The Way of Medicine: Ethics and the Healing Profession.

ence and, indeed, expertise. Medical uncertainty is often a reason to call for greater caution rather than offering more indiscriminate services. It is not clear why doctors ought to adopt a somewhat consumerist approach to trans medicine: aiming to give customers access to any medical interventions they ask for, despite the absence of robust evidence of benefit or clear conception of what is being treated. What would be the right moral course of action when it comes to adhering to good medical practice? On whose authority, when and why should doctors intervene when it comes to altering someone’s body based on how the patient identifies? There are tensions between how a clinician in trans medicine should meet the expectations of patients seeking medical interventions, and the norms of the medical profession itself: securing a diagnosis, treating that which is pathological not physiological, and seeking to minimize iatrogenic harm. More broadly, to what extent would medics risk reinforcing sex-linked social norms and stereotypes of behaviour, expectations and appearance – both when they deny such demands and when they agree to proceed? For example, cosmetic surgeons offering breast enlargements for females might be criticized for marketing and entrenching the idea that women should aspire to medically alter their secondary sex characteristics or unhappiness will ensue. If cosmetic surgery then becomes a social norm and many women elect to undergo surgical breast implantations, this can put pressure on others to follow suit. Yet, in trans medicine the same medical intervention of chest enhancement may be advertised to males who identify as women, meaning similar questions must arise around possible medical collusion with the social expectations of women and men. What is the proper role of medicine in this complicated space? One hopes Trans Medicine will inspire further work that explores such questions in closer detail.