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Five Questions for Supporters of Gender Transitioning

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Filed under Anthropology

VanityFair

In light of the Vanity Fair cover story about Bruce Jenner’s decision to undergo a "gender transition" and current desire to be called Caitlyn Jenner, I thought it would be appropriate to look at five important questions those who support gender-transitioning need to answer.

1. What determines reality: facts or feelings?

My wife used to work at a psychiatric hospital where it was standard procedure to not feed into a patient’s delusions. If a patient, for example, said he was a cat, that would not justify leaving a bowl of milk for him in his room. However, if a patient with a male genetic code and male genitalia said he was a woman, then the staff had to treat him as a woman and refer to him with female pronouns.

But what’s the difference between someone redefining his species and redefining his sex? After all, both of these things are determined anatomically and genetically. Or consider this non-hypothetical example: what if a person thinks she is disabled but is actually healthy? Should we treat her mistaken sense of identity, or should we disable her so her body conforms to her mistaken self-identity?

Well, just as transgender people make a distinction between the sex they were purportedly assigned at birth and the sex they now identify with (i.e., their gender), the “transabled” make a distinction between the disabilities society says they don't have and the disabilities they think they have.

The woman pictured below is named Chloe Jennings-White, and she is “transable.” This means that, although her legs function properly, she still uses leg braces and a wheelchair, because she identifies as “disabled.” Living as an able-bodied person is as painful for her as it is for a transgender person to live in accordance with his biological sex. Some "transabled" people even ask doctors to help them become disabled (such as by having their spinal cords severed).

But how is allowing a person to identify as transable any different from allowing him to identify as transgender? In fact, one researcher in Canada (who happens to be transgender but not transable) says the transgender community hasn’t supported the transabled community because the former doesn’t want its recent momentum in the court of public opinion to grind to a halt by being associated with what most people recognize to be a serious pathology.

Indeed, if we are disgusted that a doctor would amputate the healthy limbs of a transable person, then why aren’t we equally disgusted by a doctor who would amputate the healthy genitals of a transgender person?

2. What do the terms man and woman mean?

If I were to say that a woman is someone who wears high heels and makeup, and has long, flowing hair and a curvy figure, many people would accuse me of sexism. They would say I’m reducing what it means to be a woman to some superficial traits that aren’t representative of all women. After all, some women have short hair, and others can’t stand the aches and pains associated with high heels.

And yet, isn’t that what Jenner’s transformation into a woman is endorsing—the idea that a woman is a svelte and sultry individual who looks good (to some people) in a corset on a magazine cover? In fact, this is one reason that some feminists actually oppose gender reassignment and transgender identities.

So here’s my question to transgender advocates: “What do the terms man and woman actually mean?”

What is the difference between a gender-non-conforming man (a biological male who enjoys looking and acting like a woman but wants to be called a man) and a transgender woman (a biological male who enjoys looking and acting like a woman and wants to be called a woman)?

If the only difference is the terms themselves, then modern “gender ideology” is guilty of eviscerating the concepts of male and female of any objective meaning beyond “what I want to be called.” How can we ever hope to raise well-adjusted men and women who interact with one another in a healthy way (and so form the foundation of civilization) when no one has any idea what men and women are in the first place?

3. Is it hateful to be attracted to one sex but not to transgendered people who identify as that sex?

Many people in the transgender community complain about not being considered “real" men or “real" women. They want to end the distinction between one who is male or female by birth and one who is male or female by choice. In fact, one pro-transgender website says that the idea that transgender people are not “real men and women” is

probably the most hurtful myth of all. It tells us that transgender people are somehow less human because of their gender identification. It is proof that they do not have a place in proper society. It is hateful and unacceptable. Everyone should have the right to be men and women, regardless of sex category or anything else.

This often happens in the realm of dating and interaction with the non-transgendered. For example, a transgender man (i.e., a biological woman who dresses like a man or has undergone surgery to try to resemble a man) may not be attractive to biological women, since they usually desire biological men, not transgender men. He may become indignant when women say, "I only date actual men" or "real men."

