Dilemas éticos relacionados con la supresión de la pubertad

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María Guadalupe Grimaux
Gustavo Paez

Abstract




Pediatric gender dysphoria is a psychiatric pathology whose incidence has increased significantly. Several therapies have been proposed, but there is still no consensus on the behavior to follow in these cases. One of the suggested treatments is the suppression of puberty, whose ob- jective is to reduce the distress of the child suffering from this patholo- gy. However, this treatment has generated several ethical dilemmas that have not yet been resolved. For this reason, based on the current evidence, its indication does not seem prudent since there are other therapeutic alternatives that do not arouse controversy.




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How to Cite
Grimaux, M. G., & Paez, G. (2023). Dilemas éticos relacionados con la supresión de la pubertad. Medicina Y Ética, 34(1), 16–48. Retrieved from https://revistas.anahuac.mx/index.php/bioetica/article/view/2233
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References

American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders [Internet]. Médica Panamericana [consultado 21 noviembre de 2020]. Disponible en: https://www.eafit.edu.co/ninos/reddelaspreguntas/Docu- ments/dsm-iv-manual-diagnostico-estadistico-trastornos-mentales.pdf

Davy Z. The dsm-5 and the Politics of Diagnosing Transpeople. Arch Sex Behav. 2015; 44:1165-1176. https://doi.org/10.1007/s10508-015-0573-6

wpath. Standards of Care for the Health of Transsexual, Transgender, and Gen- der Nonconforming People [Internet] [consultado 21 de noviembre de 2020]. Disponible en: https://www.wpath.org/media/cms/Documents/SOC%20v7/Stan- dards%20of%20Care%20V7%20-%202011%20wpath.pdf?_t=1605186324

Zou Y, Szczesniak R, Teeters A, Conard L, Grossoehme D. Documenting an epi- demic of suffering: low health-related quality of life among transgender youth. Quality of Life Research. 2018; 27:2107-2115. https://doi.org/10.1007/s11136- 018-1839-y

Olson J, Garofalo R. The peripubertal gender-dysphoric child: puberty suppres- sion and treatment paradigms. Pediatr Ann. 2014; 43(6):e132-7. https://doi.org/ 10.3928/00904481-20140522-08

Zucker K. Epidemiology of gender dysphoria and transgender identity. Sex Health. 2017; 14(5):404-411. https://doi.org/10.1071/SH17067

Wallien M, Swaab H, Cohen-Kettenis P. Psychiatric comorbidity among children with gender identity disorder. J Am Acad Child Adolesc Psychiatry. 2007; 46(10):1307-1314. https://doi.org/10.1097/chi.0b013e3181373848

de Vries A, Noens I, Cohen P, van Berckelaer I, Doreleijers T. Autism spectrum disorders in gender dysphoric children and adolescents. J Autism Dev Disord. 2010; 40(8):930-6. https://doi.org/10.1007/s10803-010-0935-9

van der Miesen A, de Vries A, Steensma T, Hartman CA. Autistic Symptoms in Children and Adolescents with Gender Dysphoria. J Autism Dev Disord. 2018; 48(5):1537-1548. https://doi.org/10.1007/s10803-017-3417-5

Sevlever M, MeyerBahlburg H. LateOnset Transgender Identity Development of Adolescents in Psychotherapy for Mood and Anxiety Problems: Approach to As- sessment and Treatment. Arch Sex Behav. 2019; 48(7):1993-2001. https://doi. org/10.1007/s10508-018-1362-9

Tobin V, Bockting WO, Hughes T. Mental Health Promotion for Gender Minority Adolescents. J Psychosoc Nurs Ment Health Serv. 2018; 56(12):22-30. https://doi. org/10.3928/02793695-20180601-02

Zucker K, Wood H, Singh D, Bradley S. A developmental, biopsychosocial model for the treatment of children with gender identity disorder. J Homosex. 2012; 59(3):369-97. https://doi.org/10.1080/00918369.2012.653309

Cox P, Carrasco M. Disforia de género en niños y controversias en su tratamiento: dos concepciones distintas sobre la identidad de género. Pers Bioet. 2020; 24(1):57-76. https://doi.org/10.5294/pebi.2020.24.1.5

De Vries A, Cohen-Kettenis P. Clinical management of gender dysphoria in chil- dren and adolescents: The Dutch approach. J Homosex. 2012; 59(3):301-20. https://doi.org/10.1080/00918369.2012.653300

HartmanL,WiddershovenG,deVries,A.IntegrativeClinicalEthicsSupportinGen- der Affirmative Care: Lessons Learned. HEC Forum. 2019; 31:241-260. https://doi. org/10.1007/s10730-019-09376-6

APATaskForceonTreatmentofGenderIdentityDisorder.ReportoftheAPATask Force on Treatment of Gender Identity Disorder. Am J Psychiatry. 2012; 169:8. https://doi.org/10.1007/s10508-012-9975-x

