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She'll put up the slides

  • Narrative ethics - learn morality from stories
  • Your ethics depend on your options (opportunities presenting to you) and your predispositions (own built-in morals)
  • Listen to patients and when you do this you'll need to change your conversation to follow what the patient responds with
  • Patient is your best teacher
  • Gender reassignment is more likely to end up in a girl because it's easier to cut things out than to rebuild things
  • Boy whose penis was burned off in circumcision: wikipedia:David Reimer
  • Genital development problems are more common than DS and CF combined
    • Because of this, many people are accidentally raised as the wrong gender
    • Therefore in the first 2 years of life, peoples' genders are determined by their environment/upbringing
  • This helps people who have developed with a small penis to be surgically reassigned to be a girl (we have a surgical solution because we have a psychological solution)
  • This guy was behind the idea that physical sex and psychological gender are separate
    • E.g. the twins case with David/Bruce, a normal boy who was made into a normal girl
  • Twins case + Money's ideas together made it more acceptable to perform surgery on children with unacceptable medication
  • Anatomical differences in the brain may indicate that boys and girls have different fundamental behaviours (no evidence for this)
  • But apparently David/Bruce then started living like a man. Didn't like living like a girl or playing with girl objects. During the first 14 years, he was unhappy living as a girl.
    • Original tale of the twins didn't really work - it was a lie. Brenda was no longer living as a female, but as a male.
  • Current medical approach:
    • Can give hormones to help girls who feel like boys become masculine
    • Hormones produce risks of cancer and make you infertile
  • Now intersex or transexual is not a medical or psychological emergency
  • Delay surgery as long as possible so the child can legally consent