Many states already have laws that outlaw discrimination based on “gender identity,” which means that it is illegal for an employer to make distinctions between biological men/women and transgender men/women. Granted, the law has no authority to coerce private citizens to not make those same distinctions. However, the law can legitimize the culture's ostracizing of those who believe there is a difference between biological sex and self-proclaimed gender.

Society may, for example, consider a woman who dates biological men exclusively rather than transgender men (or men who do the same with biological and transgender women) to be as bigoted as someone who refuses to date immigrants because he or she prefers “natural Americans.” Will it become, in the words of the above critic, "hateful and unacceptable" to decline a romantic gesture from a transgendered person because that person is not an "actual" man or a "real" woman that one would normally be attracted to?

4. Will parents be guilty of child abuse if they fail to “transition” their children who identify as transgender?

In the past few years, there have been several high-profile cases of parents who helped their children undergo sex-change reassignment surgery in order to accommodate their identification of being transgendered. One famous case in 2011 involved Thomas Lobel, an 11-year-old boy who identifies as a girl named Tammy. His adoptive lesbian parents claim that Thomas (pictured below between them) has said he was a girl ever since he was three years old, and they worried about suicide risks if they didn’t help him use hormone blockers to stave off puberty.

But what about the mental health risks involved in trying to change a child’s sex? According to John Hopkins University professor Paul McHugh, “When children who reported transgender feelings were tracked without medical or surgical treatment at both Vanderbilt University and London's Portman Clinic, 70 to 80 percent of them spontaneously lost those feelings.” Imagine how devastating it would be for a little boy or girl to have his body permanently mutilated just because he or she expressed a fleeting, childish thought.

The other disturbing scenario we have to confront is this: Confronted with the claim that children with gender identity disorder are at greater risk for suicide and the assumption that a sex-change operation is the only way to prevent such a horrible outcome, will parents be convicted of child abuse if they don’t consent to a child’s sex-change therapy or operation? Imagine a child tells his teacher or counselor, even at the age of four or five, “I’m not a boy, I’m a girl; but Mommy says that’s not true.” Could this result in the child being taken from his parents' custody for his own safety? In a culture that celebrates being transgendered, it’s not hard to see this coming to pass.

5. Will a culture that celebrates transgender identities tolerate evidence that such identities are harmful?

According to McHugh:

A 2011 study at the Karolinska Institute in Sweden produced the most illuminating results yet regarding the transgendered, evidence that should give advocates pause. The long-term study—up to 30 years—followed 324 people who had sex-reassignment surgery. The study revealed that beginning about 10 years after having the surgery, the transgendered began to experience increasing mental difficulties. Most shockingly, their suicide mortality rose almost 20-fold above the comparable nontransgender population. This disturbing result has as yet no explanation but probably reflects the growing sense of isolation reported by the aging transgendered after surgery. The high suicide rate certainly challenges the surgery prescription.

When presented with evidence like this, supporters of sex-change therapy usually say that negative health outcomes arise from “social stigmas” or “lack of resources for the transgendered.” But this is a classic example of “heads I win, tails you lose.”

If a transgender person reports having no negative health outcomes, then transgender therapies and surgery are vindicated. But, if a transgender person regrets his decision to change genders or reports having high levels of stress or other disorders, then that’s not because being transgender is harmful. Instead, it’s because society oppresses the transgendered, and that causes their negative mental health outcomes. Of course, this is a convenient way to frame the issue so that one's position can’t be disproved.

We may even come to the point where testimonies of those who underwent sex-change operations and regretted their decision, such as the one shared on the Catholic Answers Focus podcast, will be seen as another cause of stigma and thus be declared anathema in the public square.

Conclusion

The bottom line is this: we should not mock or dehumanize people who have gender identity disorder. Someone struggling with this disorder requires counseling, appropriate medical intervention, and an empathetic ear that is willing to listen. But we also shouldn’t celebrate the mutilation of healthy bodies or facilitate the destruction of masculinity and femininity.

