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Depathologising Gender: Vulnerability in Trans Health Law

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A Jurisprudence of the Body

Part of the book series: Palgrave Socio-Legal Studies ((PSLS))

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Abstract

This chapter challenges how gender has been positioned under the control of health professionals in the regulation of trans bodies. Trans people have formed complex relationships with health professionals, whose influence is often crucial in determining access to body modification treatments including hormones and surgeries. Having previously argued that this constitutes an overreach of medical jurisdiction, this chapter is more forward-looking, assessing the potential of a human right to depathologisation. After deciding that latent risks in this strategy might outweigh potential benefits, we propose an alternative agenda which understands trans bodies, and the institutions which regulate their access to health care, as vulnerable. This change of emphasis offers key insights which could benefit the activists and scholars engaged in the trans depathologisation movement.

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Notes

  1. 1.

    We use the term ‘trans’ here to refer to people who do not identify with the gender that they were assigned at birth and take active steps to make some form of social and/or medical transition away from that assigned gender.

  2. 2.

    Trans issues are not considered in most medical law textbooks, including Jackson (2016) and Brazier and Cave (2016). In Herring (2018), they are considered in relation to resource allocation.

  3. 3.

    The ECtHR has found that requiring sterilisation as a pre-condition for gender recognition violates Article 8 of the European Convention on Human Rights; AP, Garçon, and Nicot v France App nos 79885/12, 52471/13, and 52596/13 (ECtHR, 6 April 2017).

  4. 4.

    Even the Yogyakarta Principles constitute an example of non-binding, ‘soft’, law, as the UK Government Equalities Office (2016: 8–9) was keen to stress.

  5. 5.

    We are grateful to the anonymous reviewer for raising this point.

  6. 6.

    ‘Cis’ is an adjective used to refer to people who do not identify as trans.

  7. 7.

    The vast majority of trans-related body modification technologies were not originally developed for use on trans patients (Riggs et al. 2019). For example, phalloplasty was developed in the aftermath of the First World War to treat the victims of landmines (Schultheiss et al. 2005). The first total penis and scrotum transplant was recently performed on a veteran soldier who had suffered injury from an improvised explosive device while serving in Afghanistan (Nitkin 2018).

  8. 8.

    The duties of the now defunct Danish Health and Medicines Authority (DHMA) have been devolved to the Danish Patient Safety Authority and the Danish Medicines Agency. The new Danish Health Authority website only alludes to these scandals, noting ‘The purpose of the organisational change is to devote more attention to medicines licensing and to improve patient safety’; ‘The history of the Danish Health Authority’ Danish Health Authority, https://www.sst.dk/en/about-us/the-history-of-the-danish-health-authority

  9. 9.

    Two other scandals attracted more controversy in Danish media: one involving two psychiatrists, who appeared to be implicated in the deaths of several patients in spite of the DHMA being aware that they had both been subject to numerous complaints; and another concerning the unauthorised use of the drug Misoprostol to induce births in hospitals, resulting in a number of tragic deaths.

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  1. School of Law, University of Leeds, Leeds, UK

    Chris Dietz

  2. School of Sociology and Social Policy, University of Leeds, Leeds, UK

    Ruth Pearce

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  1. School of Law, University of Leeds, Leeds, UK

    Chris Dietz

  2. School of Law, University of Leeds, Leeds, UK

    Mitchell Travis

  3. School of Law, University of Leeds, Leeds, UK

    Michael Thomson

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Dietz, C., Pearce, R. (2020). Depathologising Gender: Vulnerability in Trans Health Law. In: Dietz, C., Travis, M., Thomson, M. (eds) A Jurisprudence of the Body. Palgrave Socio-Legal Studies. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-42200-4_8

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