Invisible persons, invisible patients: determining the ethics of hormone-blocker therapy through an understanding of the transgender/transsexual adolescent- physician relationship
Bibliographic record
Abstract
A new ethical medical dilemma concerns the use of hormone-blockers or medications that put puberty on hold in the care of transgender/transsexual (TG/TS) adolescents. These medications are taken until she is old enough to legally consent to cross-sex hormones. Such individuals are often "invisible" in clinical medicine because of a lack of knowledge and research concerning TG/TS. Using Emmanuel and Emmanuel's preferred decision-making patient-physician relationship, I critique clinical medicine's (1) inadequacy of clinical knowledge regarding TG/TS and hormone-blocker therapy, (2) misunderstanding of the health-related values of the TG/TS adolescent, and (3) lack of appreciation of her autonomy. Despite a problematic relationship, I argue that hormone-blockers are an ethical and viable option in TG/TS care and their use can be grounded through the ethical considerations of trust, privacy, and self-determination. Clinical guidelines are recommended through the incorporation of hormone-blocker therapy in the management of TG/TS adolescents. Such suggestions are in hopes of providing greater access to transgender care so that TG/TS adolescents are finally seen and no longer "invisible".
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.027 | 0.026 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.010 | 0.046 |
| Scholarly communication | 0.009 | 0.009 |
| Open science | 0.001 | 0.006 |
| Research integrity | 0.008 | 0.015 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".