Background: Transgender health care is a subject of much debate among clinicians, political commentators, and policy-makers. While the World Professional Association of Transgender Health (WPATH) Standards of Care (SOC) establish clinical standards, these standards contain implied ethics but lack explicit focused discussion of ethical considerations in providing care. An ethics chapter in the SOC would enhance clinical guidelines. Aims: We aim to provide a valuable guide for healthcare professionals, and anyone interested in the ethical aspects of clinical support for gender (...) diverse and transgender people of all ages. Recognizing that the WPATH is a global association, we address broad challenges. We offer a reflection on general ethical principles, providing conceptual tools for healthcare providers, patients, and families to navigate the specific challenges they might encounter in transgender health care, in line with WPATH’s worldwide mission and scope. Method: This article employs a descriptive analysis, and our framework of reference is the four principles of biomedical ethics: respect for autonomy, beneficence, nonmaleficence, and justice. Results: The article presents a discussion on the four ethical principles as applied to transgender health care. We address issues such as respect for patient autonomy in decision-making, the role of beneficence and nonmaleficence in clinical interventions, and the importance of justice in equitable treatment and access to care. Some of the ethical concerns we address in this article pertain to the current sociopolitical climate, where there has been increasing legal interference, internationally, for transgender and nonbinary people, particularly youth, seeking medical care. Discussion: We highlight the interplay between ethical principles and clinical practice, underscoring the need for ethical guidance in addressing the diverse challenges faced by healthcare providers and patients in transgender health care. We advocate for continuous refinement of ethical thinking to ensure that transgender health care is not only medically effective but also ethically sound. (shrink)

One puzzling feature of Plato’s Republic is the First City or ‘city of pigs’. Socrates praises the First City as a “true”, “healthy” city, yet Plato abandons it with little explanation. I argue that the problem is not a political failing, as most previous readings have proposed: the First City is a viable political arrangement, where one can live a deeply Socratic lifestyle. But the First City has a psychological corollary, that the soul is simple rather than tripartite. Plato sees (...) this ‘First Soul’ as an inaccurate model of moral psychology, and so rejects it, along with its political analogue. (shrink)

The comprehension of anaphoric relations may be guided not only by discourse, but also syntactic information. In the literature on online processing, however, the focus has been on audible pronouns and descriptions whose reference is resolved mainly on the former. This paper examines one relation that both lacks overt exponence, and relies almost exclusively on syntax for its resolution: adjunct control, or the dependency between the null subject of a non-finite adjunct and its antecedent in sentences such as Mickey talked (...) to Minnie before ___ eating. Using visual world eyetracking, we compare the time course of interpreting this null subject and overt pronouns (Mickey talked to Minnie before he ate). We show that when control structures are highly frequent, listeners are just as quick to resolve reference in either case. When control structures are less frequent, reference resolution based on structural information still occurs upon hearing the non-finite verb, but more slowly, especially when unaided by structural and referential predictions. This may be due to increased difficulty in recognizing that a referential dependency is necessary. These results indicate that in at least some contexts, referential expressions whose resolution depends on very different sources of information can be resolved approximately equally rapidly, and that the speed of interpretation is largely independent of whether or not the dependency is cued by an overt referring expression. (shrink)