We should treat identity disorders equally and not refuse to call something a disorder just because many people disagree with that assessment (truth isn't determined by majority vote, after all). Instead, we must compassionately help the person who has an identity disorder, regardless of his or her age or stage of life, come to know his or her true self and flourish as the person he or she was created to be.
 
 
(Image credit: CNN)

Trent Horn

Written by

Trent Horn holds a Master’s degree in Theology from the Franciscan University of Steubenville and is currently an apologist and speaker for Catholic Answers. He specializes in training pro-lifers to intelligently and compassionately engage pro-choice advocates in genuine dialogue. He recently released his first book, titled Answering Atheism: How to Make the Case for God with Logic and Charity. Follow Trent at his blog, TrentHorn.com.

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  • David Nickol

    Here's an excerpt from a news story that appeared some time ago that may be of interest:

    Editor's note: This article is from the archives of the Catholic News Service. It is dated Jan-14-2003.]

    VATICAN CITY (CNS) -- After years of study, the Vatican's doctrinal congregation has sent church leaders a confidential document concluding that "sex-change" procedures do not change a person's gender in the eyes of the church. . . .

    The Vatican document's specific points include:

    -- An analysis of the moral licitness of "sex-change" operations. It concludes that the procedure could be morally acceptable in certain extreme cases if a medical probability exists that it will "cure" the patient's internal turmoil.

    But a source familiar with the document said recent medical evidence suggested that in a majority of cases the procedure increases the likelihood of depression and psychic disturbance. . . .

    • Mila

      Link?

      • David Nickol

        The link is in the editor's note.

        • Mila

          There is no link to the so-called Vatican document in that article from the NCR. It's just opinions.

          Edit: FYI NCR is not a reliable source. They oppose Church's doctrine.

          • William Davis
          • David Nickol

            FYI NCR is not a reliable source.

            First, the article is from CNS (Catholic News Service), and it is reprinted in NCR. The same article can be found reprinted in a number of other places.

            Second, granted, the Vatican document itself is not reprinted. The news story is a report based on what was said by people who had seen the document.

            Third, are you certain the authors of the Vatican study would not say "that the procedure could be morally acceptable in certain extreme cases if a medical probability exists that it will 'cure' the patient's internal turmoil"? It is hardly an endorsement of gender-reassignment surgery to say it could be morally licit in extreme cases where it would calm the patient's inner turmoil, but in the majority of cases, it is likely to make things worse!

          • Mila

            There is no link in the article to the so-called Vatican document.
            Also, from reading the NCR, I gathered that the Church still views a person the gender they were born and not the gender after a sex operation.
            "A conclusion that people who have undergone a sex-change operation cannot enter into a valid marriage, either because they would be marrying someone of the same sex in the eyes of the church or because their mental state casts doubt on their ability to make and uphold their marriage vows"

          • David Nickol

            Also, from reading the NCR, I gathered that the Church still views a
            person the gender they were born and not the gender after a sex
            operation.

            I was careful to include that fact in the part of the document I quoted:

            After years of study, the Vatican's doctrinal congregation has sent
            church leaders a confidential document concluding that "sex-change"
            procedures do not change a person's gender in the eyes of the church . . .

            There is no link in the article to the so-called Vatican document.

            No one ever said there was! It is identified as a "confidential document."

            There are two separate questions. Is the surgery ever morally permissible? Does the surgery actually change a person's gender (in the eyes of the church)? The answer to the first questions, if the CNS story is correct, would seem to be, "Yes, in extreme circumstances." The answer to the second question is, unsurprisingly, no.

          • Mila

            "No one ever said there was! It is identified as a "confidential document"
            Well, with so many people claiming to speak on behalf of the Vatican I would have loved to see who actually said anything.

  • David Nickol

    1. What determines reality: facts or feelings?

    • Chris Snowden

      How can two exclusive realities occupy the same reality? Kids also act like animals, a dog or a cat. A human cannot be both a human and a dog. The essence of dog is a domesticated canine. The essence of a human is a rational animal. One cannot be both. So that goes back to my question, how can a person, externally male (or female) also internally be female (or male). On principle of their definitions they are exclusive.

