RESUMO
This article reviews the design of a recently published randomized controlled trial (RCT) on immediate vs delayed access to gender-affirming hormones for transgender and gender-diverse (TGD) people and outlines key learning points that clinicians should know about how RCTs can and cannot contribute to advancing health equity for TGD people.
Assuntos
Equidade em Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Pessoas Transgênero , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto/ética , Feminino , Masculino , Projetos de Pesquisa , Medicina Baseada em Evidências , Assistência à Saúde Afirmativa de GêneroRESUMO
This commentary responds to Moti Gorin's article "What Is the Aim of Pediatric 'Gender-Affirming' Care?" We argue that Gorin's case against pediatric gender-affirming care rests upon numerous false conceptual binaries: female/male, public/private, objective/subjective, and medically necessary/elective. Drawing on feminist bioethics, we show how such dichotomous thinking is both inaccurate and marginalizing of gender minorities.
Assuntos
Feminismo , Humanos , Bioética , Feminino , Pessoas Transgênero , Masculino , Pediatria/ética , Minorias Sexuais e de Gênero , Identidade de Gênero , Assistência à Saúde Afirmativa de GêneroRESUMO
Gender-affirming care is almost exclusively discussed in connection with transgender medicine. However, this article argues that such care predominates among cisgender patients, people whose gender identity matches their sex assigned at birth. To advance this argument, we trace historical shifts in transgender medicine since the 1950s to identify central components of "gender-affirming care" that distinguish it from previous therapeutic models, such as "sex reassignment." Next, we sketch two historical cases-reconstructive mammoplasty and testicular implants-to show how cisgender patients offered justifications grounded in authenticity and gender affirmation that closely mirror rationales supporting gender-affirming care for transgender people. The comparison exposes significant disparities in contemporary health policy regarding care for cis and trans patients. We consider two possible objections to the analogy we draw, but ultimately argue that these disparities are rooted in "trans exceptionalism" that produces demonstrable harm..
Assuntos
Pessoas Transgênero , Transexualidade , Recém-Nascido , Humanos , Masculino , Feminino , Identidade de Gênero , Transexualidade/cirurgia , Atenção à SaúdeRESUMO
From the stress of burnout to the gratification of camaraderie, medicine is suffused with emotions that educators, administrators, and reformers have sought to shape. Yet historians of medicine have only begun to analyze how emotions have structured health care work. This introductory essay frames a special issue on health care practitioners' emotions in the twentieth-century United Kingdom and United States. We argue that the massive bureaucratic and scientific changes in medicine after the Second World War helped to reshape affective aspects of care. The articles in this issue emphasize the intersubjectivity of feelings in healthcare settings and the mutually constitutive relationship between patients' and providers' emotions. Bridging the history of medicine with the history of emotion demonstrates how emotions are instilled rather than innate, social as well as personal, and, above all else, change over time. The articles reckon with the power dynamics of healthcare. They address the policies and practices that institutions, organizations, and governments have implemented to shape, govern, or manage the affective experiences and well-being of healthcare workers. And they point to important new directions in the history of medicine.
Assuntos
Emoções , Instalações de Saúde , Humanos , Estados Unidos , Reino Unido , Política , Atenção à SaúdeRESUMO
A new infrastructure is urgently needed at the global level to facilitate exchange on key issues concerning genome editing. We advocate the establishment of a global observatory to serve as a center for international, interdisciplinary, and cosmopolitan reflection. This article is the first of a two-part series.
Assuntos
Temas Bioéticos , Edição de Genes/ética , Edição de Genes/legislação & jurisprudência , HumanosRESUMO
A new infrastructure is urgently needed at the global level to facilitate exchange on key issues concerning genome editing. We advocate the establishment of a global observatory to serve as a center for international, interdisciplinary, and cosmopolitan reflection. This article is the second of a two-part series.