Culture,  Politics

A one-legged man trapped inside a two-legged man’s body. Amputate?

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 of 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 psychiatrists have classified John’s condition as “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 it loving or helpful for friends and loved ones to encourage them to amputate 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 several 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. Friends and loved ones may mean well and may actually wish to alleviate real suffering. But they are not going to achieve that by encouraging the embrace of a psychological identity at odds with bodily identity.

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.


  • Adam Omelianchuk

    Bioethicists have been debating this question the last few years. Here are some articles worth looking up:

    Ryan, Christopher James (2009). Out on a limb: The ethical management of body integrity identity disorder. _Neuroethics_ 2 (1):21-33.
    White, Amy (2014). Body Integrity Identity Disorder Beyond Amputation: Consent and Liberty. _HEC Forum_ 26 (3):225-236.

    Muller, Sabine (2009). Body Integrity Identity Disorder (BIID)—Is the Amputation of Healthy Limbs Ethically Justified? _American Journal of Bioethics_ 9 (1):36-43.
    Patrone, D. (2009). Disfigured anatomies and imperfect analogies: body integrity identity disorder and the supposed right to self-demanded amputation of healthy body parts. _Journal of Medical Ethics_ 35 (9):541-545.

  • Jay Miller

    And what if I feel I am a different race? Shouldn’t I be allowed that privilege as well? Why did they criticize the woman who pretended to be another race recently. They should have been more understanding of her dissatisfaction with her own race and he desire to be a different race. Not sure how this is any different.

    • Robert Olsen

      It will be interesting to see how this plays out. I want to see someone who believes they are Navajo Indian apply for all of the benefits he/she is entitled to. As soon as money starts leaving the government, you will see new guidelines come into place. You can be a different gender (in spite of a single clear chromosomal marker which says otherwise) yet not a different race (in spite of much more difficult to determine genetic markers). Why? Because the government will create some arbitrary reason. As Francis Schaeffer noted, this is an escape from reason.

  • Christiane Smith

    “The church would do well to come alongside them to support them and love them.”

    ‘to come alongside’ is a phrase describing the way the Holy Spirit
    encounters us in our need . . . if we are to act in the same way, let it be done with as much of the fruit of the Holy Spirit as we can muster, for the sake of the good of the suffering person. When someone is in this much trouble, the person would be in need of medical evaluation and psychiatric care . . . medical because there is some research that shows the afflicted person may have an altered neurological pattern which can be detected with a brain scan . . . psychiatric, because SSRI drugs have been known to bring some relief under a physician’s supervision.

    But for a Christian who wants to help his friend, we cannot underestimate the power of employing love, joy, gentleness, patience, kindness, goodness, and long-suffering. We need to know that the person may not be able to ‘snap out of it’ . . . that this is a serious disorder which likely began in early childhood. Although we do not share the affliction ourselves, under the guidance of the Holy Spirit, we can ‘come alongside’ the person and help them bear their burdens with our grace-given strength, yes.

  • pauljacobsblog

    Not only should he be allowed to have his leg chopped off, the tax payer should pay for it and provide disability payments afterwards. Also, the tax payer should ensure that he has a handicapped bathroom at home and handicapped access to his government subsidized housing, and phone. He should also get transportation credits or the right to sue able bodied drivers who might discriminate as he no longer has a right foot and can’t keep up in traffic. If it is the left leg that is gone, his government subsidized car should have a hand break until such a time as he desires to have an arm amputated. It is time to bring mental illness out of the shadows and begin to celebrate our differences.

  • Thomas Witten

    This is such a weird argument to have among lay people. It seems that how to treat medical disorders should be had amongst medical professionals. These are serious problems, people need to be treated by experts. They think gender dysmorphia should be treated one way and are undecided about bodily integrity disorder, I don’t see any reason for non-professionals to be second guessing them

    • Ian Shaw

      Denny’s point isn’t about legitimate medical treatment for a disorder, but rather the logic (or lack thereof) used to legitimize anything someone wants because they self-identify or feel as “X” or “Y”.

      The source of the problem is the mind, so you treat the mind, not the symptoms.

      • Thomas witten

        But transgenderism isn’t “anything” it’s a recognized disorder with a recognized treatment plan.

    • Denny Burk

      That was a really bad, uninformed article. The brain-sex theory, for example, is one explanation of the transgender experience, but there are many others. The medical authorities do not know what causes it.

  • buddyglass

    Some thoughts on this analogy:

    1. It strains credulity to believe that “one-legged-ness” is an human essential quality in the same way “maleness” and “femaleness” are. Ironically, the motivation to transition from one sex is generally predicated on an admission of the importance of “maleness” and “femaleness” as real things.