  • This article is at points quite ugly. It was hard to read.

    As a regular reader and commenter, I would encourage the editorial staff of Strange Notions to desist publishing articles such as this one. They do not foster positive dialogue. Whether intended or not, they foster the impression that the Catholic Church is a club for sexists and homophobes. I don't want to believe that this is true (but, as we will see below, I think reality is determined by the facts, no the way I want the facts to be). Maybe we should restrict discussion to the question of God's existence, or the resurrection, or Thomistic philosophy, and avoid hot button issues that will get in the way of friendly discussion.

    For example, taking Trent's words and applying them to a different setting:

    When presented with evidence of negro inferiority, supporters of race rights usually say that heightened crime and poverty amongst blacks arise from “social stigmas” or “lack of resources for racial minorities.” But this is a classic example of “heads I win, tails you lose.”

    This is my problem. The language used in this article, let alone the position it takes, disturbs me. I'd imagine I'm not the only reader bothered by this article.

    To answer the questions, in a strained spirit of civility (I don't imagine I will engage in any further responses about this issue):

    What determines reality: facts or feelings?

    Facts, including facts about feelings.

    What do the terms man and woman mean?

    'Man' and 'woman' have various definitions, involving sex and gender. One definition of 'man' (from Google) is 'a human being of either sex; a person. God cares for all men'.

    Is it hateful to be attracted to one sex but not to transgendered people who identify as that sex?

    No. A lack of attraction isn't hateful by itself. Attraction itself can't be determined. I can't wake up one day and decide "I'm going to be sexually interested in this person." I don't think anyone has that sort of control. Other beliefs and behaviours can be controlled, and these can affect attraction. For example, if I hate all asian people, it will be harder for me to be attracted to an asian person. If I hate all transgender people, it will be more difficult for me to be attracted to a transgender person.

    Will parents be guilty of child abuse if they fail to “transition” their children who identify as transgender?

    It would depend on the nature of their failure. Does their failure involve abuse? It is possible for parents to make bad choices for their children without being abusive.

    Will a culture that celebrates transgender identities tolerate evidence that such identities are harmful?

    I don't know. Judging from the public response to The Bell Curve, people tend not to react well to claims that black people are innately less intelligent than white people. I'd imagine that in a society tolerant to transgender people, the reaction to evidence that transgender identities are harmful would be about the same.

    The question then becomes (1) Is there such evidence (and does it rest on good science)? And (2) even if solid scientific evidence existed that it's harmful to change oneself from man to woman (or the other way), what affect should that evidence have on social norms, if any?

    • Manuel Buen Abad Najar

      So, your call is to avoid sensitive issues such as this one because of fear that the Church might be looked at as a club for homophobes and sexists. That is, because it is "good" to avoid hurting people's feelings or make them feel uncomfortable (even if this apparently happens EVERY TIME someone dares to challenge another person's view, regardless of the tone or of the amount of charity that the person contradicting was employing) we should sacrifice Truth and, instead of showing to the World the Christian proposal for what life on Earth is supposed to mean, just shut up our mouths.

      In other words, you say that discussions and intellectual search for Truth should be conditioned by whatever subject is sensitive at a particular moment, in a particular place in human history.

      Wow. I don't know what to tell you, except maybe recommend some Catechism reading and praying. I'm just not gonna leave.

      • David Nickol

        The point is not that sensitive issues should be avoided. It is that they should be approached with sensitivity. The above criticism was not of "the Church." It was of Trent Horn.

      • William Davis

        In general I'd say the problem with the author of this article (and many Catholic articles I've seen) is that he doesn't seem to be searching for truth, but presupposing he has the truth. The comparison of those who have received transgender surgery to the general population is representative of either an agenda, or a major lapse in critical thinking. Any thinking person would realize the only valid comparison would be between those with gender identity confusion who had not received the intervention, and those who had. This is a basic idea in epidemiology, so perhaps one should study epidemiology before incorrectly attempting to use it to make claims.
        If such studies (not just one, but a series) do indicate there is long term harm, that would be a legitimate secular reason to consider the practice unsafe. Walking into a room screaming that you have the "Truth" just makes you look silly to the rest of us, sorry but that's the truth.

