Paternalism and Competent Patient Choice in the Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People

In 2016 physicians in Ontario will be granted the authority to refer patients with gender dysphoria for sex reassignment surgery. In order to be granted this authority physicians must be trained in the World Professional Association for Transgender Health’s Standards of Care, which outlines healthcare procedures for the treatment of gender dysphoria and provides background information concerning transgender health. The Standards of Care require that patients undergo a process of 12 months of continuous living in a gender role that is congruent with their gender identity prior to being given access to sex reassignment surgery. While this requirement can sometimes be helpful it can also cause more harm than benefit. This paper argues that the requirement is strongly paternalistic in its current form and should no longer be mandatory in most cases.

The Causes and Effects of Consumer Competence Perceptions

Consumers are constantly making consumption decisions and engaging in marketplace activities that require some level of competence. In other words, consumers possess and require some knowledge, skills, and abilities to engage in the marketplace and obtain what they want. But what causes consumers to infer they are or are not competent? And, what are the consequences of these competence inferences on consumer behaviour? This dissertation examines the role consumption plays in consumers’ inferences of their own competence to enhance our understanding of these issues. By integrating the literature on competence and attributions of blame, this dissertation develops a theory for when and how consumption influences self-perceptions of competence and how these self-perceptions of competence impact future consumer behaviours. Evidence from five studies suggests that consumers infer their own competence from their consumption outcomes, despite who is actually responsible for causing these outcomes. This means consumers potentially see themselves as incompetent for negative outcomes that are entirely firm-caused. This dissertation argues that people infer their own competence from firm-caused outcomes because they conflate their decisions made prior to an outcome with the cause of that outcome. This dissertation also examines how these variations in self-perceptions of competence can influence future consumer behaviours.