Shihani De Soysa Msc. C.A.M.H, CBT C&A AAC Senior Psychology Teacher and Counsellor

There’s a legal argument here which is obvious that children under the age of 18 cannot give consent to a medical procedure. There are exceptions to this in different countries where the child can be deemed Gillick competent where the court decides that the child can make a sound medical decision for themselves. When looking at gender reassignment now better known as gender affirming surgery, as a mental health practitioner, I feel the number one priority should be to ensure that the child is not made to feel like they are irrelevant in this process. Even if they are not able to give consent to a medical procedure, it’s crucial that they feel supported and heard through this journey which may or may not end in gender affirming surgery. But a sure way of assuring that a child makes a decision that you don’t want them to make, is to say they CANNOT do something. This will only create resentment and distance between parent and child, at a time where a child needs the parents the most. So instead of using language that asserts the parent’s authority and power over the child, using an approach that says, “I hear you and I understand, however, there are some things that we need to think about”, and using dialogue and open communication with the child might be the better way to deal with this. From all the chats I have had with students one of the main things they say when asked about what they wished parents did differently is, “I wish they just explained that to us.” Sometimes, keeping the lines of communication open is all it might take to avoid conflict. Once parent and child are on the same page, the process and what is in the child’s best interest becomes the focus and the right steps from seeking a mental health assessment in order to assess for gender dysphoria followed by right next steps all fall into place. Hence, in my opinion, the focus needs to be on the child. So, for an example, if it is in their best interest to have gender affirming surgery, and if the law does not allow it until they’re 18 years of age, then it is the responsibility of the adults in that child’s life to help them cope with the possible stressors that might come with that. Be in through counselling or support groups or being accepting in general.”