Dilemas éticos relacionados con la supresión de la pubertad

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María Guadalupe Grimaux
Gustavo Paez

Resumen




La disforia de género pediátrica es una patología psiquiátrica cuya inci- dencia ha crecido significativamente. Se han propuesto diversas tera- pias, pero aún no hay consenso sobre la conducta a seguir en estos casos. Uno de los tratamientos sugeridos es la supresión de la puber- tad, cuyo objetivo es el de disminuir la angustia del niño que padece esta patología. Sin embargo, este tratamiento ha generado diversos di- lemas éticos que todavía no han sido despejados. Por este motivo, ba- sándonos en la evidencia actual, no parece prudente su indicación exis- tiendo otras alternativas terapéuticas que no despiertan controversias.




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Grimaux, M. G., & Paez, G. (2023). Dilemas éticos relacionados con la supresión de la pubertad. Medicina Y Ética, 34(1), 16–48. Recuperado a partir de https://publicaciones.anahuac.mx/index.php/bioetica/article/view/2233
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Artículos

Citas

American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders [Internet]. Médica Panamericana [consultado 21 noviembre de 2020]. Disponible en: https://www.eafit.edu.co/ninos/reddelaspreguntas/Docu- ments/dsm-iv-manual-diagnostico-estadistico-trastornos-mentales.pdf

Davy Z. The dsm-5 and the Politics of Diagnosing Transpeople. Arch Sex Behav. 2015; 44:1165-1176. https://doi.org/10.1007/s10508-015-0573-6

wpath. Standards of Care for the Health of Transsexual, Transgender, and Gen- der Nonconforming People [Internet] [consultado 21 de noviembre de 2020]. Disponible en: https://www.wpath.org/media/cms/Documents/SOC%20v7/Stan- dards%20of%20Care%20V7%20-%202011%20wpath.pdf?_t=1605186324

Zou Y, Szczesniak R, Teeters A, Conard L, Grossoehme D. Documenting an epi- demic of suffering: low health-related quality of life among transgender youth. Quality of Life Research. 2018; 27:2107-2115. https://doi.org/10.1007/s11136- 018-1839-y

Olson J, Garofalo R. The peripubertal gender-dysphoric child: puberty suppres- sion and treatment paradigms. Pediatr Ann. 2014; 43(6):e132-7. https://doi.org/ 10.3928/00904481-20140522-08

Zucker K. Epidemiology of gender dysphoria and transgender identity. Sex Health. 2017; 14(5):404-411. https://doi.org/10.1071/SH17067

Wallien M, Swaab H, Cohen-Kettenis P. Psychiatric comorbidity among children with gender identity disorder. J Am Acad Child Adolesc Psychiatry. 2007; 46(10):1307-1314. https://doi.org/10.1097/chi.0b013e3181373848

de Vries A, Noens I, Cohen P, van Berckelaer I, Doreleijers T. Autism spectrum disorders in gender dysphoric children and adolescents. J Autism Dev Disord. 2010; 40(8):930-6. https://doi.org/10.1007/s10803-010-0935-9

van der Miesen A, de Vries A, Steensma T, Hartman CA. Autistic Symptoms in Children and Adolescents with Gender Dysphoria. J Autism Dev Disord. 2018; 48(5):1537-1548. https://doi.org/10.1007/s10803-017-3417-5

Sevlever M, MeyerBahlburg H. LateOnset Transgender Identity Development of Adolescents in Psychotherapy for Mood and Anxiety Problems: Approach to As- sessment and Treatment. Arch Sex Behav. 2019; 48(7):1993-2001. https://doi. org/10.1007/s10508-018-1362-9

Tobin V, Bockting WO, Hughes T. Mental Health Promotion for Gender Minority Adolescents. J Psychosoc Nurs Ment Health Serv. 2018; 56(12):22-30. https://doi. org/10.3928/02793695-20180601-02

Zucker K, Wood H, Singh D, Bradley S. A developmental, biopsychosocial model for the treatment of children with gender identity disorder. J Homosex. 2012; 59(3):369-97. https://doi.org/10.1080/00918369.2012.653309

Cox P, Carrasco M. Disforia de género en niños y controversias en su tratamiento: dos concepciones distintas sobre la identidad de género. Pers Bioet. 2020; 24(1):57-76. https://doi.org/10.5294/pebi.2020.24.1.5

De Vries A, Cohen-Kettenis P. Clinical management of gender dysphoria in chil- dren and adolescents: The Dutch approach. J Homosex. 2012; 59(3):301-20. https://doi.org/10.1080/00918369.2012.653300

HartmanL,WiddershovenG,deVries,A.IntegrativeClinicalEthicsSupportinGen- der Affirmative Care: Lessons Learned. HEC Forum. 2019; 31:241-260. https://doi. org/10.1007/s10730-019-09376-6

APATaskForceonTreatmentofGenderIdentityDisorder.ReportoftheAPATask Force on Treatment of Gender Identity Disorder. Am J Psychiatry. 2012; 169:8. https://doi.org/10.1007/s10508-012-9975-x

