Autonomy vs duty of care : ethical considerations in the management of gender dysphoria and gender reassignment surgery

Abstract

The management of gender dysphoria and gender reassignment surgery is typically centred around the principle of autonomy. This dissertation compares autonomy and duty of care perspectives in addressing these issues. Specifically, it investigates whether the predominantly autonomous stance currently underpinning transgender healthcare, legislation and politics serves the best interests of transgender populations or whether advocating a duty of care imperative is a preferrable alternative to transgender care. To test the hypothesis that a duty of care standard produces superior transgender health and wellbeing outcomes over an autonomy-based approach, a literature review that included a broad range of data on the subject was conducted. Special consideration was given to transgender healthcare, legislative and political contexts, and their engagement with autonomy and duty of care philosophies. The findings demonstrated that upholding a duty of care imperative in the confrontation of transgender issues is more conducive to the attainment of diligent transgender personal and socio-familial quality of life and welfare goals. These results imply that existing transgender healthcare, legislative and political practices are inadequately targeting transgender difficulties. On this basis, a radical transformation of pertaining policies reflecting duty of care precepts is solicited and specific actions for change are proposed.