Transgenders, Polysexuals and Sex Reassignment Surgery
WASHINGTON, D.C., 25 APRIL 2012 (ZENIT)
Here is a response to questions on bioethics regarding issues related to sex and gender, answered by the fellows of the Culture of Life Foundation.
E. Christian Brugger writes:
This week's ruling by the EEOC (Equal Employment Opportunity Commission) to make "transgender" a protected status under the 1964 Civil Rights Act is another reminder of the confusions that characterize our community's understanding of sex and gender. Indeed, a range of sex/gender related psycho-affective conditions traditionally designated as disorders are now identified as ordered expressions of gender and sexual identity by some members of the medical profession and wider secular society. These include transgenderism, transsexualism, transvestism, bigenderism, genderqueerism, homosexuality, bisexuality, pansexuality, polysexuality and asexuality, to name a few.
This baffling multiplication of categories of sexuality often confuses people. They wonder whether the terms have any validity or whether they're partially contrived by sexual libertines to flaunt their rejection of traditional morality. They might be tempted to disregard the terms and the people who advocate for them as representative of the "other side" of the culture wars and not worth much attention. Or they might find themselves silently doubting their own views of sex, gender and morality and the traditional Christian view that prevailed historically till yesterday.
In this column, I intend to do three things: first, provide some simple definitions of the unfamiliar terms mentioned above; second, reply to the view that the conditions to which they refer are ordered expressions of human sexuality; and third, offer some very brief ethical reflections in light of Catholic teaching on "sex reassignment surgery" (SRS), more popularly called a "sex-change operation," but also known as "genital reconstruction surgery."
"Gender identity" vs. "sexual orientation"
We may begin by dividing the new terms (as defined by their advocates) between two overarching although not mutually exclusive categories. The first category is "gender identity." This refers to how one defines oneself with respect to sex and gender. Does one psychologically identify with masculinity or femininity (classifications generally taken to be exclusively socially constructed), with maleness, femaleness, both, or neither? One's self-definition is shaped principally, but not exclusively, by one's experience of one's enduring psycho-affective states.
The category of "sexual orientation" is more familiar so I will only comment briefly on it. As a term fabricated by defenders of the sexual revolution, "sexual orientation" refers not in the first place to how one factually experiences erotic interest in and attractions toward other people, but precisely to how one defines oneself in light of those experiences. In addition to the familiar terms "heterosexual," "homosexual" and "bisexual," advocates have coined the neologisms "pansexual" (referring to one who experiences erotic attraction towards persons of all gender identities), "polysexual" (meaning attracted to many but not all gender identities), and "asexual" (referring to one who experiences no sexual attraction to any group or individuals).
Gender Identity: "Transgender": transsexuals, transvestites, bigenders, genderqueers
"Transgender" is a catchall term referring to all persons who do not identify themselves exclusively with their own biological sex. Transgender persons are called "transsexuals" if they feel an enduring desire to live and be accepted as members of the opposite sex. They are called "bi-genders" if they find emotional satisfaction in alternating between feminine and masculine gender-typed behaviors in different situations. The term "transvestites" refers specifically to those who find emotional or sexual gratification in dressing in the clothes of the opposite sex. And the recently coined term "genderqueers" refers to persons who do not identify themselves as either male or female; some feel like they are both male and female, or neither male nor female (i.e., genderless), or a third gender other than male or female. This new pangenderism makes room for any freely constructed gender self-definition, whether it exists somewhere on the continuum between the so-called "binaries" of male and female, or outside of it.
It is important to see that these categories presuppose that a valid anthropological separation can be made between "gender" and "sex." Sex refers to one's biological identity as determined principally by nature's chromosomal assignment (xx=female; xy=male); so sex is a function of biology. The basis of "gender" on the other hand is one's feelings and perceptions about oneself and one's sexual urges toward other people or groups; so gender is a function of psychology.
