Transgender: When Psychological Identity Trumps Bodily Identity

Earlier this week, I spoke at the ERLC National Conference in Nashville, Tennessee. I was asked to address the topic of transgender. An adapted excerpt from my manuscript is below. The full video is below.

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Now that the gay marriage cause is all but won, sexual revolutionaries are turning their attention to the “T” in LGBT. Both Newsweek and Time have written cover stories in the last two years arguing that the transgender cause is the next phase of the LGBT revolution. There seems to be evidence confirming this in headlines across the country. From the city ordinance in Houston that led to the subpoena of pastors’ sermons to children being allowed into the opposite sex bathrooms in public schools, there is no question that significant cultural changes are afoot.

At the heart of the transgender revolution is the notion that psychological identity trumps bodily identity. In this way of thinking, a person is whatever they think themselves to be. If a girl perceives herself to be a boy, then she is one even if her biology says otherwise. If a boy perceives himself to be a girl, then he is one even if his biology says otherwise. Gender is self-determined, not determined by the sexual differences that the Creator has embedded into every cell in our bodies.

Have Americans thought through the implications of believing that one’s psychological identity should trump one’s biological identity when the two seem to be out of sync? I am doubtful that we have.

Fox News did an anonymous interview in 2009 with a person named “John” who has been consumed with feelings of dissatisfaction with his body for as long as he can remember. Ever since he was a child, he has felt like a one-legged man trapped inside a two-legged man’s body. He has suffered psychological angst his entire life because of his two legs. Even as an adult after 47 years of marriage, he still wishes and hopes to have one of his legs amputated. He says, “When I see an amputee — when I imagine the amputee — there is this inner pull that says ‘why can’t I be like that?'”

He never wanted to reveal his desire to amputate his leg to anyone and only shared his secret with his wife after being married for 42 years. John says, “As you can understand, my wife was not exactly pleased with finding out that I wanted to get a leg lopped off… She asked me and said ‘you know, you’re a rational man, you should be able to deal with this. And what I answered is that most of the things we hold deep within us – are not rational.”

The primary ethical question is whether a man in John’s position would be right to amputate an otherwise healthy limb. Would it be right for a doctor to remove his leg so that John can feel whole? If John feels himself to be a one-legged man inside a two-legged man’s body, why not encourage him to have his leg amputated? At a gut level, most people recoil at the suggestion. Nevertheless, this is the implication of the view that psychological identity trumps bodily identity.

It turns out that “John” has a condition that pychiatrists call “Body Integrity Identity Disorder.” According to a 2012 study, the only known treatment that provides psychological relief is amputation. Nevertheless, doctors have by and large resisted this, and people suffering from this disorder typically cannot find doctors willing to do the surgery unless they injure themselves. I have seen the testimonies of two men who did just that. One froze his own leg in dry ice until it was irreparably damaged and another shot himself in the leg with a shotgun.

Should a person ever be encouraged to amputate otherwise healthy limbs? Is the trouble here with limbs or with the mind? As Robertson McQuilkin and Paul Copan have asked, “Does the body need adjusting, or does the thinking?” (p. 271). I daresay most people would answer that in this case the mind needs to be changed not the body.

If that is the case with amputations, then what are we to make of the woman who claims that she is a man trapped inside a woman’s body? That is the experience that many transgender persons report, and one of the treatment protocols for such “gender dysphoria” is sex-reassignment surgery. For men, these surgeries may include vaginoplasty, which involves the creation of a neovagina by removing the penis and testes. For women, this surgery involves removal of the breasts, uterus and ovaries. It may also include the creation of a neophallus (Yarhouse and Tan, p. 334).

The ethical question that we have to ask is the same one that we have already asked. Is it right for people to amputate otherwise healthy limbs? Is the problem here damaged limbs or a damaged mind? Does the body need adjusting, or does the thinking? Is our culture ready to embrace the implication of the view that psychological identity trumps bodily identity? Is our culture willing to make those permanent body-altering decisions for children who report transgender feelings? Although this is not a majority view, it is clear that some people are ready to make these decisions for children.

