Although patients’ medical gender transition can be facilitated by counseling, as a matter of medical ethics, informed consent must be obtained for treatment.
AMA J Ethics. 2016;18(11):1079-1085. doi:
10.1001/journalofethics.2016.18.11.ecas2-1611.
A physician in a university student health center may feel a duty to intervene when he finds out from a patient that a student who is not a patient is diverting medication, but doing so would violate patient confidentiality.
Particularly in a small community, patients may want to avoid the social stigma of seeking mental health care by receiving it from their primary care physician—who may know them well enough to have some insights an unfamiliar specialist would not.
Writing a case study of a psychiatric patient may change the patient-physician dynamic even if the patient consents to be written about. And when the patient is a minor and consent must involve her parents, the process becomes even more complicated.