Paternalistic Restrictions on Gender-Affirming Healthcare

Recently the UK and many US states have brought in policies and laws that limit or entirely prevent trans adults and/or trans youth’s access to gender-affirming healthcare. These restrictions on trans access to gender-affirming healthcare are justified on paternalistic grounds, that is, on the basis of the benefits to trans youth and trans adults of these restrictions. This paper argues that a state cannot permissibly limit trans people’s access to gender-affirming healthcare on paternalistic grounds. First, the paper constructs and defends a weak anti-paternalist principle (§2). Second, the paper argues that paternalistic restrictions on trans adults accessing gender-affirming healthcare that have been implemented in Florida, Missouri, and the UK fall afoul of this weak anti-paternalist principle (§3- 5). Finally, the paper discusses the bans on trans teenagers accessing puberty blockers that have been implemented by 25 US states and the UK. It argues that the combination of (a) extant accounts of when paternalistic restrictions on teenagers accessing X can be justified even though restrictions on adults accessing X cannot be justified and (b) the argument made in the rest of the paper implies that these paternalistic bans on trans teenagers accessing puberty blockers are impermissible.