Over the last few years, we have seen a number of reports about parents who are letting gender-confused children undergo hormone therapy to delay puberty indefinitely until a decision can be made about gender reassignment surgery (see here). Ironically, these parents believe that it is permissible to surgically alter a child’s body to match his sense of self but it is wrong to try and change his sense of self to match his body. Yet this leads to an obvious question. If it is wrong to attempt to change a child’s gender identity (because it is fixed and meddling with it is harmful), then why is it morally acceptable to alter something as fixed as a biological body of a minor? The moral inconsistency here is plain. To this we must also observe that the vast majority of children who report transgender feelings grow out of those feelings. I would argue that it is irresponsible and wrong to physically alter a child’s body through surgery or hormones when we know that most of these children grow out of their gender-conflicted feelings (source).

But these kinds of things are exactly the kinds of conundrums a person faces if he accepts the notion that psychological identity trumps bodily identity. I’m not convinced that people have thought through the implications of embracing such a view. That is precisely why we need to be critical about the claims of the transgender movement. Yes, we need to be compassionate towards those who experience deep conflict between their psychological identity and their body. The church would do well to come alongside them to support them and love them. But that kind of care will involve persuading them to change their minds before surgically and permanently altering their bodies.

21 Responses to Transgender: When Psychological Identity Trumps Bodily Identity

  1. John Howard October 31, 2014 at 12:37 am #

    Another implication is we will have to allow procreation as the other sex using stem cell gametes, artificial wombs, transplanted wombs, etc. That should obviously be prohibited, because it will be so risky for the child, and expensive for the public, and is so unnecessary. Yet, when LGBT activists are presented with the possibility, they demand that it be considered a right, a cool thing, something that would be awesome, overcoming fixed sex. It’s called “postgenderism” and it needs to be ruled out by a federal law, a Natural Marriage and Reproduction Act that would also end same-sex marriage because it would also rule out same-sex procreation.

    • Tammy Rainey October 31, 2014 at 9:42 pm #

      Well spoken, James B. The notion that less than 1% of the population asking to be respected is the end of “gender norms” is as silly as suggesting that all this came about because we tolerated the existence of tomboys

  2. James Bradshaw October 31, 2014 at 8:03 am #

    No one is suggesting that people “overcome” their biological gender on a broad scale (just as no one’s suggesting everyone get married to someone of the same sex). For most of us, we are happy with the bodies we have. Don’t confuse issues of sexual orientation with gender identity just because of the acronym. Most gay men and women have no desire to switch genders.

    We understand, however, that there is a very small population of people whose minds align more closely to that of the opposite gender and who feel miserable and “trapped” inside the body they were born into. They feel like aliens inside their own skin. It would have to be stressful and deeply miserable, I’d think, and not a feeling most of us can relate to. I certainly don’t. However, for these folks, reconciling the mind and the body (even if imperfectly) might allow them to thrive and live a happy and productive life.

  3. James Bradshaw October 31, 2014 at 8:06 am #

    On a further note, though, I should say that I strongly disagree with doing any reassignment surgery on minors. Our psychology is still developing (really, until the early 20s), and it seems foolish to make such a drastic change to a youth in those formative years.

    It’s sort of like giving liposuction to a toddler.

  4. amblakes October 31, 2014 at 10:16 am #

    I’m amazed at how quickly many Christians think we’ve got this all figured out – how we assume that if gender dysphoria exists, it must be the mind that has been affected, not the body. If all of creation is fallen, could not the opposite be true? Why are we so quick to assume that in all instances of gender dysphoria, altering the psyche of a person is healthy and God-honoring, but altering the physical body is unhealthy and sinful? Why do many assume that bodily identity trumps psychological identity? Can we agree that both are valid aspect of gender? Appealing for less arrogant certainty and more grace-filled curiosity.

    • Christiane Smith October 31, 2014 at 9:02 pm #

      ‘transgender’ people suffer . . . a lot . . . I don’t think they have chosen that pain, and they are not ‘sinning’ by having that pain unwillingly

      their journey, whether they choose intervention medically or not, is a difficult one. In the spirit of the Good Lord we follow, I would want for Christian people at least not to add to the pain of these persons . . .

      the children . . . and their parents . . . this is difficult . . . we do know of cases where in the past, a baby has been born with the sexual organs of both male and female present and the parents have ‘chosen’ for the infant and the baby was operated on to remove the organs that the parents did not want the baby to have . . . the tragedy being that in later years, the child recognized itself to be the sex that the parents had rejected and so their lives were altered irrevocably as to what they might have had, if the parents had waited for the child to develop their personality. . . .