SimonsL,LeibowitzS,HidalgoM.Understandinggendervarianceinchildrenand adolescents.PediatrAnn.2014;43(6):e126-e131.https://doi.org/10.3928/00904481- 20140522-07

Saleem F, Rizvi S. Transgender Associations and Possible Etiology: A Literature Review. Cureus. 2017; 9(12):e1984. https://doi.org/10.7759/cureus.1984

SimonsL,LeibowitzS,HidalgoM.Understandinggendervarianceinchildrenand adolescents. Pediatr Ann. 2014; 43(6):e126-31. https://doi.org/10.3928/00904481- 20140522-07

de Vries A, Steensma T, Doreleijers T, Cohen-Kettenis P. Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. J Sex Med. 2011; 8(8):2276-83. https://doi.org/10.1111/j.1743-6109.2010.01943.x

Ehrensaft D. From gender identity disorder to gender identity creativity: true gen- der self-child therapy. J Homosex. 2011; 59:337-56. https://doi.org/10.1080/0091 8369.2012.653303

JamesH,ChangA,ImhofR,SahooA,MontenegroM,ImhofN,GonzálezC,Lteif A, Nippoldt T, Davidge C. A community-based study of demographics, medical and psychiatric conditions, and gender dysphoria/incongruence treatment in transgender/gender diverse individuals. Biol Sex Differ. 2020; 11(1):55. https://doi. org/10.1186/s13293-020-00332-5

ButlerG,DeGraafN,WrenB,CarmichaelP.Assessmentandsupportofchildren and adolescents with gender dysphoria. Arch Dis Child. 2018; 103(7):631-636. https://doi.org/10.1136/archdischild-2018-314992

ButlerG,WrenB,CarmichaelP.Pubertyblockingingenderdysphoria:suitablefor all? Arch Dis Child. 2019; 104(6):509-510. https://doi.org/10.1136/archdis- child-2018-315984

LevitanN,BarkmannC,RichterH,SchulteM,BeckerI.Riskfactorsforpsycholo- gical functioning in German adolescents with gender dysphoria: poor peer rela- tions and general family functioning. Eur Child Adolesc Psychiatry. 2019; 28(11):1487-1498. https://doi.org/10.1007/s00787-019-01308-6

Day D, Saunders J, Matorin A. Gender Dysphoria and Suicidal Ideation: Clinical Observations from a Psychiatric Emergency Service. Cureus. 11(11):e6132. https:// doi.org/10.7759/cureus.6132

TempleJ,PyneJ,WintersK,FederS.Acriticalcommentaryonfollow-upstudies and “desistance” theories about transgender and gender non-conforming chil- dren. International Journal of Transgenderism. 2018; 19:2,212-224. https://doi. org/10.1080 / 15532739.2018.1456390

López J, González C. Valoración de la supresión de la pubertad en menores con problemas de identidad de género. Cuadernos de Bioética. 2018; 29(97):247-56. https://doi.org/10.0.30444/CB.9

TollitM,PaceC,TelferM.Whatarethehealthoutcomesoftransandgenderdiver- se young people in Australia? Study protocol for the Trans20 longitudinal cohort study. BMJ Open. 2019; 9:e032151. https://doi.org/10.1136/bmjopen-2019-032151

KreukelsB,CohenP.Pubertysuppressioningenderidentitydisorder:theAmster- dam experience. Nat Rev Endocrinol. 2011; 7(8):466-72. https://10.1038/nren- do.2011.78

JamesH,ChangA,ImhofR,SahooA,MontenegroM,ImhofN,GonzálezC,Lteif A, Nippoldt T, Davidge C. A community-based study of demographics, medical and psychiatric conditions, and gender dysphoria/incongruence treatment in transgender/gender diverse individuals. Biol Sex Differ. 2020; 11(1):55. https://doi. org/10.1186/s13293-020-00332-5

Costa R, Carmichael P, Colizzi M. To treat or not to treat: puberty suppression in childhood-onset gender dysphoria. Nat Rev Urol. 2016; 13(8):456-62. https://doi. org/10.1038/nrurol.2016.128

Hruz P, Mayer L, McHugh P. Growing Pains. Problems with Puberty Suppression in Treating Gender Dysphoria. The New Atlantis. 2017; 52:3-36. https://doi. org/10.1177/0024363919873762

Hernández R. Disforia de género infantil: Una reflexión ética a partir de la vulne- rabilidad, la responsabilidad y la beneficencia en Colombia. Revista Iberoameri- cana de Bioética. 2020; 12:01-12. https://doi.org/10.14422/rib.i12.y2020.009

Frith L. The concise argument: choice, choices and the choice agenda. J Med Ethics. 2022; 48(1):1-2. https://doi.org/10.1136/medethics-2021-108052

TurbanJ,KingD,CarswellJ,KeuroghlianA.PubertalSuppressionforTransgen- der Youth and Risk of Suicidal Ideation. Pediatrics. 2021; 147(4):e2020049767. https://doi.org/10.1542/peds.2020-049767