Physicians should provide women considering abortion after Down syndrome screening with unbiased information and not attempt to influence their decision.

In referring transgender patients for medical transition, clinicians should be guided by harm reduction, respect for autonomy, and continuity of care.

Although patients’ medical gender transition can be facilitated by counseling, as a matter of medical ethics, informed consent must be obtained for treatment.

In treating children with autism, physicians should reframe the common dynamic in which the family wants medication that the doctor is withholding to focus instead on the family’s and physician’s share goal—the patient’s well-being.

Minors, including those with autism, have the right in certain states to make decisions about their own medical care provided they meet certain criteria. Even in cases in which the “mature minor exception” does not apply, physicians should actively engage patients in discussion of their treatment.

In treating children with autism, physicians should focus on involving parents in a shared decision making partnership and seeking safe, evidence-based, and medically and cost-effective treatments.

Diagnosing a child with borderline signs of Asperger disorder can be a gateway to needed interventions and services and also a label that stigmatizes or influences the child’s development.

Adolescents with gender dysphoria should be active participants in decisions about their gender-related health care.

Tension between realistic goals and unrealistic views about how to achieve them is compounded when patients are eager to revise a prior surgeon’s gender-affirming procedure.

This commentary on a case considers a transgender patient’s mental health and risk for DVT in ethical decision making about feminizing gender-affirming hormone therapy.