THE RIGHT TO BE WRONG - MILTON DIAMOND, PH.D. & HAZEL GLENN BEH, PH.D., J.D

Sex and Gender Decisions
1. INTRODUCTION
A series of events occurred within a very short period and prompted consideration of the ethical dimensions of how, when, and
why individuals, institutions or governments decide to get involved in people’s lives. In particular we began to question if they
should get involved with allowing, or not allowing, people to make major decisions regarding their own bodies. This is an essay
reflecting such thoughts. It involves consideration of two tenets of medical practice: Relieve pain and suffering; and First, do no
harm.
In order of occurrence, the events started when we were considering a legal case involving a 13-year-old female.’ Alex, as the
judge sitting on the case called her, had successfully argued in an Australian court that, in accordance with her wishes, she could
live as a male and obtain the necessary medical help to achieve this. This means Alex, from that time on, will be getting
hormones to prevent typical female puberty and at the age of sixteen years will receive androgenic hormones to virilize bodily
and facial features. At the age of eighteen Alex will be eligible to obtain a hysterectomy and ovariectomy to stop any menses and
feminization, and eventually to have a phallus constructed if he so wishes. The appropriate legal and professional psychological
and medical experts, consulted prior to the decision, have made these recommendations Religious and other factions, however,
immediately challenged the decision. They complained Alex was too young to make such a choice, that the procedures would
lead to later regret, and most crucially, would end Alex’s ability to have children. 2
The second instance involved a legal suit brought against a gender clinic by someone who had surgically and socially
transitioned from living as a male to living as a female. Alan Finch, at the age of twenty-one had applied to the clinic for help
with a desire for sex reassignment surgery (SRS). Therapists at the clinic vetted Mr. Jones’s situation and approved of the
transition. Surgeons subsequently removed his penis and testicles and in their stead fashioned a vulva and vagina. After living as a
woman for eight years Mr. Finch decided it had been a mistake and now feels he should never have been allowed to transition
and he ought to live as a man.3 Mr. Finch blames the psychiatrists who counselled him and is suing the clinic at which they
worked. Although he admits to having lied to the therapists during his meetings
[EditorS. Systma] (ed.), [Intersex & Ethics], I—li. In Press
© 2005 Kiuwer Academic Publishers. Printed in the Netherlands.

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