

Controversy surrounding the pathologization and treatment of cross-gender identity and behaviors, particularly in children, has been evident in the literature since the 1980s.^[1] Proponents argue that therapeutic intervention helps children be more comfortable in their bodies and can prevent adult gender identity disorder. Opponents say that the equivalent therapeutic interventions with gays and lesbians (titled conversion or reparative therapy) have been strongly questioned or declared unethical by the American Psychological Association, American Psychiatric Association, American Association of Social Workers and American Academy of Pediatrics. The World Professional Association for Transgender Health (WPATH) states that treatment aimed at trying to change a person’s gender identity and expression to become more congruent with sex assigned at birth “is no longer considered ethical.” Critics also argue that the GIDC diagnosis and associated therapeutic interventions rely on the assumption that an adult transsexual identity is undesirable, challenging this assumption along with the lack of clinical data to support outcomes and efficacy.

An address and panel discussion at QUT on Tuesday 13 October 2015 will consider the legal and ethical issues relevant to the treatment of childhood gender dysphoria. Dr Malcolm Smith of the Australian Centre for Health Law Research will be joined by Professor Jennifer Batch, Dr Stephen Stathis and Ms Nicole Morgan.