      apparently the Christian right is very concerned that parents might possibly let the child determine sex changes based on the child’s personality at that stage in their development . . . I can understand this, if the child has changes that might not be altered back in future should the child arrive at maturity and ‘reconsider’ (if this is possible) . . .

      from what I am hearing, some parents have opted to permit their children to be given hormonal therapy, but have NOT allowed them to have sex-change operations before they are ‘of age’ . . . my understanding is that hormonal therapy can be ‘reversed’ by stopping the medication

      but whatever Christian people do, let it be FOR the sake of suffering people, and not out of fear or contempt for what is not YET fully understood

  5. Chris Ryan October 31, 2014 at 2:51 pm #

    Interestingly I strongly agree with much of what you say. I often use this precise example myself when discussing this issue with friends. I’d say you misidentify the reason DRs dont amputate legs. Theres a utilitarian reason to having both legs. In fact with utilitarian reasoning its prolly best to do it in severe cases (as with the guy who used a shotgun or another man I know who laid down on railroad tracks to self amputate his leg). However with sex reassignment theres no utilitarian reason to decline the surgery. That being said, I dont think we should surgically intervene with minors (as others point out above).

    My mother suffers from epilepsy and it causes most sufferers severe psychological issues, ranging from anxiety to depression to full blown psychosis. DRs know very little abt how or why. We understand very little abt the brain and theres no neat dividing line between psychology and biology.

    In fact much of the time psychology is biology. Theres an interesting case playing out in international track and field, where a girl is being told that she can no longer compete as a woman bcs internally shes male–even tho outwardly shes female and has always been raised as such. We know very little abt this stuff.

  6. Daniel Moody October 31, 2014 at 4:17 pm #

    The ‘one-legged man’ illustration works, but Gender goes beyond it: Gender says a two-legged man is a one-legged man if he he says he is. Amputation is optional, but not necessary.

    The illustration represents mind in competition with body, whereas Gender represents mind in denial of body.

  7. Tammy Rainey October 31, 2014 at 9:26 pm #

    “Gender is self-determined, not determined by the sexual differences that the Creator has embedded into every cell in our bodies.”

    Do any other human beings consult the cells of their body in order to determine their sex? Does not the intersex person, with conflicting biological evidence not know what sex they are? Is it not self evident that it is your mind which tells you what sex you are? Your sex is not “self determined” except in that only the self can understand what the brain/mind knows?

    “…a person named “John” who…”

    Laying aside the reference to Fox News which has a propensity to inflammatory spin (see, for example, Tod Starnes) the whole comparison is flawed at the root because ones sex/gender IS something that s determined through natural biological processes in the womb. There’s no such natural process which tells you that you should have one leg, or three for that matter. Beyond that, if “John” only wants one leg, that’s none of my concern and not a biblical question. I trust medical and psychological professionals to sort it out.

    “Is the trouble here with limbs or with the mind? ”

    What difference does it make? If you CAN’T change the brain, and you CAN change the APPEARANCE (and let’s be clear, critics are up in arms about people asking to modify their APPEARANCE) then why not? What is it to the culture at large whether or not less than 1% of the population does not conform to your appearance expectations?

    “I daresay most people would answer that in this case the mind needs to be changed not the body.”

    Of course. Because 99+% of the population has absolutely no mental frame of reference for what this condition (being transsexual) feels like. “Most” people are wildly unqualified to voice an opinion.

    “Is our culture willing to make those permanent body-altering decisions for children who report transgender feelings? ”

    Since this isn’t happening…

    ” Ironically, these parents believe that it is permissible to surgically alter a child’s body to match his sense of self…”

    I challenge you to cite even ONE example of an American child having any sort of gender surgery before the age of 16 (and VERY few before 18) – excepting alterations done to intersex infants. It undermines the credibility of the entire rest of your talk for you to infer this falsehood is true.

    ” we know that most of these children grow out of their gender-conflicted feelings (source).”

    You need better sources than McHugh. He’s a good support for the religious bias – his superpower – but not sound science. Many kids have a very brief phase they pass out of, it’s not demonstrated the kids demonstrating long-term peresistant and insistent claims nevertheless “grow out of it”.

    ” I’m not convinced that people have thought through the implications of embracing such a view”

    Maybe the implication is that each ethical question stands or falls on it’s own merits rather than assuming an illogical “slippery slope? If the slippery slope argument were valid, then I could argue that if I concede to the church the veto over my appearance, then I concede the power to tell a woman whether or not to wear makeup, or a man whether or not to wear a beard, or (as some churches do) whether or not women can wear pants? It would be just as invalid.

