Transgender youth and the treatment of them by gender transition medical therapies affect very few young people but it has become a controversial issue in our nation. Donald Trump made transgender care an important part of his media content during his run for the presidency. He indicated that “there will no longer be girls who were once boys play on a girls’ team”. Trump’s view appearing in many interviews is: “Your child could go to school as a girl and come home as a boy.” This was a key part of his messaging during his campaign…fear.
The Justices of the Supreme Court weighed in on whether there should be transgender care including various therapies available to miners. I will summarize the perspective of the liberal and conservative points of view and then give the ethical issues associated with each. It should be no surprise at this point that all the conservatives and the liberals have markedly different views. The conservatives are against access to treatment for transgender youth and the liberal judges believe that the therapies should be made available.
My view on the subject will be the Via Media and will include statements such as “wrong but necessary” or the “lesser of two evils.”
Those who oppose the transgender therapies have different arguments to their perspective. The conservative perspective sees this as an “age” or “agism” point of view. Others on the liberal side of the argument see it as a matter of human sexuality. The first step in a discussion must be how you, the reader, sees it. Age or sex. The liberal point of view is that we give testosterone hormones to boys for to assist in their adolescent developmental issues. Why shouldn’t girls have the same opportunity to receive hormones for their developmental change from girls to boys.
The conservative view also appeals to the Hippocratic Oath. “First do no harm.” What if someone who is a minor decides that he or she wants to switch back to their sex assigned at birth. Their point is based in a caring ethic. We, they say, have the young person’s best interest at heart. For example, if a girl identifies as a boy and goes through transgender treatment that would mean that she wouldn’t be able to have children.
However, argument for the liberal side would be that the American Medical Association. They recognize Gender Dysphoria, feeling that discomfort or distress can occur when a person’s gender identity differs from their sex assigned at birth. There are many more suicides in the transgender community compared to any other groups in our nation.
The Judgement from the Court will come in July. It looks like they will support Tennessee’s ban on puberty blockers and hormones, treatments that trans patients call lifesaving. However, the Court said that they are ill equipped to deal with this medical issue. They certainly had no trouble deciding on abortion rights which is also a medical decision.
So here comes my point of view. When Nancy Mace proclaimed that she didn’t want our new member of Congress who is transgender, Sarah McBride, to use the women’s restroom, I wondered if she had ever met a transgender person. It was documented on video just a year ago that congressman Mace was for transgender rights. Let me tell you why I raise the question. As Chaplain I always liked the 50th reunion class to pick the chapel speaker for alumni weekend. When I got the call from the class rep, he wanted to have Clemmie Engle for their speaker. That class was all male, but chose her, a transgender person to be the speaker. She was the UNANIMOUS choice, a rarity. The rep indicated that she was everything that the school values. I had that rep introduce her with the accolades he shared with me. She received a standing ovation after her address. There was a small group that refused to stand or clap. That night at a dinner for the 50th class Clemmie said to me, “Jim, this is going to be about bathrooms.” I had a restroom next my office so any transgender person could use it as it had no designation.
One of my core beliefs about diversity and sexual orientation is that once you get to know someone, all the labels go away. This 50th reunion class was a conservative bunch of tough-minded males.
Another of my core diversity beliefs is that no one wakes up in the morning and says, “I think I will be transgender today. It will be fun.” They have been subject to terrible bullying.
I know several transgender people and their families. What makes the issue of treatment of adolescents so difficult is that their identity is being formed during that period. Parents will say to me things like, “I don’t even know who he or she is.” “I feel like I am living with a stranger.” I also know transgender youth who finally feel alive after making their transgender identity known to parents and friends who feel safe to them. It may feel wrong to others but may be necessary to the young person.
My ethical position is that it is about BOTH SEX AND AGE. I believe that the situations I know have been where the parents determine whether the child is happy and fulfilled or not. I believe it should be handled in the same way that we handle abortion in the states where it is permitted. The young person must get permission and support that only a parent can give until the adolescent is 18 years of age. This exchange should include a trusted and savvy physician who won’t do as the Supreme Court has done which is to make this a black and white issue when it contains a great deal of gray. The Court needs an ethicist! Notice that in all the deliberations about this issue, I didn’t see or hear once that parents should be the most important part of the process. They missed the key ingredient.
I have worked with kids for a long time. There is one thing that is an absolute. Sure, they can make a parent crazy, but if parents communicate that they genuinely want to understand the child’s point of view, it may not be one that anyone wants, but the path forward will contain heart.
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