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Case/Article Review 10

You have two minutes to read the enclosed article, and you will subsequently be asked a range of questions by the interviewer. You may wish to make notes, however please note you will not be allowed to refer to your notes or the article during the discussion.

A watchdog is threatening NHS England with legal action if it does not begin offering fertility treatments to transgender patients as standard. Transitioning can lead to fertility loss, but many patients are not offered a chance to have eggs or sperm stored. The Equality and Human Rights Commission said this is "outdated" discrimination as patients with other conditions routinely get that option.

NHS England says it is a matter for government ministers to decide upon. According to the EHRC, the decision on who should be offered the extraction and storage of eggs and sperm - known as gamete extraction and storage - falls to individual Clinical Commissioning Groups (CCGs). "But many choose not to [offer this service]" to transgender patients, the watchdog said.

The EHRC sent a pre-action letter to NHS England on Friday, which it said was the first step towards a judicial review, and asked them to make gamete extraction and storage available to anyone having treatment for gender dysphoria. The NHS defines gender dysphoria as a condition where a person experiences discomfort or distress because there is a mismatch between their biological sex and gender identity. Rebecca Hilsenrath, chief executive of the EHRC, said: "Our laws and our values protect those who seek treatment for gender dysphoria. "This means that where appropriate, treatment should be made available in order to ensure that access to health services is free of discrimination. "A choice between treatment for gender dysphoria and the chance to start a family is not a real choice."

She added: "We have asked NHS England to reflect on the true breadth of their statutory mandate and the impact on the transgender community of these outdated policies."

 
(Adapted from: https://www.bbc.co.uk/news/health-45073576)
 
  Outline the main issues raised.

Average Candidate Response
This article discussed whether transgender patients should be offered fertility treatment, especially as transitioning often leads to fertility loss.
​
Excellent Candidate Response
The principal issue highlighted in this article is whether fertility treatment should be provided to transgender patients; currently, such treatment is not made available to these individuals.

When discussing the case against offering this care, the article says that a potential cost of the treatment is fertility loss. Therefore, it could be argued that in order to ensure the principle of non-maleficence is abided, it would be advisable to mitigate such a risk and prohibit this practice, to protect the patient from harm.

Despite this, it must be considered that any patient with capacity has the right to make their own decision regarding their healthcare; to respect their autonomy, they should be given information about all forms of treatment before coming to a conclusion. Furthermore, denying such treatment to transgender patients may cause emotional distress. This therapy would be provided to those suffering from gender dysphoria, a condition that can cause extreme discomfort, hence to impede it could go against the duty of clinicians to act in the best interests of their patients.

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