The First Stage of Medical Treatment

Abstract The first stage of medical treatment involves the decision about whether or not to prescribe GnRHa in order to interrupt pubertal development. This chapter provides a brief history of the controversies around puberty suppression and begins to outline and examine the ethical and clinical concerns around provision of this therapy. It offers clarification around the stage in which medical treatment can commence and the eligibility criteria. The main ethical concerns are: suspending puberty is playing God and interfering with nature; gender dysphoria is a social problem, not a medical problem; GnRHa has unknown risks; GnRHA is not reversible treatment; GnRHA is experimental; minors lack capacity to make decisions around their gender. This chapter discusses the first two ethical concerns: medical treatment is playing God, or interfering with a spontaneous natural process, and it is using medicine to address a social problem.