Transgender healthcare faces a dilemma. On the one hand, access to certain medical interventions, including hormone treatments or surgeries, where desired, may be beneficial or even vital for some gender dysphoric trans people. But on the other hand, access to medical interventions typically requires a diagnosis, which, in turn, seems to imply the existence of a pathological state—something that many transgender people reject as a false and stigmatizing characterization of their experience or identity. In this paper we argue that developments (...) from the human enhancement debate can help clarify or resolve some of the conceptual and ethical entanglements arising from the apparent conflict between seeking medicine while not necessarily suffering from a pathology or disorder. Specifically, we focus on the welfarist account of human enhancement and argue it can provide a useful conceptual framework for thinking about some of the more contentious disagreements about access to transgender healthcare services. (shrink)

Issues pertaining to sex and gender continue to be some of the most hotly debated topics of our time. While many of the most heated disputes occur at the level of politics and public policy, metaphysics, too, has a crucial role to play in these debates. In this essay, I explore several key metaphysical debates concerning sex and gender through the lenses of two important areas in contemporary metaphysics: the metaphysics of essence and the ontology of the human person. The (...) goal here is not to advocate any particular position on these issues, but to show how the tools of contemporary metaphysics can help to offer a more comprehensive map of the conceptual terrain, indicating where major areas of agreement can be found and where the most important disagreements really lie. (shrink)

Volume 19, Issue 6, June 2019, Page W10-W15.

In this article, we analyse the novel case of Phoenix, a non-binary adult requesting ongoing puberty suppression to permanently prevent the development of secondary sex characteristics, as a way of affirming their gender identity. We argue that the aim of OPS is consistent with the proper goals of medicine to promote well-being, and therefore could ethically be offered to non-binary adults in principle; there are additional equity-based reasons to offer OPS to non-binary adults as a group; and the ethical defensibility (...) of facilitating individual requests for OPS from non-binary adults also depends on other relevant considerations, including the balance of potential benefits over harms for that specific patient, and whether the patient’s request is substantially autonomous. Although the broadly principlist ethical approach we take can be used to analyse other cases of non-binary adults requesting OPS apart from the case we evaluate, we highlight that the outcome will necessarily depend on the individual’s context and values. However, such clinical provision of OPS should ideally be within the context of a properly designed research study with long-term follow-up and open publication of results. (shrink)

Trans theory is characterized in part by the apparent tension between discursive analyses of cisgender society and phenomenological descriptions of trans experiences. While traditional inquiry into the history of philosophy proposes an interminable opposition between phenomenology and discourse analysis, Rubin’s alternative suggestion is that within the domain of trans studies that they fulfill complimentary dimensions of investigation. Discourse analysis and phenomenology converge in trans studies because they are submitted to the same ethical and political imperative: the systematic development of the (...) trans archive. Both discourse analysis and phenomenology as methods in trans studies are directed toward the development of a genuinely trans history, perspective, and theory, with special methodological consideration toward the way that this perspective is misunderstood or obscured by dominant frameworks within cisgender society. In what follows, I provide a brief reconstruction of two major interventions in trans phenomenology, demonstrating that each is carefully concerned with distinctly archival considerations, but I further argue that each project remains incomplete because of an incomplete bracketing of medicalized cisgender concepts. I then propose a brief alternative program aimed at the full suspension of cisgender categories that I call transgender existentialism. (shrink)