Hormone replacement therapy: informed consent without assessment?

Florence Ashley has argued that requiring patients with gender dysphoria to undergo an assessment and referral from a mental health professional before undergoing hormone replacement therapy (HRT) is unethical and may represent an unconscious hostility towards transgender people. We respond, first,...

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Bibliographic Details
Authors: Saad, C. (Author) ; Blackshaw, Bruce Philip (Author) ; Rodger, Daniel (Author)
Format: Electronic Article
Language:English
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Published: BMJ Publ. 2019
In: Journal of medical ethics
Year: 2019, Volume: 45, Issue: 12, Pages: 824-825
Online Access: Presumably Free Access
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520 |a Florence Ashley has argued that requiring patients with gender dysphoria to undergo an assessment and referral from a mental health professional before undergoing hormone replacement therapy (HRT) is unethical and may represent an unconscious hostility towards transgender people. We respond, first, by showing that Ashley has conflated the self-reporting of symptoms with self-diagnosis, and that this is not consistent with the standard model of informed consent to medical treatment. Second, we note that the model of informed consent involved in cosmetic surgery resembles the model Ashley defends, and that psychological assessment and referral is recognised as an important aspect of such a model. Third, we suggest that the increased prevalence of psychiatric morbidity in the transgender population arguably supports the requirement of assessment and referral from a mental health professional prior to undergoing HRT. 
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