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Writer's pictureIoannis Ntanos

The Ethics in Gender-Affirming Care

In a recent livestream interview, Mr Ioannis Ntanos shared his expertise on ethics and gender-affirming care. Hosted by Lilia Koss from Facial Feminisation Surgery provider Facialteam, the live stream touched on topics that ranged from being a vocal ally to non-binary surgical aesthetics.



Ethics is fundamental to healthcare

Mr Ntanos described how considering counterarguments and keeping an open mind to nuance are both ethically important. It’s a perspective “that life is non-binary. It’s not yes or no,” he explained.


Considering your patient’s best interests and autonomy is crucial for any medical professional. In gender-affirming healthcare, that’s taken even further. Key ideas of consent, individualised care, and patient-centred care are vital components to the overall patient experience.

Despite often being optional or even side-lined during medical schooling, Mr Ntanos made it clear that this bioethics (defined as the ethics of medical and biological research) is in fact fundamental for all medical and surgical practitioners. “On top of medical school, bioethics should be a part of everyday practice,” he said.


Mr Ntanos believes that self-reflection and interrogation of standards for aesthetics should be started earlier in the training process. He also emphasised the importance of surgeons actively listening to patients. “It's very important to allow individuals to speak up to explain what they need,” he stressed.


For example, to a surgeon unfamiliar with trans-specific surgery, a bilateral mastectomy with a non-nipple reconstruction might sound awkward. Nevertheless, this is the desired aesthetic for many trans and non-binary patients.



Being an outspoken ally

During the discussion, Mr Ntanos highlighted how important it is for healthcare providers and businesses to speak up as trans allies and advocate for the community. For example, regardless of whether the patient is out of the room, or unconscious on the operating table, Mr Ntanos makes sure to correct any misgendering of his patients that might occur by other team members.


Mr Ntanos explains that another reason to be vocal is the policies that have severely impacted gender-affirming care. He believes political action is necessary, as “At the end of the day what we are restricting is essential care to someone who needs it. I cannot see any justification for that.”



Gender-affirming healthcare as a trailblazer

The teachings of gender-affirming healthcare have much to offer other medical disciplines. Mr Ntanos pointed to the acceptance of continuous education, adapting to change, and the amount of time surgeons spend discussing surgeries with their patients.


“The fact that gender-affirming care is in its essence patient-centred should be a paradigm for healthcare,” he said.


Despite the challenges faced by gender-affirming care, such as long waiting times pushing patients into medical tourism, restrictive policies, and misconceptions about the care itself, Mr Ntanos encouraged more providers across healthcare to be LGBTQ-friendly.


“Being involved in gender-affirming care has made me a better surgeon,” he acknowledged.

You can access the live-streamed discussion between Lilia Koss and Dr Ioannis Ntanos here.

Mr Ntanos will be delivering the first Top Surgery Masterclass on May 26th. Find out more about how you can take part here.

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