TRANSGENDER

I know a man who had a "sex change" operation and is now a "woman." What moral teaching does the Church give on this subject? ? A reader in Roseville, California

Before addressing the morality of "sex change" operations, or what is more formally termed "sexual reassignment," we need to first call to mind the fundamental moral foundation governing this issue. Each person is a precious human being made in God's image and likeness with both a body and a soul. Vatican II's "Pastoral Constitution on the Church in the Modern World" asserted, "Man, though made of body and soul, is a unity. Through his very bodily condition he sums up in himself the elements of the material world. Through him they are thus brought to their highest perfection and can raise their voice in praise freely given to the Creator. For this reason man may not despise his bodily life. Rather he is obliged to regard his body as good and to hold it in honor since God has created it and will raise it up on the last day" (No. 14). St. Paul also reminds us that our bodies are temples of the Holy Spirit (1 Cor 6:19), and therefore we should not degrade our bodily dignity by allowing the body to participate in the act of sin. Moreover, such sin hurts the body of the Church. For this reason, the Church teaches, "Except when performed for strictly therapeutic medical reason, directly intended amputations, mutilations, and sterilizations performed on innocent persons are against the moral law" (Catechism, No. 2297).

Given this foundation, we can address the issue of sexual reassignment, which is a type of reconstructive surgery whereby a male is altered anatomically to resemble a female, or vice versa. Transsexual surgery coupled with hormonal treatment and psychotherapy are used to treat the disorder transsexualism or gender dysphoria syndrome, "a condition in which there is apparent psychological and social identification with attributes of the opposite sex" (Meyer, "Psychiatric Consideration in the Sexual Reassignment of Non-Intersex Individuals" in Clinics in Plastic Surgery, 1974). The Diagnostic and Statistical Manual of Mental Disorders, published under the auspices of the American Psychiatric Association, lists five symptoms of transsexualism: (1) a sense of discomfort and inappropriateness about one’s anatomical sex; (2) a wish to be rid of one’s own genitals and to live as a member of the other sex; (3) the disturbance had been continuous (not limited to periods of stress) for at least two years; (4) the absence of physical intersex or genetic abnormality; (5) and the lack of cause due to another mental disorder, such as schizophrenia.

Without question, the cause of these symptoms and their diagnosis is extremely complex. Nevertheless, once a person has made the decision to pursue a sexual reassignment, eventually radical surgery is performed which involves for a male, castration and the construction of a pseudo-vagina, and for a female, mastectomy and hysterectomy, and the construction of a non-functional pseudo-penis and testes (confer Colin Markland, "Transsexual Surgery" in Obstetrics & Gynecology Annual, 1975). Obviously, such procedures involve a radical and grotesque mutilation of the body.

No transsexual surgery will ever be able to duplicate completely the anatomy or the functioning of the opposite sex. A male transsexual will never be able to ovulate or conceive; and a female transsexual will never be able to germinate sperm. Transsexuals will need to use synthetic hormones continuously to sustain their change, which in turn runs the risk of cancer.

Another moral consideration is whether the condition of transsexualism justifies surgery. No biological cause of transsexualism has been identified. Rather, the cause appears to stem from psychological development, and thereby transsexualism should be treated with psychotherapy. Interestingly, even after surgery, transsexuals need at least some psychotherapeutic support.

Finally, a transsexual will never be able to enter validly into the sacrament of Matrimony. A man who undergoes sexual reassignment will never really be a woman, or vice versa; rather, a man will be a man (or a woman will be a woman), except with a mutilated body and profound psychological disordering. Moreover, a transsexual will never be able to consummate the marriage in the fullest expression of love of husband and wife, and never will there be a real openness to life and the creation of children.

To destroy organs purposefully that are healthy and functioning, and to try to create imitation organs which will never have the genuineness and functioning of authentic organs is gross and lacks charity. Such surgery which purposefully destroys the bodily integrity of the person must be condemned.

Nevertheless, individuals suffering from gender dysphoria syndrome must be treated with compassion. They need spiritual counseling which will help them realize the great love of God who loves them as individuals who have been created in His image and likeness. They need proper psychotherapy which will help them to face realistically their human situation and the world, and the consequences of their actions on themselves and their relationships with family and friends. Such counseling will also direct them to spiritual, intellectual and social pursuits to realize their self-worth and divert their preoccupation with sexual identity.

