In her revealing new book, Carrie Hull employs examples from biology, anthropology and psychology to illustrate and endorse the progressive ideals of post structuralism while demonstrating the superiority of a realist account of sex and sexuality.

Transgender children who are not treated for their condition are at high risk of violence and suicide. As a matter of survival, many are willing to take whatever help is available, even if this is offered by illegal sources, and this often traps them into the juvenile criminal system and exposes them to various threats. Endocrinology offers a revolutionary instrument to help children /adolescents with gender identity disorder: suspension of puberty. Suspension of puberty raises many ethical issues, and experts dissent (...) as to when treatment should be commenced and how children should be followed up. This paper argues that suspension of puberty is not only not unethical: if it is likely to improve the child’s quality of life and even save his or her life, then it is indeed unethical to defer treatment. (shrink)

ABSTRACTRecently an acrimonious debate has emerged about transgenderism. Trans-activists defending the full spectrum of the latter have advocated a form of identity politics based upon individual self-definition. However, gender-critical feminists have disputed the legitimacy of these bids for self-determination, especially when considering men who are claiming to be women. These contrasting positions are examined and their political implications explored. The focus of the paper is on the intransitive aspects of sex and the transitive aspects of gender. The former, with rare (...) exceptions, is a binary whereas the latter is open to social negotiation and variation. The article argues that the gender-critical position is broadly aligned with critical realist philosophy, though the counter view is represented in order to clarify this point of reflection. It ends with a discussion of the ‘trans debate’ and the public policy development emerging in its wake. (shrink)

This book explores the ethical dilemma clinicians may face when disclosing a diagnosis of atypical sex. The moment of disclosure reveals an epistemic incompatibility between scientific fact and social meaning in relation to sex. Attempting to assess the bio-psychosocial implications of this dilemma highlights a complex historic antagonism between fact and meaning making satisfactory resolution of this dilemma difficult. Drawing on David Hume, WVO Quine and Michel Foucault the author presents an integrative model, which views scientific fact and social meaning (...) as codetermining threads in one fabric of knowledge. From this epistemic perspective, the ethical dilemma is understood as a tear in the fabric signifying a rupturing of ontological integrity. To mend this tear and resolve the ethical dilemma three metaphysical perspectives are considered: essentialism, naturalism and emergentism. The book’s unique features include: an exploration of the impact of diagnostic disclosure on people with atypical sex ; a synthesis of the epistemic perspectives of social and natural science facilitating interdisciplinary collaboration; a critical evaluation of three metaphysical perspectives on atypical sex ; the application of Hume’s epistemological and moral distinctions to contemporary biomedicine and bioethics. The book’s target audience includes academics, students and professionals whose work intersects the natural and social sciences, and individuals interested in the metaphysics, epistemology and meta-ethics of sex. (shrink)

What do the terms sex and gender identity, or gender history, mean in a medical context? When does it matter to a healthcare professional whether a patient has male or female reproductive biology?...

Although informed consent models for prescribing hormone replacement therapy are becoming increasingly prevalent, many physicians continue to require an assessment and referral letter from a mental health professional prior to prescription. Drawing on personal and communal experience, the author argues that assessment and referral requirements are dehumanising and unethical, foregrounding the ways in which these requirements evidence a mistrust of trans people, suppress the diversity of their experiences and sustain an unjustified double standard in contrast to other forms of clinical (...) care. Physicians should abandon this unethical requirement in favour of an informed consent approach to transgender care. (shrink)