# Pubertal Suppression for Transgender Youth: A Right to an Open Future Approach in Support of a Youth-Empowered Legal Framework

## TL;DR

This paper argues that transgender youth should have the autonomy to decide about puberty suppression to protect their future options and well-being.

## Contribution

The paper applies Joel Feinberg’s 'right to an open future' theory to justify youth autonomy in transgender medical decisions.

## Key findings

- Puberty suppression decisions should be youth-empowered to preserve future options.
- Feinberg’s theory supports autonomy in transgender care to protect mental and physical health.
- Current legal frameworks often overlook the philosophical basis for youth decision-making in transgender care.

## Abstract

Irreversible alterations to the form and function of youths’ physical bodies before sexual maturity, and particularly, the potential foreclosure of youths’ fertility options via long-term puberty suppression, is a reason oft-raised in resistance to the provision of puberty blockers (PBs) for minors. Despite the pervasiveness of such assertions by lawmakers and other authorities, the concept of the foreclosure of transgender youths’ future has been subject to surprisingly little philosophical scrutiny in bioethical literature. Joel Feinberg’s “right to an open future” theory provides a foundation for other discussions about childcare decision-making, such as the choice to raise children in a particular religion or to foster their musical talents over their sporting ones. However, relatively fewer attempts have been made to apply Joel Feinberg’s “right to an open future” theory to paediatric transgender medical decision-making. In this article, I consider the relevance of Feinberg’s theory to the context of pubertal suppression for transgender youth and advance in this article reasons why transgender youth should be allowed to make their own decisions about the commencement of puberty suppression to a maximally feasible degree, in order to safeguard their physical health, mental health, autonomy, and capacity for future self-fulfilment.