Advocates of the new pangenderism believe that one and the same person can be at once biologically male and psychologically female; or biologically female and psychologically genderless, and so on. This gross form of anthropological dualism does away with the necessary connection between bodily identity ("sex") and subjective personal identity (i.e., the basis of how one views oneself for purposes of, among other things, moral behavior). It reduces the body to instrumental data in our subjective self-definition. If my body does not conform to how "I" feel psychosexually, then I'm invited to surgically modify it by amputating my genitals, constructing new genitals and supplementing the surgery with powerful hormonal therapy. Advocates go so far as to argue that if a person is born male, but comes to gender-identify himself as female, and feels erotic attraction to men, he should be identified as heterosexual. This pyrrhic victory for the radically autonomous "psychological self" comes at a significant cost to human bodily identity.
Nobody disputes the fact that some men and women (and boys and girls) experience "gender identity disorder" and so suffer from painful feelings of dissatisfaction about who and what they are. But up until recently, few ever doubted whether if the person was biologically male he was fully a male person (although in the tragic and rare cases of "intersex" babies, congenital and genetic anomalies may make it very difficult to know whether they are male or female; I shall discuss this situation in my next ZENIT column). This changed in 1965, when psychiatrists and plastic surgeons at Johns Hopkins (JH) began playing philosophers and decided that persons psychologically distressed about their gender identity could be made whole and happy if their sex — not their psychological state — was changed. And so JH became the first hospital in the nation to introduce its celebrated sex change program. Thanks to the later research of JH psychiatrist Dr. Jon Meyer and the relentless leadership of Dr. Paul McHugh, psychiatrist-in-chief at JH Hospital and professor of psychiatry at the university, JH Hospital ceased doing sex reassignment surgery. But the genie was long out of the bottle and hospitals throughout the country were happy to pick up the business that Hopkins forfeited. The follow-up research on sex change patients convinced McHugh that patients gained no noticeable psychological benefit from undergoing sex reassignment surgery. In 2004 in an article entitled Surgical Sex, McHugh wrote: "... I concluded that to provide a surgical alteration to the body of these unfortunate people was to collaborate with a mental disorder rather than to treat it."
Catholic teaching and sex reassignment surgery
Although neither the Catechism of the Catholic Church (CCC) nor — to my knowledge — specific documents by the magisterium on moral issues address directly the question of trangenderism or sex reassignment surgery, a fairly clear assessment of both can be gathered from what is taught in scripture and tradition. Catholic teaching going back to the Middle Ages definitively affirms that human personhood is constituted by an inseparable unity of body and soul (cf. Council of Vienne, Constitution Fidei Catholicae; Lateran V, Bull Apostolici Regiminis; Vatican II, Gaudium et Spes, no. 14; Veritatis Splendor, no. 48). St. Paul admonishes the church in Corinth to shun immorality in the body because our bodies — not just our souls — are temples of the Holy Spirit (cf. 1 Corinthians 6:18-19). And Genesis 1 teaches that human persons proceed from the creative will of God as male and female.
We may say, then, that humans are essentially their bodies, although not reducible to their bodies. In other words, their personal identity is constituted in part by their bodies. Since the human person is a substantial unity of body and soul, if the body is a particular sex, so too, must we conclude, is the whole person. Therefore, the proposition that a person can be a "woman trapped in a man's body," or any other similarly dualistic proposition, must be firmly rejected. (I prescind here from a discussion of "intersex" individuals.) We are warranted in concluding from this, indeed required to conclude, that the painful psychological disharmony that some people feel in relation to their settled biological sex is due to psychological disorder.
Attempting to satisfy psychological states, therefore, is not a valid therapeutic reason to amputate healthy genitals and to undertake to reconstruct new ones. The choice to do so should be assessed as a form of unethical bodily mutilation. The CCC teaches: "Except when performed for strictly therapeutic medical reason, directly intended amputations, mutilations, and sterilizations performed on innocent persons are against the moral law" (no. 2297).
Finally, to hold that such surgery is unethical to undergo (as well as to perform and support) is not to make a judgment about the subjective culpability of those persons who request and undergo it. I expect that in a community as confused as our own, many of them "knoweth not what they do" and so, although doing serious harm to themselves, do so with diminished culpability.