Both the diagnosis and medical treatment of gender dysphoria (GD)—particularly in children and adolescents—have been the subject of significant controversy in recent years. In this paper, we outline the means by which GD is diagnosed in children and adolescents, the currently available treatment options, and the bioethical issues these currently raise. In particular, we argue that the families and healthcare providers of children presenting with GD currently face two main ethical dilemmas in decision making regarding treatment: the pathway dilemma and the consent dilemma.
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Contributors TB conceptualised the manuscript and is the primary author. GD coauthored and revised critically for important intellectual content. Both authors approved the version of this work to be resubmitted after review at JME.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Author note Since the acceptance of this paper for publication, the Tavistock High Court decision it mentions has been overturned on appeal. For a summary of that appeal see the following editorial by McMillan and Gavaghan https://jme.bmj.com/content/47/11/717.