The Corner

Health Care

Will MDs Be Forced to Perform Mastectomies on Children with Gender Dysphoria?


Good grief. When I read Jane Robbins’ piece in The Federalist reporting that doctors were actually performing mastectomies on girls as young as 13 who identify as boys, I couldn’t believe my eyes. But sure enough. Not only is it happening, but a medical study published in JAMA Pediatrics recommends that children not be precluded from such radical body-altering surgery based simply on their youth:

Chest dysphoria was high among presurgical transmasculine youth, and surgical intervention positively affected both minors and young adults. Given these findings, professional guidelines and clinical practice should consider patients for chest surgery based on individual need rather than chronologic age.

Note also that doctors suppress normal puberty in children diagnosed with gender dysphoria.

This is unethical human experimentation as far as I am concerned because we don’t know the long-term physical, psychological, or emotional consequences of such interventions. And remember, some children with the condition cease to experience trans-identity as they grow older. (I hope I put that correctly.) If that happens, what then?

But Wesley, it’s a study! Sorry. In our ideological times, that doesn’t mean as much as it once did. After all, a peer-reviewed study on gender dysphoria was apologized for by Brown University because it reached an ideologically disfavored conclusion.

(In this regard, Robbins’ deconstruction of the JAMA Pediatrics study is a real eye-opener. Please read the whole thing.)

I bring this up because of the potential impact such “studies” could have on the issue of “medical conscience.” Many bioethicists, the medical intelligentsia, some Democratic politicians, as well as media pundits, wish to force doctors and other healthcare professionals to perform morally contentious procedures desired by patients–even if it violates their religious or moral beliefs. This is all part of “patient-centered care,” don’t you know.

Advocacy for this authoritarian policy proliferates the bioethics and medical professional journals. Ezekiel Emanuel put it this way in the New England Journal of Medicine: If a requested procedure is accepted generally by the medical community and the doctor has a moral objection to it, the MD must either do the deed or find another doctor who will . Otherwise (my emphasis):

Health care professionals who are unwilling to accept these limits have two choices: select an area of medicine, such as radiology, that will not put them in situations that conflict with their personal morality or, if there is no such area, leave the profession. 

Mostly, the conscience debate has revolved around whether doctors should be forced to cooperate with abortion. (Emanuel explicitly argues that they must.) But there is absolutely no reason to think that the issue will be so restricted, or that it will not soon also include the question of novel treatments being developed for gender dysphoric children.

Indeed, with the JAMA Pediatrics study, one could conclude that such surgery is already becoming generally accepted within the medical community. And 19 Democrat state attorneys general have sued the Trump administration to prevent increased enforcement of existing laws protecting medical conscience because they deem such planned actions to be potentially discriminatory against the LGBT community. Think about what all of this could portend.

A doctor need not be a religionist or disagree with the concept of gender dysphoria generally to be morally opposed to cutting off the healthy breasts of adolescents (or inhibiting the onset of a child’s normal puberty) as a form of “doing harm” in violation of Hippocratic ideals. But if Emanuel and his ilk have their way, in the not too distant future, a surgeon approached to perform a mastectomy on a girl who identifies as a boy could be forced into a terrible conundrum: either remove the child’s healthy body parts–or risk being charged with transphobic discrimination, investigated by medical authorities, and possibly forced out of the profession.

Those with eyes to see, let them see.

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