CASE REPORTS: Ethical Conflicts over the Management of Transsexual Adolescents—Report of Two Cases

Authors

  • Danilo Antonio Baltieri MD, PhD,

    Corresponding author
    1. Department of Psychiatry of ABC Medical School, Santo André—São Paulo, Brazil;
    2. Interdisciplinary Group of Studies on Alcohol and Drugs of the Psychiatric Institute of the Clinical Hospital—Faculty of Medicine—University of São Paulo, Brazil;
    3. Penitentiary Counseling of the State of São Paulo, Brazil
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  • Fernanda Cestaro Prado Cortez MD,

    1. Department of Psychiatry of ABC Medical School, Santo André—São Paulo, Brazil;
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  • Arthur Guerra De Andrade MD, PhD

    1. Department of Psychiatry of ABC Medical School, Santo André—São Paulo, Brazil;
    2. Interdisciplinary Group of Studies on Alcohol and Drugs of the Psychiatric Institute of the Clinical Hospital—Faculty of Medicine—University of São Paulo, Brazil;
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  • Ambulatory for the Treatment of Sexual Disorders of ABC Medical School—Santo André—São Paulo, Brazil.

Danilo Antonio Baltieri, MD, PhD, Rua Dr. Melo Alves, n° 110. Conjunto 01. São Paulo—S.P. CEP: 01417-010. Brazil. Tel: +55-11-3082-0649; Fax: +55-11-3082-0649; E-mail: dbaltieri@uol.com.br

ABSTRACT

Introduction.  The diagnosis and the treatment of transsexualism, particularly during adolescence, generate considerable discussion among specialists. Many health and legal professionals have not yet reached a strong consensus on medical treatment for juvenile transsexuals. Hormonal therapy cannot only represent a medical procedure to adjust the somatic sex to the psychological gender, but can also be a reasonable means of preventing some juvenile transsexuals from engaging in undesirable and risky behavior.

Aim.  To report the cases of two transsexual adolescents who resorted to prostitution to afford hormonal medications when treatment was denied because of age criteria.

Results.  Hormonal medications were not recommended by the endocrinology staff because specific laws regulating this medical procedure for juvenile transsexuals in Brazil are lacking. In response, these adolescents chose to use illegally obtained sex hormones to treat themselves.

Conclusions.  We propose “harm reduction” as a means of coping with this dilemma in some cases. Baltieri DA, Cortez FCP, and de Andrade AG. Ethical conflicts over the management of transsexual adolescents—report of two cases. J Sex Med 2009;6:3214–3220.

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