Justdad7 is another important information source to follow in Canada about the issues surrounding the unwarranted sterilization of children in the name of transgender ideology.

A Different Model of Care – justdad7’s Substack.

The major difficulty with the application of the mature minor doctrine in gender medicine is that the case law assumes that the minor is making decisions under the guidance of a doctor who is following the conventional medical model with clear diagnostic criteria and treatment goals. Practice in gender clinics is very different.

In the case of a disease like cancer, the diagnosis is usually confirmed by multiple objective tests including diagnostic imaging, laboratory tests and tissue biopsies. There are also objective measures of the effectiveness of treatments, such as shrinkage of the tumour. A doctor will recommend a treatment that is likely to cause sterility or other serious side effects only after making a firm diagnosis and concluding that the benefit of the treatment outweighs the risks.

In gender medicine, there is no known biological marker for transgender identity. The diagnosis of gender dysphoria under the DSM-5 depends entirely on self-reported symptoms which are largely tied to conformity to social stereotypes of male and female.

Furthermore, while a DSM-5 diagnosis may still be required in some places for insurance purposes, the WPATH SOC8 recommends relying in the ICD-11 diagnosis of Gender Incongruence. The definition of gender incongruence of childhood is similar to the DSM-5 diagnosis of gender dysphoria, but does not require the presence of distress. For older patients, the definition reads:

Gender incongruence of adolescence and adulthood is characterized by a marked and persistent incongruence between an individual´s experienced gender and the assigned sex, which often leads to a desire to ‘transition’, in order to live and be accepted as a person of the experienced gender, through hormonal treatment, surgery or other health care services to make the individual´s body align, as much as desired and to the extent possible, with the experienced gender. The diagnosis cannot be assigned prior the onset of puberty. Gender variant behaviour and preferences alone are not a basis for assigning the diagnosis.

The concept of ‘experienced gender’ is entirely subjective, with no possible test other than self-declaration. In other words, if a teenagers claim to have a transgender identity and wants medical transition badly enough, they should have it.

It is also difficult for a doctor to inform a patient of the prospects of success of a gender affirming treatment because there are no clear criteria for measuring success. The goal of transforming a body into one of the opposite sex is unobtainable but success might be measured in how close an approximation the treatment achieves.

However, patients seek to transform their bodies in the hope of relieving their mental distress. A good cosmetic result from a treatment is pointless if the patient still feels miserable and distressed by their body. The evidence that gender transition helps to improve mental health is low quality. Ultimately, the conventional measures of success are irrelevant to the new model of gender medicine where the “goals have shifted from reducing suffering to achieving personal ‘embodiment goals.’”

Informed consent in gender medicine therefore raises different issues from the conventional medical model. In conventional treatment, the minor’s decision making is being guided by a doctor who has made a diagnosis and determined that a treatment is in the patient’s best interest. In gender medicine, it is necessary to ask whether a minor should be entitled to proceed with risky and irreversible treatments based on a sense of personal identity which is unfalsifiable but may prove to be transitory.