    2. There’s no brain chemistry argument to make. We may not understand them, but at an aggregate level we’ve been able to tease out cognitive and psychological differences between men and women. They don’t apply to every man and every woman, but at an aggregate level they hold. No such differences for one-legged individuals vs. two-legged.

    3. Amputating a leg is handicapping one’s self. Nothing is gained. Trans supporters would argue that a sex change operation subtracts one set of genitalia but adds the facsimile of another. From their perspective it’s a swap. You exchange bits A for bits B, changing from one type of able-bodied person to another type of able-bodied person. Amputating a leg is subtraction with no addition.

    4. In making a big deal about the operation, you’re choosing to argue against the most “extreme” (and consequently most easily attacked) version of transexualism. What if instead of a two-legged person wanting to become one-legged you had a right-handed person insisting he was actually left-handed? He simply chooses to act as if his left hand is dominant even though it is demonstrably not true. This would be analogous to a man or woman who chooses to dress and behave as the other sex but without any physical alteration. That’s something you presumably also strenuously oppose, but it’s harder to argue against because there’s no surgery involved.

    In the interest of making the best argument against transsexualism you can, it might be worth going after after the hardest-to-attack formulations thereof and not the “easy” ones.

    • Denny Burk


      There are a number of problems with this:

      (1) Really? You don’t believe human beings are bipeds? Most people believe that they are and even point to that as one of the distinguishing characteristics of the species.

      (2) How do you know there is no brain chemistry argument to make? On what basis are you making that claim? Also, the brain chemistry theory of transgenderism is ONE THEORY AMONG MANY. There is no consensus in the medical community about this. I’ve read the DSM-5 on this and other clinically competent sources. The idea that the brain chemistry view is THE SCIENTIFIC view of things is a popular myth, not one backed up by actual science.

      (3) Sex-change surgeries amputate healthy, functioning body parts. Those body parts and their functions are destroyed by the surgeries. By definition, they are not “able-bodied” anymore with respect to the parts that were destroyed in the surgery.

      (4) Yes, but it proves the falsity of the transgender claim–that psychological identity trumps biological identity. And that is the central issue whether or not one has the surgery. Accepting that claim is destructive to individuals and the communities they inhabit.


  • Robert Olsen

    This same argument can be made regarding anorexia. If someone believes they are overweight and yet are underweight, should we be forced to act as if the person is overweight? If there is a 5’9″ woman who is 80 pounds who struggles with thoughts of being overweight, should we encourage them to go on a diet? Everyone in the medical community and society recognizes that the person needs to have their perception altered. Yet regarding transgender issues, everyone has to affirm that this person is who they feel they are, regardless of chromosomes and physiology.

  • Ted Weis (@TedWeis)

    Here’s another transgender quagmire: What if the man who says he’s a woman doesn’t want to “fully” dress like a woman? What if he wants to be a tom girl? Who is the arbiter of the extent he must dress like a woman? If the HRC says no one may tell a transgender how they dress, then on what basis can anyone assess who should or shouldn’t be in a restroom?

    • Ezra Thomas

      That’s why I think laws banning or legalizing transgender usage of whatever bathroom they want to use is pointless. The intent for either seems to be symbolic. Transgender folks, post-op or not, were using whatever bathroom without issues or hassle until now. I find it sad that we need to waste energy and resources on regulating the actions of 0.5% of the population. People seem to be afraid that it will be become cool to be transgender now that its socially acceptable. That’s not how it works.

      • Ian Shaw

        Why stop at 0.5% of the population? Why waste energy and resources on 4-5% of the population?

        We’re in a time where a small group of individuals make laws that they think are good for the general public at the very moment. That’s not progress or forward thinking.

  • Curt Day

    I find that a lot of these “gotcha” type analogies are designed more for the choir to hear than for anyone else. The logic used in is not sound. The assumption is that there are no valid subjectively based identities that go against external evidence. And so if we show how one such kind of identity fails, then none of them are valid. In short, one can’t prove a statement with a universal quantifier by using a single example.

    I think that it would be best if we listened to those from the LGBT community more than we make silly analogies that don’t fit. Not that we should agree with those from the LGBT community about their identities and orientations, but if we are going to say anything that is meaningfully challenging to them, we can only do so after paying some dues in listening.

  • Nathan Cesal

    The way you understand the Bible is the way cisgendered straight men have understood and taught it for millennia. You may think that you are not projecting your experience onto what you read and teach to others, but I that’s nearly impossible for anyone especially for the majority opinion.

    Human sexuality is likely more complicated than you think. I’ve seen you sweep obvious examples like the inter-sexed under the rug. It is no surprise that trans-sexism is too big a stretch.

    Scientists will eventually find developmental pathways for LGBT. They will likely involve things completely outside of any choice, moral or otherwise, that anyone involved makes. They will be just one of the ways babies are fearfully and wonderfully made.

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