Editors Choice

Medical Ethics and Treatment Is in a Nasty Fight for Its Existence

Medicine, the area of science that has been slowly backed into a corner by insurance reimbursement, is now in another fight for its moral life; ethical treatment of transgender individuals.

In a time when a vocal percentage of the American population is screaming to outlaw all forms of abortion, whether by rape or incest, there is also a nascent move to deny treatment to transgender persons. How does this fit with the Hippocratic Oath physicians take when they graduate from med school?

No one forces anyone to take on a patient. The reasons may include a lack of knowledge in the area, an inability to accept more patients, or personal reasons. I would assume that force is not applied and wouldn’t stand up in court.

I’m not a lawyer, but physicians, just as psychologists, have a right not to accept everyone who comes to them asking for treatment. In my experience, denying a patient an appointment for treatment is never easy and can be a soul-searching experience. Imagine what it must be like for a woman or man, whether transgender or not, in a desperate situation who needs medical treatment. How do you do it?

The American Medical Association had stepped into the fray and outlined its thinking on the topic. The AMA’s first salvo was released last year, related to transgender children.

The AMA letter to the governors of the US stated in part: “…evidence has demonstrated that forgoing gender-affirming care can have tragic consequences. Transgender individuals are up to three times more likely than the general population to report or be diagnosed with mental health disorders, with as many as 41.5 percent reporting at least one diagnosis of a mental health or substance use disorder.” When you think of mental health disorders, think of what I would call legally provoked suicide.

The Endocrine Society and the Pediatric Endocrine Society have joined in efforts to keep the doors open for medical care for transgender youth. The Pediatric Endocrine Society has supplied a page for anyone interested in more information.

Why would transgender persons’ lives not be worthwhile if any life is worth saving? When do we advance the laws to prevent medical care of the elderly, the disabled, or people without blonde hair? Remember the film “Soylent Green”?

Aren’t transgender persons productive members of our society, and don’t they contribute to our national economy? What crime did they commit that they should be sentenced by law to be denied healthcare or insurance reimbursement for medical care?

We are at the top of the legal/medical sliding pond, and the grease is being applied quickly to prevent healthcare to an increasing number of Americans. Is it done in the service of faithful husbanding of our financial resources? Undoubtedly, it is not because we appear to have more than enough finance to aid anyone in need.

The undeniably tangled network to get medical help under normal circumstances has stopped many, but it will be even worse for transgender individuals. Now, those in Congress and state legislatures and too many of their constituents are hard at work to deny, deny, deny.

The American Psychological Association has weighed in on the issue in agreement with President Biden’s sentiments. They have indicated:

The American Psychological Association welcomes the Biden administration’s statement reaffirming support for advancing the dignity, respect, and self-determination for transgender people. At a time when transgender and gender-nonconforming people are being targeted by governors and state legislatures, the measures put forth by the White House are a vital step toward not only protecting transgender people but ensuring they are treated equitably.”

The association noted that in 2008 they adopted a resolution in support of transgender youth and for full equality for any individual who identifies as transgender or as a gender-variant person. The citation is on their website.

Pat Farrell PhD

I'm a licensed psychologist in NJ/FL and have been in the field for over 30 years serving in most areas of mental health, psychiatry research, consulting, teaching (post-grad), private practice, consultant to WebMD and writing self-help books. Currently, I am concentrating on writing articles and books.

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