Edward Stein

Commentary on the Treatment of Gender Variant and Gender Dysphoric Children and Adolescents: Common Themes and Ethical Reflections

This commentary offers preliminary ethical reflections on the range of treatments for gender variant and gender dysphoric children, adolescents, and young adults described in the preceding five clinical articles. After clarifying the terminology used to discuss these issues, this commentary reviews several common themes of the clinical articles. Focusing on ethical values of informed consent, full disclosure, the minimization or avoidance of harm, and the maximization of life options, the commentary expresses concerns about various treatment options endorsed by some of the articles. In particular, this commentary focuses on how these practices problematically reproduce social prejudices and stereotypes and how they fail to acknowledge and embrace the multiple pathways for expressing ones gender. It also compares and contrasts the ethical issues related to gender variant and gender dysphoric youths and youths who identify as lesbian, gay, bisexual, or queer.

Choosing the Sexual Orientation of Children

Many people believe that a person’s sexual orientation is genetic. Given the widespread prejudice against, and hatred of, lesbians, gay men, and bisexuals in many societies, it seems likely that many parents will be interested in using genetic technologies to prevent the birth of children who will not be heterosexual. This paper considers the moral and legal implications of such procedures, whether or not they would work. It is argued that the availability of procedures to select the sexual orientation of children would contribute to discrimination and prejudice against lesbians, gay men and bisexuals and, more generally, undermine the maintenance of a just society. These effects carry significant weight in determining whether genetic technologies should be developed and whether their use is, or should be, legally permissible and morally acceptable.

Effects of Barium Chloride on Resting and Action Potentials of Ventricular Fibers of the Frog

By means of an intracellular capillary electrode the effects of barium chloride on the resting and action potentials of ventricular fibers of the frog were recorded in hearts with circulation intact and hearts isolated and perfused. The changes were essentially similar in both preparations. The major change observed was a statistically significant (p <0.01) increase in duration of the action potential. Changes were also observed in the magnitude of the resting and action potential, in the rate of depolarization, and in rhythm, but these did not occur invariably. By a series of exclusion experiments it was demonstrated that barium has a direct effect on the ventricular fibers of the frogs heart.

THE ACTION OF IODOACETATE ON THE ELECTRICAL AND MECHANICAL ACTIVITIES OF THE ISOLATED PERFUSED FROG HEART

The use of enzyme inhibitors on cardiac tissue has permitted a better understanding of the relationship between derangements of metabolism and function. The metabolic and physiologic actions of iodoacetate (IAA) have been reported by a number of investigators (1-4). In low concentrations IAA has been show n to act as a specific inhibitor of triosephosphate dehydrogenase therebv blocking the glv coly tic process (5, 6). This is in contrast to its reported action as a general sulfhvdrvl inhibitor when relatively higher concentrations are employed (6, 7). Studies with C14 labeled pyruvate (8) have show-n that the addition of 10-3 and 10-i M IAA reduces the pyruvate utilizationi (66 per cent) in heart slices w-ithout affecting oxygen consumiption wN-hereas greater amounts depress both oxygen consuml)tion and pyruvate disappearance. Earlier studies oIn the physiological effects of IAA have demiionstrated a (lepression of contractility and spontaneous rate of isolated rabbit and frog auricles (2, 3). In a recent study on the isolated rabbit auricle Gardner. Wilson, and Farah (4) reported that IAA produced far greater effects on contractility and spontaneouis rate than on the excitability or the actioin potential. They predicate(l the differences in 1miechanical and electrical behavior on a differenice in the energy requirements of these functions. They believe the IAAsensitive functions (such as rhythmicity and contractility) require a greater amount of energy than the IAA-insensitive functions (electrical excitability and action potential) and therefore are affected earlier. In further support of this ex-

Ethical Implications of Scientific Research on the Causes of Sexual Orientation

In this article, we evaluate the status of current biological research into sexual orientation and examine the relevance of such research on the legal and social status of gay men and lesbians. We begin with a review of hormonal, neuroanatomical and genetic studies of sexual orientation. We argue that the scientific study of sexual orientation is, at best, still in its infancy. We turn then to the ethical and social implications of this research. We argue that even if scientists could explain how sexual orientation develops, no significant ethical conclusions would follow. Further, we suggest that the current emphasis on finding a biological basis for sexual orientation is potentially harmful to lesbians, gay men and other sexual minorities in various ways (although perhaps it is in some ways potentially helpful as well).

