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  • 1.
    Diamond, Milton
    et al.
    University of Hawaii, John A. Burns School of Medicine.
    Garland, Jameson
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Juridiska fakulteten, Juridiska institutionen.
    Evidence regarding cosmetic and medically unnecessary surgery on infants2014Inngår i: Journal of Pediatric Urology, ISSN 1477-5131, E-ISSN 1873-4898, Vol. 10, nr 1, 2-6 s.Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    The Journal of Pediatric Urology has recently published several articles from the Annecy (France) Working Party on DSD. We question several of the presented findings and recommendations. In two key articles summarizing their review, the authors concluded that identified studies are not representative and suffer from methodological weaknesses, such that they "lack the necessary detail to base further recommendations". In a third article, the Working Party reported that the science supporting early surgery is "scanty", and that "no studies" support the belief that gender variant children require early genital surgery. Nevertheless, the Working Party warned that without long-term research, "if no effort is made, we will be left, in the next generation, to continue making the same judgment, based on 'experience' and 'expert opinion' ". None of the studies cited in the articles support such assertions as we read them. We maintain that reviewed evidence suggests a moratorium on early surgical intervention is imperative for children with differences in sex development, and that the best ethical and scientific considerations require that gender surgery should be delayed until the child can consent. We further present evidence that UN and case law presently under way in the USA support such a moratorium.

  • 2.
    Garland, Jameson
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Juridiska fakulteten, Juridiska institutionen.
    On Science, Law, and Medicine: The case of gender-“normalizing” interventions on children who are diagnosed as different in sex development2016Doktoravhandling, monografi (Annet vitenskapelig)
    Abstract [en]

    For the last six decades in Sweden and the US, surgical and other medical interventions have been utilized to reconstruct and “normalize” children  diagnosed as different in their sex development. Under traditional treatment protocols, clinicians chose an “optimal” gender for the children and used different procedures to give them a typical appearance for that gender – aspiring to support them psychologically – and to facilitate penile-vaginal intercourse. Because these treatments have involved reconstructive surgery and other measures, they risk genital dysfunction, loss of sensitivity, loss of fertility, and the risk that the gender assigned will be wrong for the child.

    Since the 1990s, expert practitioners have acknowledged that the evidentiary support for the safety and benefits of these procedures for young children is low, relative to later in life. Indeed, they have described the need for evidence has been described as “urgent”, with a “crisis in clinical management”. As of 2016, there appears to be no consensus among expert-practitioners on the timing and nature of these interventions, not only because of the invasive and irreversible nature of the procedures, but also because the gender identity of the children cannot be predicted with certainty. Human rights authorities have also called on nations to stop the procedures. Since 2013, eight such organizations have done so – three from the United Nations, two each from the Council of Europe and European Union, and most recently, the Organization of American States. To date, only three nations – Colombia, Malta, and Chile – have taken formal action in this regard.

    This study begins with the proposition that the issues involved raise critical questions about the limits of science, law, and medicine. Specifically, it is a study of medical law in Sweden and the US, to explore how the regulation of medicine might permit or restrict these procedures. It also places medical law in its broader context in relation to critical perspectives on rights related to gender and children. The study attempts to address the question of how law and medicine together determine what happens to the affected children, and what the studied treatments say about medicine, law, and the boundaries of science.

