Vatican Advisor Offers Limited Support for Puberty Blockers Aiding Transgender Youth

A Vatican advisor has suggested that puberty blockers for transgender and gender non-conforming youth may be permissible in certain limited circumstances if youth are at risk of self-harm.

Laura Palazzani, a member of the Pontifical Academy for Life and a philosophy of law professor at Lumsa Universtiy, Rome, spoke to Vatican News about developments in Italian healthcare regarding the drug Triptorelin. The drug is primarily used for treating cancer, but is also used “off label” to suppress the effects of puberty for youth roughly ages ten to twelve.

Asked by the interviewer about the ethical questions involved with treating a child who has so-called gender dysphoria, Palazzani responded:

“Aware of the gravity of the issue and the scarcity of available scientific literature, [the National Committee for Bioethics] suggested allowing use of this drug only in very circumscribed cases, with prudence, with a case by case assessment.”

She suggested this treatment could occur”when we are in the presence of the profound suffering of children with psychopathologies and who are at risk of self-injurious behavior or attempting suicide, and who are always under the vigilant monitoring of a multi-specialist team, composed of endocrinologists, developmental psychiatrists, psychologists as well as ethicists and experts. Treatment should be administered only for a short period of time, in order to overcome any serious risks and find the most appropriate forms of accompaniment for the child.”

Palazzani explained how she understands the complexities of gender dysphoria, acknowledging that children who from a young age are persistently gender non-conforming will most likely gender transition at an older age. She added to her comments:

“The drug allows, in the cases outlined, to open a time window and help the diagnosis, but above all to prevent the children, who see their body developing in the direction they do not want – because of gender dysphoria – to avoid irreversible acts such as, as mentioned, self-harm or suicide or even forms of self-medication with drugs bought online and without medical supervision.”

Finally, Palazzani emphasized the need to obtain consent from a minor, which can sometimes be difficult given their age and that they need to be well-informed on the issues at hand.

Questions about how to treat gender non-conforming youth are indeed complicated given the medical, psychological, ethical, and legal issues raised. Disagreement exists even among transgender-positive experts and providers about what appropriate treatments may be. To this point, most Church officials have refused to engage transgender issues with any of this complexity, relying instead on abstract and dated ideas about sex and gender. Only a few leaders, like England’s Monsignor Keith Barltrop, have suggested the Church should support people who transition genders.

But Palazzani’s approach, while perhaps not the ideal for transgender advocates, shows that a Catholic approach to gender identity issues can be more nuanced and can evolve according to the latest knowledge. Employing puberty blockers at  least for young people who are at risk of self-harm clearly upholds Church teachings on the value of life and dignity of each person. Officials at the Pontifical Academy for Life (as well as beyond) should follow their advisor’s lead by engaging the complexities of gender with more informed minds and more pastoral hearts.

—Robert Shine, New Ways Ministry, June 6, 2019