        • Just a personal note. Rem. my son is an epidemiologist. In a way I felt sad that he didn't become a mathematician, after getting the dean's award for that. But he does know his statistics, which saved the army over $50 million by coming up with a different inoculation program. They gave him a $5,000 bonus! But he's happy he helped people. I wish I could give 'facts like you guys do'. But Wittgenstein said that everything that is, is a fact. I'm not a doctor. I'm not a scientist. I have transgendered friends. My son at eight years of age, (with respect to a gay tenant I had in the house) came to the immediate conclusion that 'you don't choose your sex'. From what has happened with my children, perhaps we should not think that 'morality' can be purposely taught, especially within the limitations of generalized thought. (One of my difficulties with such things as strict logical division, although I'm not as functional a philosopher on these issues as I'd like to be.) It's so difficult to figure out what is wrong. The Catholic sense of an absolute personhood recognizes the subjectivity of morality, but without recognition of an individual context. So 'God' provides an 'objective' criteria. It' all so abstract- yes? And then I read of their concept that 'morality' is something that cannot have a structure. Similar in some ways to Kant's treatment of morality only within the context of 'regulative' universals and the concepts of necessity. I don't believe we really understand what 'morality' is all about. We only have "knowledge of good and evil". But that does not mean for me that there is no wisdom in the bible. There is however so much seeming 'contradiction'. But I do think the emphasis within the new Testament is directed to an understanding of the particular/individual over the universal, although there is an inter-relationship between the two. If only those guys on EN would attempt to translate all of these norms within the context of their reductionism, instead of attempting to constantly criticize and find the limitations of the Catholic position. (I don't think they are going to 'get rid of' religion, Buddhism, to Islam that way. ) They could begin with that parable of the mote and the beam, for instance! Theory related to practice. How does one 'forgive and love one's enemy'? I mean' scientifically'!! How does one 'resist not evil', when most people I believe cannot comprehend the 'true meaning' of this phrase!!!!. We could offer the examples of Gandhi, and Jesus. Morality they say, the Catholics, is often best learned from/through example, for instance. But wouldn't it be nice if EN could find a scientific explanation for all of this and that!!! Wouldn't it be nice if they could put all of these thoughts within a 'material' context?

          This comment was 'inspired' by your last sentence. Can you translate Nietzsche's phrase, beyond good and evil, for example, in this regard. His 'meaning' is 'beyond my comprehension. He is talking about the individual 'conquering' 'himself' but I cannot put the 'beyond' within any 'context' Could this even be another version of the Golden rule, sans reference to God) These remarks just to promote my little idea that perhaps an understanding of meaning could have consequences in eliminating the problems found in some forms of argument. (in some contexts, of course.) Indeed is that not what the better comments here achieve: a kind of redefinition of the original questions by giving more specific information and commentary., and thus perhaps even a wider scope of human sensibility. .

          • William Davis

            To genuine concern for other people is the core of morality. Sure, we want and need a sense of structure and limits because concern by itself isn't enough, we need to understand outcomes to be able to make moral decisions. (One example is thinking it's moral to steal a drunk's liquor. One might mean well and do it out of concern, but the drunk is just going to buy more liquor and then hate you for a long time, removing any chance you have of helping him). Morality can get really complex and the situation always affect moral judgement. Personally I think utilitarianism is probably the best route for a democracy, though, as with any moral philosophy it has it's problems.
            With regards to Nietzsche, one has to be careful with "Will to Power". He didn't directly write that book, his Nazi sister took over his estate when he became ill and put the book together out of his notes (with the help of her Nazi husband). I prefer to judge him more by the works he actually wrote, but I'm no Nietzsche expert.
            In general Nietzsche understood what I believe is the truth, that morality is a human construct, thus it is important to realize this and intentionally take charge of morality. It's not "out there" it's in us. Even though we create morality, it's isn't free form art. Some things work much better than others. I think history demonstrates a clear selection mechanism with regards to morality...I like the way E.O. Wilson put it (though he may have got it from someone else) "Selfish individuals beat altruistic individuals, but altruistic groups beat selfish groups." Morality is largely an argument of "me" vs. "us" and figuring out where to draw the line.

