this post was submitted on 18 Nov 2024
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I agree with informed consent and bodily autonomy, that seems like a great ethical foundation - but one downside might be in not preventing harm done when people duped by mannosphere social media influencers pushing pseudo-science claims about testosterone ask their doctor for testosterone therapy. The clinical value of hormone therapy for trans individuals is well grounded in empirical research, but testosterone therapy for healthy, young cis-men is not based on clinical benefits.
There clearly needs to be some counter-measure to misinformation about testosterone therapy, this is not like trans healthcare.
The main hurdle to trans healthcare is simmiliar misinformation spread by those same type of manosphere or evangelical actors. Many will say that trans folk receiving care are simmiliarly brainwashed or misinformed. I don't see value in a 3rd party saying a patient is receiving care from a doctor for the" wrong" reasons.
Disinformation will always exist, especially among the general public. Which is the exact reason informed consent and a knowledgeable health professional explaining the risks is so important. It's not our place to say another is misguided in the persuit of reproductive or gender affirming care.
Of course a third party can claim a trans patient is seeking care for the wrong reasons, or that their care is actually harmful, etc. - but we have to remember that we can still parse claims and test them against reality.
Doctors have a moral and legal obligation to practice evidence-based medicine, and they should not take seriously pseudo-science fad treatments that are contrary to the well-being of the patient. It is their place to deny a patient such a treatment.
That said, because transphobia in our society has resulted in gatekeeping and withholding gender-affirming care from trans patients for so long (including my own care!), it is hard for me not to agree with you: the patient should be free to make choices about their body. I believe hormones should be accessible over the counter, without a required prescription.
But again, this rights-based approach and desire for radically free access to hormones has downsides, namely the harm done if there isn't anything done to mitigate something like this testosterone therapy fad.
I think we agree that one solution is that a doctor can provide informed consent, but I think this is too much responsibility on doctors to combat misinformation campaigns. As a society we are having to come to terms with how destructive misinformation can be, and what needs to be done to combat it. I actually have no idea how to best solve this, even if I can see that it is naive to expect a single visit with a doctor to deprogram an incel from their ideology or adequately protect them from starting a needless and harmful treatment.