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

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.

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Publication Details

Journal
Journal of Bioethical Inquiry
Published
2025-11-20
DOI
https://doi.org/10.1007/s11673-025-10493-w
Primary Topic
LGBTQ Health, Identity, and Policy
Type
article
Field-Weighted Citation Impact
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article

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

Richard Lee
Journal of Bioethical Inquiry
LGBTQ Health, Identity, and Policy
article

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

Richard Lee
article en

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.

Journal of Bioethical InquiryVol. 22(4)
Imperial College London (GB)
Openalex Percentile: Top 60%
LGBTQ Health, Identity, and Policy
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Pubertal Suppression for Transgender Youth: A Right to an Open Future Approach in Support of a Youth-Empowered Legal Framework — Richard Lee · Journal of Bioethical Inquiry (2025) | TGRS Research Map | TGRS