  • 3. Garland, Jameson
    Sex as a Form of Gender and Expression after Lawrence v. Texas2006Inngår i: Columbia Journal of Gender and Law, Vol. 15, 297-324 s.Artikkel i tidsskrift (Annet vitenskapelig)
  • 4.
    Garland, Jameson
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Juridiska fakulteten, Juridiska institutionen.
    The legal status of transsexual and transgender persons in Sweden.2015Inngår i: The legal status of transsexual and transgender persons / [ed] Jens M. Scherpe, Mortsel: Intersentia, 2015, 281-312 s.Kapittel i bok, del av antologi (Fagfellevurdert)
  • 5.
    Garland, Jameson
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Juridiska fakulteten, Juridiska institutionen.
    The Legal Status of Transsexual and Transgender Persons in the United States2015Inngår i: The legal status of transsexual and transgender persons / [ed] Jens M. Scherpe, Mortsel: Intersentia, 2015, 585-612 s.Kapittel i bok, del av antologi (Fagfellevurdert)
  • 6. Garland, Jameson
    The Low Road to Violence: Governmental Discrimination as a Catalyst for Pandemic Hate Crime2001Inngår i: Law & Sexuality, Vol. 10, 1-91 s.Artikkel i tidsskrift (Annet vitenskapelig)
  • 7. Garland, Jameson
    Why the Law Has Failed to Recognize Sex as Expressive Conduct Under The First Amendment, and Why Sex Between Men Proves That It Should2003Inngår i: Law & Sexuality, Vol. 121, 159-269 s.Artikkel i tidsskrift (Annet vitenskapelig)
  • 8.
    Garland, Jameson
    et al.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Juridiska fakulteten, Juridiska institutionen.
    Diamond, Milton
    John Burns School of Medicine, University of Hawaii.
    Response to 'Re. Evidence regarding cosmetic and medically unnecessary surgery on infants'2014Inngår i: Journal of Pediatric Urology, ISSN 1477-5131, E-ISSN 1873-4898, Vol. 10, nr 5, 977-978 s.Artikkel i tidsskrift (Fagfellevurdert)
  • 9.
    Zillén, Kavot
    et al.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Juridiska fakulteten, Juridiska institutionen.
    Garland, Jameson
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Juridiska fakulteten, Juridiska institutionen.
    Slokenberga, Santa
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Juridiska fakulteten, Juridiska institutionen.
    The Rights of Children in Biomedicine: Challenges posed by scientific advances and uncertainties2017Rapport (Annet vitenskapelig)
    Abstract [en]

    The Committee on Bioethics of the Council of Europe commissioned this study to identify potential areas of heightened concern for the rights of children that may be unfavorably affected by scientific advances and uncertainties in biomedicine. This report is the result of that study. It provides substantive illustrations of the diversity of problems generated by biomedical developments, including the expanded use of certain biomedical procedures, emerging technologies, and innovative therapies. It also addresses uncertain risks to children through the continuation of longstanding biomedical practices that lack sufficient scientific support. Because considerable legal protections have been developed for biomedical research and continue to be debated in great depth, this report focuses more broadly on biomedicine as a whole. The specific concern addressed here is not about the research process and regulation as such, but rather on how scientific advances and risk-laden practices reach children in biomedicine – whether through health care practices or in other biomedical settings. Mapping out the areas of concern for this report required not only identifying the technological advances and scientific challenges at stake but contemplating these challenges first and foremost from the perspective of the rights of children as class – formally collectively defined as persons from birth to age 18, unless they have attained majority status. Because a subsequent report will analyze the potential legal frameworks protecting children from the scientific risks and uncertainties identified here, this report identifies the challenges in protecting children relative to those rights that are commonly described in international human rights discourse, with only summary references to specific legal instruments in the report’s conclusions. The aim of the report is to demonstrate how the scientific risks and uncertainties illustrated here may affect the rights of children from birth through adolescence, in a variety of ways. Chapter 2 surveys differences in childhood development to illustrate why the lack of protection from scientific risks and uncertainty persists, in part because of limited understanding of the developmental differences and vulnerabilities of children at different phases of life. The report then expands on how many interventions may reach children at the earliest stages of their development, such as through assisted reproduction and other interventions in utero (Chapter 3) as well as in the field of genetics (Chapter 4). The report then addresses children who have been subjected to high-risk and controversial clinical practices, many of which lack sufficient scientific support regarding their safety. Among those children at risk are sexual or gender minority children (Chapter 5) and children diagnosed with serious physical and mental health needs (Chapter 6). The next chapters address two areas affecting critically ill children where considerable policy debate has taken place, but without sufficient regard to scientific advances and uncertainties, specifically in transplantation (Chapter 7) and end-of-life decisions (Chapter 8). In the final chapter, the report sets forth numerous rights of children in biomedicine that are currently at stake from scientific advances and uncertainties – not only the right to the highest attainable standard of health but rights protecting their physical and psychological integrity and their privacy and identity, as well as freedom from discrimination. The landscape of these rights is as vast and potentially complex as biomedicine. The report thus concludes that the biomedical controversies surveyed here signal a need for systemic, continuous and multidisciplinary oversight of these issues, as well as for many biomedical interventions that could not be covered here in depth. These matters cannot be left to biomedical expertise alone, but instead require vigilant oversight from human rights authorities and scholars with an understanding of these issues.

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