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.