          • Quote: "Selfish individuals beat altruistic individuals, but altruistic groups
            beat selfish groups." Morality is largely an argument of "me" vs. "us"
            and figuring out where to draw the line.

            Ooh! That's a tricky one. I always find it so difficult to find an 'us'. And I have problems with some forms of 'tribalism'. Consequentialism. There is I understand direct and indirect consequentialism. The Direct is the direct product of a specific intention. Yet how do you determine what to do, if you can only judge the effect of what you do by a later consequent? I wrote an analysis of all the forms of morality in Western thought, well almost all, but 'feared to post it inappropriately'. There is also thought - The road to hell is paved with good intentions. (even when based on a virtue ethic, or a categorical imperative, or natural law??? I think we also have to make a distinction between knowledge and 'wisdom'!!!
            I will learn to keep my silence!!!!!! At least that is my 'intention'.

    • Ladolcevipera

      I agree with most of what you have said, except with the suggestion to desist publishing certain articles. I think any subject must be open for discussion but this must be done with respect for all parties involved.

      • I agree, in an ideal world. In the real world, I'm not sure this can be accomplished with this medium. Much is lost in online communication. Intent and tone can be read into sentences. Bad motives can be attributed to a poor choice of words or turn of phrase.

        When the online communication is public, as it is here, then words and opinions are given a more or less wide audience, and certain positions end up being given more consideration and respect than they deserve.

        For these reasons, I think some topics are best discussed in private, in person, over a beer. Not in an online forum.

        If a buddy of mine sits me down over a couple pints and tells me that the holocaust didn't happen, I'll happily sit with him and show him why that's an idiotic and insulting opinion. If someone submits an article to Strange Notions article about how the holocaust didn't happen, then I think it would be a mistake for SN to print it.

        Not everything needs to be openly discussed in all forums.

        • Ladolcevipera

          Do you have any idea why your comment was deleted? I read it before it was and I do not see why it should be removed. Unless you had second thoughts and deleted it yourself? I understand your position, although I still do not fully agree with it.

          • I deleted it, mostly because I thought about what I had just typed (after I hit "Send") and realized I didn't agree with it.

  • GCBill

    2. What do the terms man and woman mean?
    The terms "man" and "woman," like most categories, designate a cluster of various correlated attributes that can nonetheless come apart. We are normally confused by cases where a person possesses a set of features that don't neatly fit inside one cluster. We expect there to be an "essence" at the center, but in truth there are only correlations. So when we ask "what gender is this person?", we think we've asked a question which has some definitive easy answer, but which in actuality depends on the categorization scheme that we use. And choosing a categorization scheme depends on what you're trying to accomplish through demarcation. So it's possible that someone could be a "man" for some categorization purposes and a "woman" for others. I guess this means one could be addressed as a female despite being forbidden from using the women's restroom, or allowed to use it but forbidden from competing on a women's sports team. Such are the complexities of making categories out of clusters, but hey, reality is complicated.

    With this in mind, I think the other 4 questions are fairly easy to answer:

    1. What determines reality: facts or feelings?
    Facts, of course. But I have subverted the rhetorical implication that those who accommodate trans folk to some degree are merely acting on their "feelings."

    3. Is it hateful to be attracted to one sex but not to transgendered people who identify as that sex?
    It is not hateful to prefer romantic partners whose features are more or less tightly clustered, and who are (as a result) more or less easy to categorize.

    4. Will parents be guilty of child abuse if they fail to “transition” their children who identify as transgender?
    I don't think they should be considered guilty of child abuse in the eyes of the law, though it's possible they will be on our current legal trajectory. I haven't kept up with this legal issue as much as I should, and am speaking now as a philosopher. I would not legally condemn parents for failing to transition their children because it is a decision which should not be made lightly and which in some cases can be resisted for good reasons. However, I do think it's possible they would be acting against their children's best interests for failing to do so in others. Parents should exercise prudence in determining whether their child is really ready to go through such a permanent, arduous, and expensive change. But if they have the means and the child has demonstrated that (s)he understands the risks and requirement, then I think it can be a positive thing.