SimonsL,LeibowitzS,HidalgoM.Understandinggendervarianceinchildrenand adolescents.PediatrAnn.2014;43(6):e126-e131.https://doi.org/10.3928/00904481- 20140522-07

Saleem F, Rizvi S. Transgender Associations and Possible Etiology: A Literature Review. Cureus. 2017; 9(12):e1984. https://doi.org/10.7759/cureus.1984

SimonsL,LeibowitzS,HidalgoM.Understandinggendervarianceinchildrenand adolescents. Pediatr Ann. 2014; 43(6):e126-31. https://doi.org/10.3928/00904481- 20140522-07

de Vries A, Steensma T, Doreleijers T, Cohen-Kettenis P. Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. J Sex Med. 2011; 8(8):2276-83. https://doi.org/10.1111/j.1743-6109.2010.01943.x

Ehrensaft D. From gender identity disorder to gender identity creativity: true gen- der self-child therapy. J Homosex. 2011; 59:337-56. https://doi.org/10.1080/0091 8369.2012.653303

JamesH,ChangA,ImhofR,SahooA,MontenegroM,ImhofN,GonzálezC,Lteif A, Nippoldt T, Davidge C. A community-based study of demographics, medical and psychiatric conditions, and gender dysphoria/incongruence treatment in transgender/gender diverse individuals. Biol Sex Differ. 2020; 11(1):55. https://doi. org/10.1186/s13293-020-00332-5

ButlerG,DeGraafN,WrenB,CarmichaelP.Assessmentandsupportofchildren and adolescents with gender dysphoria. Arch Dis Child. 2018; 103(7):631-636. https://doi.org/10.1136/archdischild-2018-314992

ButlerG,WrenB,CarmichaelP.Pubertyblockingingenderdysphoria:suitablefor all? Arch Dis Child. 2019; 104(6):509-510. https://doi.org/10.1136/archdis- child-2018-315984

LevitanN,BarkmannC,RichterH,SchulteM,BeckerI.Riskfactorsforpsycholo- gical functioning in German adolescents with gender dysphoria: poor peer rela- tions and general family functioning. Eur Child Adolesc Psychiatry. 2019; 28(11):1487-1498. https://doi.org/10.1007/s00787-019-01308-6

Day D, Saunders J, Matorin A. Gender Dysphoria and Suicidal Ideation: Clinical Observations from a Psychiatric Emergency Service. Cureus. 11(11):e6132. https:// doi.org/10.7759/cureus.6132

TempleJ,PyneJ,WintersK,FederS.Acriticalcommentaryonfollow-upstudies and “desistance” theories about transgender and gender non-conforming chil- dren. International Journal of Transgenderism. 2018; 19:2,212-224. https://doi. org/10.1080 / 15532739.2018.1456390

López J, González C. Valoración de la supresión de la pubertad en menores con problemas de identidad de género. Cuadernos de Bioética. 2018; 29(97):247-56. https://doi.org/10.0.30444/CB.9

TollitM,PaceC,TelferM.Whatarethehealthoutcomesoftransandgenderdiver- se young people in Australia? Study protocol for the Trans20 longitudinal cohort study. BMJ Open. 2019; 9:e032151. https://doi.org/10.1136/bmjopen-2019-032151

KreukelsB,CohenP.Pubertysuppressioningenderidentitydisorder:theAmster- dam experience. Nat Rev Endocrinol. 2011; 7(8):466-72. https://10.1038/nren- do.2011.78

JamesH,ChangA,ImhofR,SahooA,MontenegroM,ImhofN,GonzálezC,Lteif A, Nippoldt T, Davidge C. A community-based study of demographics, medical and psychiatric conditions, and gender dysphoria/incongruence treatment in transgender/gender diverse individuals. Biol Sex Differ. 2020; 11(1):55. https://doi. org/10.1186/s13293-020-00332-5

Costa R, Carmichael P, Colizzi M. To treat or not to treat: puberty suppression in childhood-onset gender dysphoria. Nat Rev Urol. 2016; 13(8):456-62. https://doi. org/10.1038/nrurol.2016.128

Hruz P, Mayer L, McHugh P. Growing Pains. Problems with Puberty Suppression in Treating Gender Dysphoria. The New Atlantis. 2017; 52:3-36. https://doi. org/10.1177/0024363919873762

Hernández R. Disforia de género infantil: Una reflexión ética a partir de la vulne- rabilidad, la responsabilidad y la beneficencia en Colombia. Revista Iberoameri- cana de Bioética. 2020; 12:01-12. https://doi.org/10.14422/rib.i12.y2020.009

Frith L. The concise argument: choice, choices and the choice agenda. J Med Ethics. 2022; 48(1):1-2. https://doi.org/10.1136/medethics-2021-108052

TurbanJ,KingD,CarswellJ,KeuroghlianA.PubertalSuppressionforTransgen- der Youth and Risk of Suicidal Ideation. Pediatrics. 2021; 147(4):e2020049767. https://doi.org/10.1542/peds.2020-049767