Just as an aside, the question posed for this article involved the following story: The reader is a retired family practice physician, who still works part-time at the community hospital. His grandchildren had a regular pediatrician. Once his daughter (the mother of the children) asked if he would take them for their appointment. He noticed that their pediatrician seemed distant, pre-occupied and cold. Several months later, he was eating lunch at the hospital cafeteria and a female physician approached who asked if she could join him. He said, "Yes." He then asked, "Do I know you?" The female physician paused and said, "Yes. I used to be so-and-so, your grandchildren’s pediatrician." After a pause, the retired doctor replied, "I have to say. You are looking well." What else could he say?

When examining this moral issue, one must not simply focus on the gravity of the physical mutilation. Rather, one must also focus on the devastating impact this act has on loved ones, parents, spouses, children as well as friends and the community at large. Couldn’t a child say in this story, "My father killed himself to be someone else?" Therein lies the tragedy of this heinous act.

Fr. Saunders is pastor of Our Lady of Hope Parish in Potomac Falls and a professor of catechetics and theology at Christendom’s Notre Dame Graduate School in Alexandria.

Those who espouse “transgenderism” argue that a human person is assigned their gender at birth, based on their observed anatomy. Consequently, when a biological male identifies as female and then has related surgery, they speak of that medical practice as “gender confirmation” vs. “gender reassignment,” because they believe their anatomy now reflects their true identity as a human person.

The Church has a different take, one that is grounded in genuinely confirmed reality. One is born either or male or female, and this also applies to hermaphrodites who, though they manifest both male and female anatomical aspects at birth, are either biological boys or girls.

In this light, the Church recognizes that every human person is created in the image and likeness of God, male or female (Gen. 1:26-27). And so we should help people discover their true identities as children of God, not support them in the disordered attempt to reject their undeniable biological identity.

In this light, we should act in love toward those who experience gender identity disorder, and reprove those who engage in name-calling and other uncharitable behavior toward them.

Regarding preferred pronouns, I would advise avoiding that problem and just call the person by their preferred name. Let me give an example. In previous work for the Church, I once received a phone call from a man who had had “sex-change” surgery and now identified and lived as a woman. He referred to himself as “Mary” (not the person’s self-identified name). I saw no point on first introduction over the phone to tell him I wanted to know the name his parents gave him at birth, and that I would only and always refer to him via that birth name during our conversation, lest I transgress and affirm him in his gender identity disorder.

Well, had I followed such pastorally misguided advice, that would’ve been a real short conversation. In addition, this person was calling a faithful Catholic apostolate to receive genuinely Catholic counsel, not persuade me to affirm them re: their self-identified gender. If I wanted to have hope of giving a fruitfully faithful witness, I couldn’t let minor details derail my witness. In other words, I couldn’t let style get in the way of substance.

Rather, while using this person’s preferred name, I lovingly explained how they had to live a chaste life, which in their case meant not simply ending a sexually intimate relationship with a Christian man who wanted to continue the relationship despite having learned about Mary’s surgery, but refraining from dating altogether and living a life of complete continence.

As a result of my witness, which included fundamentally reminding them that Jesus really loved them amidst their struggles, they gratefully recommitted to living a chaste life. (On a related note, given the expense and potential psychological trauma involved, the Church would not require a person who had had “sex-change” Church to have a second surgery to reverse that change.)

If we give faithful witness to the teachings of Christ and his Church, then using a person’s preferred name will become a moot point. In contrast, if we insist at the outset on setting them straight on which name we will use to refer to them, we will likely lose the opportunity to give them a faithful witness through which Christ can soften their heart to receive and embrace the true Gospel.

And if they correct you on calling them “Mr.,” “Miss,” etc., circumvent that issue by asking them their name, which will likely reflect their self-identified gender. And then proceed in Christian love from there.

For more on this issue, see Trent Horn’s articles here and here, Karlo Broussard’s here, and Cy Kellet’s interview with Dr. Ryan Anderson here.

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