    5. Will a culture that celebrates transgender identities tolerate evidence that such identities are harmful?
    Perhaps not, but I don't see why such evidence would be troubling. I expect that people would suffer from trying to fit into a category that wasn't a good fit for them psychologically. This expectation, like the surgeon's scalpel, cuts both ways, and is one of the reasons why physical transitioning should not be taken lightly.

  • David Nickol

    By the way, Caitlyn Jenner has not had "sex-reassignment surgery." She has had hormone treatments, facial feminization surgery, and breast implants, but she still has male genitals.

  • GCBill

    Transperson Ozymandias has written "On Trans Regret," a blogpost which contains information pertinent to the claims made in support of question 5.

  • David Nickol

    5. Will a culture that celebrates transgender identities tolerate evidence that such identities are harmful?

    It is no secret that people with gender dysphoria (as it is called in the DSM 5, a change from "gender identity disorder') often have other problems. According to WebMD:

    Diagnosis and treatment are important. People with gender dysphoria have higher rates of mental health conditions. Some estimates say that 71% of people with gender dysphoria will have some other mental health diagnosis in their lifetime. That includes mood disorders, anxiety disorders, schizophrenia, depression, substance abuse, eating disorders, and suicide attempts.

    I do not think that Trent Horn's thoughts on the matter do the topic justice. The causes of gender dysphoria are not understood. It seems clear, though, that those with gender dysphoria don't whimsically decide they are mentally of the opposite sex. This is a deep rooted, possibly biological feature of their makeup.

    It seems to me very unhelpful to compare (as in the Swedish study cited) people who have had sex-reassignment surgery to the general population. It would only be meaningful, in assessing sex-reassignment surgery, to compare a group of transgender people who do have the surgery to a group of transgender people who do not have the surgery but were as similar as possible to those who do.

    It is difficult to imagine what it must be like to be convinced you are a woman in a man's body or a man in a woman's body. It is a predicament that, it seems clear, people find themselves in, not one they choose. And so without advocating political correctness, I would say it is a personal issue of the utmost seriousness and should be approached with great care—certainly with greater care than in the OP.

    • William Davis

      It seems to me very unhelpful to compare (as in the Swedish study cited) people who have had sex-reassignment surgery to the general population. It would only be meaningful, in assessing sex-reassignment surgery, to compare a group of transgender people who do have the surgery to a group of transgender people who do not have the surgery but were as similar as possible to those who do.

      My thoughts exactly. Critical thinking is our friend :)

  • David Nickol

    Imagine how devastating it would be for a little boy or girl to have his
    body permanently mutilated just because he or she expressed a fleeting,
    childish thought.

    And you do have to imagine this, because it does not and cannot happen. Sex-reassignment surgery is never performed on anyone under 18 (in the United States), in part so that they can give informed consent as an adult. There are various sets of guidelines by medical groups and insurance companies for when surgery is permissible. Here are the guidelines from one major insurance company (Aetna):

    A. Two referral letters from qualified mental health professionals, one in a purely evaluative role (see appendix); and
    B. Persistent, well-documented gender dysphoria (see Appendix); and
    C. Capacity to make a fully informed decision and to consent for treatment; and
    D. Age of majority (age 18 years and older); and
    E. If significant medical or mental health concerns are present, they must be reasonably well controlled; and
    F. Twelve months of continuous hormone therapy as appropriate to the
    member’s gender goals (unless the member has a medical contraindication
    or is otherwise unable or unwilling to take hormones); and
    G. Twelve months of living in a gender role that is congruent with their gender identity (real life experience).

    Nobody gets sex-reassignment surgery because of a childish, fleeting thought, and it is absurd to suggest otherwise.