Past and Present Proposed Amendments to the United States Constitution Regarding Marriage

Proposals to amend the Constitution to prohibit same-sex marriages were recently actively discussed in the U.S. Senate and are likely to receive attention in the House before the year’s end. This article situates arguments for these proposals within the history of attempts to amend the Constitution related to marriage by providing the first detailed, synthetic analysis of such previously proposed amendments. This examination reveals 133 previously proposed amendments to the Constitution relating to marriage, consisting primarily of proposals to prohibit interracial marriage, proposals to prohibit polygamy, and proposals to empower Congress to make uniform laws concerning marriage and divorce. By tracing the arguments made in support of these amendments, this article reveals a strong resonance between prior attempts to constitutionalize aspects of the institution of marriage and current proposed amendments. The article also argues that, in hindsight, the previously proposed amendments were not necessary because state and federal legislatures and courts were able to address problems relating to marriage without amending the Constitution and without destabilizing the delicate balance of power between states and the federal government. Against this background, the article concludes that current proposals to amend the Constitution are similarly neither necessary nor wise.

Reply to Martha Nussbaum and Ian Hacking

The author responds to Nussbaum’s (21(3) Law & Phil. 317-334) and Hacking’s (id. at 335-347) discussions of his book, The Mismeasure of Desire: The Science, Theory, and Ethics of Sexual Orientation (1999). Among other points, he addresses whether sexual orientations are natural human kinds, clarifying his position that there is no connection between that question and the legal and ethical issues about homosexuality. In addition, he assesses Nussbaum’s proposal for a sophisticated version of the “born that way” argument and sets forth some better possible arguments for gay and lesbian rights, suggesting a fusion of privacy and equality-based arguments.

Rationality and Reflective Equilibrium

Cohen (1981) and others have made an interesting argument for the thesis that humans are rational: normative principles of reasoning and actual human reasoning ability cannot diverge because both are determined by the same process involving our intuitions about what constitutes good reasoning as a starting point. Perhaps the most sophisticated version of this argument sees reflective equilibrium as the process that determines both what the norms of reasoning are and what actual cognitive competence is. In this essay, I will evaluate both the general argument that humans are rational and the reflective equilibrium argument for the same thesis. While I find both accounts initially appealing, I will argue that neither successfully establishes that humans are rational.

Ethical, Legal, Social, and Political Implications of Scientific Research on Sexual Orientation

Scientific research on the causes of sexual orientation has captured the attention of many Americans. Some researchers, citing evidence from neuroscience, genetics, and psychology, claim that sexual orientation is either inborn or fixed at an early age. Many lesbians, gay men, bisexuals, and their allies have welcomed this claim, finding in it confirmation of their sense that they did not choose to be attracted to people of the same sex. Some parents of lesbians and gay men have also found solace in such research, finding in it assurance that nothing they did made their children homosexual. Furthermore, some lawyers, activists, politicians, religious leaders, scientists, and psychologists have tried to parlay this research into good news for lesbian and gay rights. Their main argument, which I call the “born that way” argument, goes as follows: If sexual orientations are innate, genetic, firmly rooted in biology, and/or not chosen, it is wrong to criminalize the sexual behavior of lesbians, gay men, and bisexuals, to discriminate against them, and to withhold from them benefits that heterosexuals take for granted. This argument has intuitive appeal and is deployed with increasing frequency.

Can We Be Justified in Believing that Humans are Irrational

In this paper, the author considers an argument against the thesis that humans are irrational in the sense that we reason according to principles that differ from those we ought to follow. The argument begins by noting that if humans are irrational, we should not trust the results of our reasoning processes. If we are justified in believing that humans are irrational, then, since this belief results from a reasoning process, we should not accept this belief. The claim that humans are irrational is, thus, self-undermining. The author shows that this argument and others like it fail for several interesting reasons. In fact, there is nothing self-undermining about the claim that humans are irrational; empirical research to establish this claim does not face the sorts of a priori problems that some philosophers and psychologists have claimed it does.