Case study on Nurse practitioner course: Gender reassignment surgery



A 27-year- old genetic man presents to your clinic wearing women’s clothing. He tells you that from a very young age he has believed he was born with the wrong assigned gender. He also reports that he is most comfortable living life as a woman and that he has done so for the past 6 months. This patient also reports that he is ready for the next step in the process of becoming a woman. He is requesting to be started on female hormones to gain more feminine physical qualities.


Read the following case study and answer the following questions in a narrative format:


Q 1) What are the potential ethical issues for yourself and the patient?






Centuries back gender change was considered just a fairy dream by all. But nowadays, medical science has made it possible. This type of therapy is known as Gender reassignment surgery (GReS), and is benevolence for those who are suffering from Gender identity disorders since their childhood.


The present case is one of those. It is important to note that Kantian autonomy and utilitarian reasoning has always been in favor of this changing gender approach.


Answer 1.


Ethical issues


The first and the foremost issue is ‘health’. Health is related to physical disorders in medical terminology. The given case seems to be a case of transsexuality; which has been dubbed as a psychiatric disorder; in psychiatric disorders surgeries are not permitted


The nurse’ primary responsibility is to refer the case to a senior doctor or a team of doctors who will decide whether gender change is permissible or not.


Sometimes it is simply a mind-body imbalance. In such a case, it is known as a psychiatric disorder. DSM-IV has also confirmed to the same. One important thing to know that according to WHO recommendations, surgery should be done only if it brings benefit to the patient medically. But in GReS, there is actually no medical benefit incurred to the patient. The benefit is only physical.


Apart from the above, sometimes changing the healthy genitals results in procreative insufficiency for the patient in future; this is not at all permitted on medical grounds. It is scrupulously wrong for a physician to remove healthy, functional genitals under all circumstances.




What are the unknowns? List all the subjective and objective data you need.