Paternalistic Restrictions on Gender-Affirming Health Care
Bibliographic record
Abstract
Recently the UK and many US states have brought in policies and laws that limit or entirely prevent access to gender-affirming health care for trans adults and/or trans youth. These restrictions on trans access to gender-affirming care are justified on paternalistic grounds; that is, on the basis of the benefits to trans youth and trans adults of these restrictions. This paper argues that a state cannot permissibly limit trans people’s access to gender-affirming health care on paternalistic grounds. First, the paper constructs and defends a weak antipaternalist principle (§2). Second, the paper argues that paternalistic restrictions on trans adults accessing gender-affirming care that have been implemented in Florida, Missouri, and the UK fall afoul of this weak antipaternalist principle (§3–5). Finally, the paper discusses the bans on trans teenagers accessing puberty blockers that have been implemented by the UK and twenty-five US states. It argues that the combination of (a) extant accounts of when paternalistic restrictions on teenagers accessing X can be justified even though restrictions on adults accessing X cannot be justified and (b) the argument made in the rest of the paper implies that these paternalistic bans on trans teenagers accessing puberty blockers are impermissible.
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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 | 0.011 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.005 | 0.024 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.003 | 0.008 |
| Insufficient payload (model declined to judge) | 0.003 | 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".