Evidence map›Paper›PMID 34330798›Full record

ArticleJournal of medical ethics2021

To be, or not to be? The role of the unconscious in transgender transitioning: identity, autonomy and well-being.

Alessandra Lemma, Julian Savulescu

Abstract read
In one paragraph

Article in Journal of medical ethics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Psychodynamic psychotherapy for gender dysphoria is not conversion therapy.Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent · 2024
    Article
  6. Gender detransition: A critical review of the literature.Actas espanolas de psiquiatria · 2023
    Article
  7. Interrogating Gender-Exploratory Therapy.Perspectives on psychological science : a journal of the Association for Psychological Science · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Alessandra LemmaVisiting Professor, Psychoanalysis Unit, University College London, London, UK.
Julian SavulescuFaculty of Philosophy, University of Oxford, Oxford, UK julian.savulescu@philosophy.ox.ac.uk.ORCID http://orcid.org/0000-0003-1691-6403

Funding

Wellcome Trust
6 · The paper itself

Abstract

The exponential rise in transgender self-identification invites consideration of what constitutes an ethical response to transgender individuals' claims about how best to promote their well-being. In this paper, we argue that 'accepting' a claim to medical transitioning in order to promote well-being would be in the person's best interests iff at the point of request the individual is correct in their self-diagnosis as transgender (i.e., the distress felt to reside in the body does not result from another psychological and/or societal problem) such that the medical interventions they are seeking will help them to realise their preferences. If we cannot assume this-and we suggest that we have reasonable grounds to question an unqualified acceptance in some cases-then 'acceptance' potentially works against best interests. We propose a distinction between 'acceptance' and respectful, in-depth exploration of an individual's claims about what promotes their well-being. We discuss the ethical relevance of the unconscious mind to considerations of autonomy and consent in working with transgender individuals. An inquisitive stance, we suggest, supports autonomous choice about how to realise an embodied form that sustains well-being by allowing the individual to consider both conscious and unconscious factors shaping wishes and values, hence choices.

Indexed as

autonomychildrenconcept of healthethicssexuality/gender

Identifiers

PMID34330798
PMCPMC9811073

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.