Table 70-14 Bioethical issues in transgender health care

"Do no harm" imperative applies to providing or withholding somatic treatments on case-by-case basis
Concern about providing somatic treatments for a psychiatric condition
Religious and moral concerns regarding somatic treatments
Lack of confidence in providing specialized gender care
Performing sex reassignment surgery on "healthy" organs
Lack of well-designed, controlled studies of treatment options
Role of bloodborne pathogens (human immunodeficiency virus [HIV], hepatitis C, etc.) in treatment planning
Definition of "medical necessity" as applied to gender identity disorder
Level of care for incarcerated persons with gender identity disorder
Role of passive suicidality in those who have been denied - or cannot access - transgender health care