    ” The church would do well to come alongside them to support them and love them. But that kind of care will involve persuading them to change their minds before surgically and permanently altering their bodies.”

    First, many of us have decades of experience with the church trying to persuade us that our appearance matters more to God than our heart; second, the case has not begun to be made that this is a biblical absolute.

    I repeat the question that won’t go away: if your genitals can be born sexually ambiguous or inconsistent…if your chromosomes can be…then by what logical or even biblical argument do we conclude the brain CAN’T be?

    God made our brain and our mind just as he made the rest of us and I q

  8. James Stanton November 1, 2014 at 6:50 pm #

    “Now that the gay marriage cause is all but won, sexual revolutionaries are turning their attention to the “T” in LGBT.”

    Well, we could also say that now that the gay marriage cause is all but lost, social conservative elites are turning their attention to the “T” in LGBT,

    “If it is wrong to attempt to change a child’s gender identity (because it is fixed and meddling with it is harmful), then why is it morally acceptable to alter something as fixed as a biological body of a minor? The moral inconsistency here is plain.”

    Indeed, Denny is quite right here although I’m not sure that he agrees with the notion that it’s wrong to attempt to change a child’s gender identity.

  9. Sandra Stewart November 1, 2014 at 7:02 pm #

    A study, reproduced twice found that there are 13.5 million transgender individuals in the US about equally divided between female to male and male to female, the percentages are 80% are crossdressers (and F to M may not know that they are) due to culture change. 16% are transgenderist, pre-op and no-op transsexual and 4% are post-op transsexuals.
    I challenge Denny to biblicaly support his assertion that being transgender is inherently sinful. You can not remove a verse from its historical, cultural and linguistic context and have it still be true.

    • Larry Geiger November 3, 2014 at 3:16 pm #

      “I challenge Denny to biblicaly support his assertion that being transgender is inherently sinful.” Challenge accepted. Being human is inherently sinful, therefore anyone (being human) is sinful. Even the T. Boy, that was easy.

      Sandra, I’m not sure that’s where you want to go. But, you can think about it for a while.

      • Tammy Rainey November 4, 2014 at 4:03 am #

        surely you know that did not meet the challenge. You might as well have declared that you proved being left handed was inherently sinful

        • Larry Geiger November 4, 2014 at 10:34 am #

          “You might as well have declared that you proved being left handed was inherently sinful” I’m left handed. Really. And I also meet the qualification of inherent sinfulness.

          • Jay Ryder November 6, 2014 at 10:22 am #

            Dear Larry,
            By your (faulty!) logic though, you are saying that you’ve proven, therefore, that being left-handed is inherently sinful.

            Surely, we (Evangelicals) need to do better than this! Otherwise, we will just bolster progressives’ position.

            I go back to what Denny is saying and agree with him on the psychological challenge, but I also push back on his argument somewhat because in some cases the transgender dilemma does have a valid physical and physiological component. The trouble is neither side is really in a position to make bold, universal pronouncements that apply in all cases. And because of this, we must err on the side of caution– and especially we must not support reassignment of children!

            • Jay Ryder November 6, 2014 at 10:27 am #

              Caveat: I do think that Evangelicals can and should build the case toward taking a bold, universal stance on rejecting reassignment. I just don’t think arguing against psychology gets the job done. (In fact, this was the crux of the problem with much of the reparative therapy movement – emphasizing psychology as the problem, rather than acknowledging the tension between biological elements and the orientation of the heart.)

  10. Steven Prevost December 31, 2014 at 7:17 pm #

    Christians need to stay out of other people’s lives. What does it matter to you if someone is transgender or not? You are not God, who are you to judge what is right or wrong? The Bible says in Philippians 2:12 “…work out YOUR OWN salvation with fear and trembling.” It doesn’t say you have the right to force your views onto other children of God. You should keep to the call of Christ who said the greatest commandment is LOVE THEY NEIGHBOR as thyself. The LGBT folks aren’t trying to oppress your christian beliefs, they are trying to find their way in this world just like everyone else.

    • Tim Elliott January 1, 2015 at 3:56 pm #

      “Christians need to stay out of other people’s lives.”

      Sounds an awful lot like a judgment to me…
      You may want to practice what you preach, Steven Prevost.

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