Ethical issues in the mental health treatment of trans adolescents
With few exceptions (Mallon, 1999; Mallon and DeCrescenzo, 2006), there has been far less attention paid to transgender adolescents than to transgender adults. Yet these adolescents may be suffering from isolation, shame, rejection, school refusal, depression, and suicidality (Rubin, 2003). They may feel desperate enough to take hormones obtained on the street without prescription and without medical follow-up, or engage in selfmutilation in attempts to further their trans identification. These emotions and behaviors may bring them to the attention of mental health professionals and social service workers in a variety of settings. Significant issues may arise for the therapists if trans adolescents wish to cross-dress, use pronouns of the gender with which they feel most comfortable, and participate in activities as their desired gender rather than their biological sex. This engenders difficult ethical discussions among mental health professionals, and requires thoughtful interventions.