Ethical concerns have been raised about routine practice in paediatric gender clinics. We discuss informed consent and the risk of iatrogenesis in the prescribing of gonadotropin-releasing hormone analogues (GnRHas) and cross sex hormones to children and adolescents respectively. We place those clinical concerns in a wider societal context and invite consideration of two further relevant ethical domains: competing rights-based claims about male and female personhood; and freedom of expression about those claims. When reflecting on the assessment and medicalization of children and adolescents presenting at gender clinics, the matters of informed consent and iatrogenic risk should be the most pressing for clinicians. However, this is not just a matter of medical ethics, it also implies the need for a full ethical debate on competing notions of personhood and the defence of freedom of expression about transgender and its implications within contemporary democracies.

中文翻译：

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儿童和青少年的GnRHa（“富裕阻止者”）和性激素：知情同意，人格和表达自由

在儿科性别诊所的常规做法引起了伦理关注。我们讨论了促性腺激素释放激素类似物（GnRHas）和性交激素分别针对儿童和青少年的处方中的知情同意和医源性风险。我们将这些临床关注点放在更广泛的社会环境中，并请考虑另外两个相关的伦理学领域：基于竞争的基于权利的关于男女性的主张；关于这些主张的表达自由。当反思在性别诊所就诊的儿童和青少年的评估和医疗时，知情同意和医源性风险问题应该是临床医生最紧迫的问题。但是，这不只是医学伦理问题，