title: Ethical conflicts over the management of transsexual adolescents--report of two cases.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
authors: Department of Psychiatry of ABC Medical School, Santo André-São Paulo, Brazil. dbaltieri@uol.com.br
authors: Danilo Antonio
authors: DA
authors: Baltieri
authors: Fernanda Cestaro
authors: FC
authors: Prado Cortez
authors: Arthur Guerra
authors: AG
authors: de Andrade
mesh_terms: D000293:Adolescent; D004992:Ethics, Medical; D005260:Female; D005783:Gender Identity; D012739:Gonadal Steroid Hormones / Q000627:therapeutic use; D006801:Humans; D008297:Male; D016079:Refusal to Treat / Q000941:ethics; D011477:Sex Work; D014189:Transsexualism / Q000523:psychology / Q000628:therapy*
chemical_list: D012739:Gonadal Steroid Hormones