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Fifth Annual Krug Conference Examines Issues Related to Medical Care of Transgender Children

More than 120 people participated in the 5e Annual Ernest and Sarah Krug Lecture in Biomedical Ethics to learn about issues related to the medical care of transgender children.

The event took place Oct. 12 at the Auburn Hills Marriott Pontiac with approximately 70 people attending virtually and the remainder in person.

The guest speaker was Timothy F. MurphyPh.D., Professor of Philosophy in Biomedical Sciences, University of Illinois College of Medicine.

His lecture was titled “Ethical Aspects of Body Modification in Minors for Gender Expression”.

“What I wanted to do was offer an advocacy for this practice of medicine to adolescent populations,” Murphy said after his talk.

Jason Wasserman, Ph.D., a professor in the Department of Basic Medical Studies, noted “there are a lot of people who are advocates in this space on one side or the other”, and described Murphy as a ” perfect fit” for the annual event.

“Good bioethics involves delving into complicated and controversial issues with rigor and thought,” he said. “I’m all for advocacy, but that’s not the same as deliberative analysis and that’s what we look for in Krug speakers. It’s hard to find on this topic.

“An indelible mark”

The annual event reflects the importance of medical humanities and clinical bioethics within the OUWB community.

Ernest F. Krug III, M.Div., MD, was instrumental in establishing this meaning through the OUWB program and values.

Before retiring, Krug served as director of the Beaumont Human Development Center and established Beaumont’s first clinical ethics consultation service. After joining the inaugural faculty of OUWB, he developed the longitudinal curriculum in Medical Humanities and Clinical Bioethics (MHCB).

The Krug Lecture in Biomedical Ethics is made possible by a generous donation from Ernest Krug and his wife, Sarah Krug. As a token of appreciation, Wasserman announced that OUWB was honoring Krug with a special inscribed chair reserved for “people who leave an indelible mark on medical school.”

Continuing that legacy, Wasserman said Murphy’s presentation is exactly the kind of thing the Krug conference was looking for.

“Important to hear these kinds of arguments”

During his lecture, Murphy identified:

  • Some contextual aspects of adolescent body modification for gender incongruence/dysphoria (GI/D);
  • The spectrum on which people modify their bodies for gender expression;
  • The characteristics of ethically justified treatment;
  • Challenges to adolescents’ decision-making capacity regarding modifications for GI/D;
  • The presumptive moral case for body modification treatment for adolescents with GI/D under certain conditions.
Left to right, Mark Navin, Ph.D., Abram Brummett, Ph.D., Jason Wasserman, Ph.D., Tim Murphy, Ph.D., and students from the Ethics Interest Group Executive Council biomedical Randy Hilleary, Corey Shafer, and Jessica Krone.

As Wasserman explained, Murphy “departs from a widely held premise in bioethics that people with decision-making capacity should, by virtue of their autonomy, make decisions about their own bodies.”

“(Murphy) then plays that premise into the issue of surgery for trans kids and draws conclusions about their rights,” Wasserman added. “Whether or not you agree with these findings, it’s important to hear these kinds of arguments.”

In just one example, Murphy noted how some challenge body modification for GI/D for teens based on potential effects. He pointed out how some argue that the practice can render a patient infertile; that some parts might change their minds halfway through the process (leaving them with unwanted body traits); and/or the practice could create a lifelong medical addiction.

Murphy responded by noting that infertility, inability to conceive, and childlessness are not necessary outcomes of intervention; that persistence can be a problem but not enough to disable the practice in its entirety; and that other types of interventions create lifelong medical dependence justified in the name of beneficial effects.

It was the kind of discussion that attendees said left them with a lot to think about.

“A lot of different opinions”

Amy Halder, M4, was among those who attended the event in person. As an undergrad, she had a class with Murphy and said the Krug lecture seemed very much in line with her approach to education.

“He would always present one idea, but then tell you a completely opposite idea to make you feel uncomfortable and challenge the students to deal with the sudden discomfort,” she said. “It was really good.”

Likewise, the topic of Murphy’s Krug lecture on the ethics of underage body modification for gender expression seemed to challenge the audience.

Michael Malian, MD, a general surgeon at Corewell Health Dearborn Hospital, said he thought it was important to attend the conference because he feels “somewhat skeptical that we should be doing this in a way very aggressive without knowing more”. He called forums like the Krug Conference a “good idea”.

“It’s good to talk about it,” he said. “There is a lot of uncertainty… (and) this should be explored at the medical school level. I’m glad I had the opportunity to come here and listen.

Jessica Krone, M2, said her biggest takeaway was that the subject “is very complex.”

“There are a lot of different opinions and considerations,” she said. “As future doctors, we need to be aware of all these different things to come to our own moral perspectives on this.”

“It’s going to be highly debated and that’s okay because it should be,” she said.

Randy Hilleary, M2, said the discussion reminded him, as a future doctor, to think about each patient individually.

“Each individual situation is very different,” he said. “As (Murphy) pointed out, it’s important to consider how fluctuating it can be, and that it’s not just a boundary between one thing and another. It’s a scale of each patient as an individual and I think that’s really important.

For more information, contact Andrew Dietderich, Marketing Writer, OUWB, at [email protected]

To request an interview, visit the OUWB Communications & Marketing Web page.

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