The Objective Model is Our Duty’s proposed approach for dealing with transgender ideation, particularly in adolescents.
This model is under development, and we would particularly welcome input from qualified professionals and clinicians so that it might become a robust alternative to the ‘gender affirmative’ model.
Our Duty calls for the treatment of transgender ideation in adolescents to be entirely objective.
It is generally unethical for health-care professionals to purport to treat anything that
is not a disorder, and they are compelled by the “do no harm” principle not to offer
treatments that are recognized as ineffective or purport to achieve unattainable results.
It is the obvious, the facts, that have to drive medical practice. Yes, evidence is needed when there is doubt. However, when there is no doubt, and when time is of the essence we need to be objective.
Transgender ideation (the term we give to the condition when people decide they are transgender, non-binary, or the opposite sex), is a purely subjective condition – it is a feeling.
It might well be a deeply held feeling, and we would never wish to discriminate against those living by these ideas. However, their ideas cannot be substantiated with any medical diagnostic. It is a symptom of deep unease, just as is suicidal ideation. For some, it is just a social identity (like being a punk rocker or a goth). These feelings can arise from typical feelings of adolescent angst and/or teenage rebellion.
The ‘gender affirming model’ is one where a young person’s ‘gender identity’ is affirmed and the young person is put on a medical pathway usually consisting of Opposite Sex Imitation treatments such as wrong-sex hormones and removal of sexual organs.
The ‘cautious approach’ argues for more care and exploration in the diagnosis of gender dysphoria but includes provision that Opposite Sex Imitation might be an appropriate palliative course for some. This approach is also called “watchful waiting“.
Both the ‘gender affirming model’ and the ‘cautious approach’ can result in young people being treated with medical interventions that are not in their best interests. Furthermore, such interventions are experimental and it is highly unlikely that truly informed consent can be given. As such, Opposite Sex Imitation Treatments are not proper medicine.
“if it ain’t broke don’t fix it”
The Objective Model relies entirely on scientific evidence. However, it takes the view that the obvious, the trite facts, are sufficient to drive ethical practice. Fundamentally, it rests on the fact that if there is nothing medically wrong with a person’s body then there is no need to alter it.
While there is no evidence that the ‘gender affirming model’ is appropriate, then the precautionary principle must lead us to reject it. It is a medical experiment, and one with permanent often catastrophic results.
Adolescents who think of themselves as non-binary, transgender, or even just the opposite sex to reality, need help. This help must be holistic, exploratory and psychotherapeutic. There is absolutely no reason to administer medicine or surgery to a healthy body.
Basic Endocrinology:
- Puberty blockers are not indicated for pubescent transgender ideation.
- Masculinizing hormones are not indicated for female transgender ideation.
- Feminizing hormones are not indicated for male transgender ideation.
‘Gender Identity Clinics’
It is a mistake to have gender identity clinics. Transgender ideation is a maladaptive coping mechanism, just like suicidal ideation. We do not usher adolescents with suicidal ideation into suicide clinics.
“You can resolve to live your life with integrity. Let your credo be this: Let the lie come into the world, let it even triumph. But not through me.”
— Aleksandr Solzhenitsyn
Background Reading
Articles that support an objective approach and/or call for the targeting of 100% desistance.
gender dysphoria: it’s a disorder; and to state the obvious, our goal should always be to alleviate disorder, not to deepen it.
https://dredles.substack.com/p/breaking-news-a-doctor-does-his-duty