Ethical conflicts over the management of transsexual adolescents--report of two cases.
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.
Baltieri
Danilo Antonio
DA
Department of Psychiatry of ABC Medical School, Santo André-São Paulo, Brazil. dbaltieri@uol.com.br
Prado Cortez
Fernanda Cestaro
FC
de Andrade
Arthur Guerra
AG
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*
D012739:Gonadal Steroid Hormones