Introduction
Gender assignment hormones are given to transgender children who experience gender dysphoria to reduce the symptoms. The primary hormones used are estrogen and testosterone, depending on whether the individual wants to transition from male to female or female to male, respectively.
Gender dysphoria is psychological distress resulting from incongruence between the sex assigned at birth and gender identity. A gender therapist can only diagnose gender dysphoria.
Pro and con
I do not support that children receive gender assignment hormones due to the adverse consequences, including negative health effects like increased risk of cardiovascular diseases, weight gain, and changes in bone density. In addition, limited research has been done concerning the treatment.
The hormones lead to persistent effects, limiting the possibility of reversing if one changes their mind about their gender identity. Inaccurate diagnosis may lead to additional psychological effects due to irreversible consequences. It has also become a societal concern due to the stigma, discrimination, and psychological discomfort associated with the treatment.
However, some research shows that it could be helpful. Data from various studies show that most young people who suffer from gender dysphoria have better mental health outcomes after access to gender assigning hormone treatment. Moreover, it has improved the quality of life for a child who suffers from the symptoms of gender dysphoria(Boerner, 2022).
Statistical Significance to pediatric nursing
Cases of gender dysphoria are rising worldwide, and many young are presenting to healthcare settings to seek treatment. They are likely to develop anxiety, depression, and other mental issues facing young people. The reports on the treatment outcomes help determine the efficacy and safety of this type of treatment. They can be helpful in the decision-making of future treatment considerations (Handler et al., 2019).
A fictional case used to illustrate gender-assigning hormones being given to children
Let us consider the following case for gender assignment hormones for children. Aden is an 11-year-old boy who started dressing like a girl six months ago. He refuses to wear clothes bought for him by his mother and tells his parents that he feels like a girl and does not want to be a boy anymore. He plays with girls and says he dislikes his sexual anatomy. The parents take him to a gender therapist who diagnoses him with gender dysphoria. After careful discussions of the benefits and the adverse side effects with the boy and his parents, the therapist suggests that he receives puberty blockers as they await if changes will take place. However, the condition persists. The child is given oestradiol therapy. The child feels better after the treatment and can involve in school and play with others. However, he undergoes stigma and discrimination from other children.
Ethical principles
Nurses routinely encounter issues that may have ethical implications. They are hence required to apply ethical principles in their practice. Various ethical principles guide the action of nurses.
One is the principle of autonomy. It states that patients have the right to self-determination, which means to decide what can be done to them based on their beliefs and values. It is crucial to consider the decision of the children to receive gender-assigning hormones based on their age and capability to make good decisions.
Another ethical principle is the principle of non-maleficence. It states that the nurse has to work to avoid or minimize harm. It requires that the nurse provides safe, effective, and high quality care. An example is holding a medication due to harmful side effects. In this case, the gender reassignment hormones are associated with adverse side effects; hence the nurse could hold them.
Applicable principles to support the proposition
The principle of autonomy applies in that the children can decide what happens to them. The principle of nonmaleficence applies in that the hormones are given to the children in time to reduce the effects of gender dysphoria on their mental health.
Applicable principles to support the cons position
The principle of nonmaleficence requires the nurse to avoid or minimize harm to the patient. Nonmaleficence is due to the lack of extensive studies on the safety and efficacy of hormone treatment and the possible negative mental and physical consequences. (American Nurses Association, 2023)
Discussions of the principles that conflict with opposing positions
The principle of autonomy and nonmaleficence conflict with each other. Although the principle of autonomy should respect the child’s decision concerning their treatment, the risk of exposing a child to the adverse side effects of hormone treatment is against the principle of nonmaleficence.
Discussion supported by scholarly sources
In the year 2022, a study led by Stanford showed better mental health among transgender individuals who received hormone treatment early than those who waited till they were 18 years old. Better mental health is due to undergoing successful adolescence with characteristics aligned with their gender identity (Digitale, 2022).
However, studies done by Chan Swe et al.,2022 show limited evidence from many studies to show the efficacy of the treatment since transgender girls taking gender hormones have a higher risk of developing cardiovascular complications like myocardial infarctions and ischemic stroke.
Self review
According to the discussion, giving gender assigning hormones to children has benefits like improving an individual’s mental health and promoting happy families. However, gender assigning hormones can have adverse health effects like increasing the risk of myocardial infarction, stroke, and weight gain, and psychological effects such as stigma and discrimination. Therefore this is a subject that needs further studies and should need thorough consideration.
References
American Nurses Association. (2023, February 17). Why Ethics in Nursing Matters: Ethical Principles in Nursing. ANA. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/why-ethics-in-nursing-matters/
Boerner, H. (2022, May 12). What the Science on Gender-Affirming Care for Transgender Kids Really Shows. Scientific American. https://www.scientificamerican.com/article/what-the-science-on-gender-affirming-care-for-transgender-kids-really-shows/
Digitale, E. (2022, January 12). Better mental health found among transgender people who started hormones as teens. News Center. https://med.stanford.edu/news/all-news/2022/01/mental-health-hormone-treatment-transgender-people.html
Handler, T., Hojilla, J. C., Varghese, R., Wellenstein, W., Satre, D. D., & Zaritsky, E. (2019). Trends in Referrals to a Pediatric Transgender Clinic. Pediatrics, 144(5), e20191368. https://doi.org/10.1542/peds.2019-136
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