Importance of being persistent. Should transgender children be allowed to transition socially?

Journal of Medical Ethics 45 (10):654-661 (2019)


Studies suggest that the majority of gender diverse children revert to the gender congruent with the sex assigned at birth when they reach puberty. These children are now known in the literature as ‘desisters’. Those who continue in the path of gender transition are known as ‘persisters’. Based on the high desistence rates, some advise being cautious in allowing young children to present in their affirmed gender. The worry is that social transition may make it difficult for children to de-transition and thus increase the odds of later unnecessary medical transition. If this is true, allowing social transition may result in an outright violation of one of the most fundamental moral imperatives that doctors have: first do no harm. This paper suggests that this is not the case. Studies on desistence should inform clinical decisions but not in the way summarised here. There is no evidence that social transition per se leads to unnecessary medical transition; so should a child persist, those who have enabled social transition should not be held responsible for unnecessary bodily harm. Social transition should be viewed as a tool to find out what is the right trajectory for the particular child. Desistence is one possible outcome. A clinician or parent who has supported social transition for a child who later desists will have not violated, but acted in respect of the moral principle of non-maleficence, if the choice made appeared likely to minimise the child’s overall suffering and to maximise overall the child’s welfare at the time it was made.

Download options


    Upload a copy of this work     Papers currently archived: 72,855

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library


Added to PP

26 (#444,301)

6 months
4 (#162,565)

Historical graph of downloads
How can I increase my downloads?

Citations of this work

No citations found.

Add more citations

Similar books and articles

B-Time Transition.Clifford Williams - 1998 - Philosophical Inquiry 20 (3-4):59-63.
Changement social et mouvements sociaux.Lun Zhang - 2007 - Cahiers Internationaux de Sociologie 122 (1):7.
Transition From Man.Cardwell Lee Sheridan - 2008 - Bennett & Hastings.
Relationships Among the Transition Elements.Geoff Rayner-Canham - 2011 - Foundations of Chemistry 13 (3):223-232.
Moving Beyond Mismatch.Robin Dembroff - 2019 - American Journal of Bioethics 19 (2):60-63.