    • Mila

      That case was in the UK and the boy did go through surgery.
      Whether Aetna or any other insurance company have those conditions in place now, it doesn't mean that they might not change them. And the way things are going, it is not hard to imagine either.
      Also, I would love to see if they have any conditions for hormone treatments for children.
      Can anyone say with any certainty that those conditions will not change? Nope, especially not in this society today.
      So what is your opinion about the boy in the UK case?

      • David Nickol

        So what is your opinion about the boy case?

        Suppressing puberty is becoming increasingly common in both boys and girls who exhibit gender euphoria. The couple seems to have been ahead of their time. It is not surgery. It is not irreversible. In fact, it allows the child involved more time to decide whether or not he or she really wants to go through with surgery. I do not want to second guess parents and physicians in individual cases. It seems to be an appropriate medical intervention under the right circumstances.

      • David Nickol

        Whether Aetna or any other insurance company have those conditions in place now, it doesn't mean that they might not change them.

        Refer to question 1 above:

        1. What determines reality: facts or feelings?

        I would prefer to discuss reality—the way things are now—rather than scenarios invented by people frightened about the future. How to deal with gender dysphoria in children is an extremely difficult problem, probably best left to parents and medical professionals.

      • William Davis

        We don't even allow people under 18 to get tattoos, much less a surgery like this.

  • Kraker Jak

    Too much information. Please pass the gravol.

  • daniel santos

    the problem of the English language! terms are not as exact as it is.

  • Michael Murray

    A 2011 study at the Karolinska Institute in Sweden produced the most illuminating results yet regarding the transgendered, evidence that should give advocates pause. The long-term study—up to 30 years—followed 324 people who had sex-reassignment surgery. The study revealed that beginning about 10 years after having the surgery, the transgendered began to experience increasing mental difficulties. Most shockingly, their suicide mortality rose almost 20-fold above the comparable nontransgender population. This disturbing result has as yet no explanation but probably reflects the growing sense of isolation reported by the aging transgendered after surgery. The high suicide rate certainly challenges the surgery prescription.

    In the language of medical trials you are comparing the group that had treatment to the group that didn't have the disease. How does challenge anything about the treatment ?

    Thanks to Andrew G for pointing this out. I missed it the first time I read through.

    http://outshine-the-sun.blogspot.com.au/2015/06/estranged-notions-five-questions-for.html#more

    • David Nickol

      Thanks for the credit. But I basically just made an objection. Andrew G effectively destroys the section devoted to Question 5 as it currently stands in the OP by quoting the study itself. Everyone should take the time to read Andrew G's post.

      • Michael Murray

        Good point. Perhaps I should quote that bit as well in case people don't want to risk clicking on a link to Estranged Notions :-)

        It is therefore important to note that the current study is only informative with respect to transsexuals persons health after sex reassignment; no inferences can be drawn as to the effectiveness of sex reassignment as a treatment for transsexualism. In other words, the results should not be interpreted such as sex reassignment per se increases morbidity and mortality. Things might have been even worse without sex reassignment. As an analogy, similar studies have found increased somatic morbidity, suicide rate, and overall mortality for patients treated for bipolar disorder and schizophrenia.[39], [40] This is important information, but it does not follow that mood stabilizing treatment or antipsychotic treatment is the culprit.

        http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885

    • Mary B Moritz

      Important point. The study itself tries to "buy results fast and easy" by comparing transgender persons with healthy controls. The Swedish group found 800 patients (!) with gender identity disorder, out of which 384 had confirmed transgender surgery. Only these 384 patients were then taken into the study.
      What about the rest? Some of them did not have gender dysphoria but soime other diagnosis, well taken. But the rest? This would have been a very interesting group to look at. It is, though, not an easy "comparator" and would have needed more in-depth analysis - taking healthy controls is just easier....

  • David Nickol

    5. Will a culture that celebrates transgender identities tolerate evidence that such identities are harmful?

    I don't think the culture celebrates "transgender identities." I think what the culture celebrates is having the courage to be who you are. I know it sounds a little trite. But it is not that people celebrating the apparent fact that Bruce Jenner had feelings inside that he felt he had to keep hidden. They are celebrating the fact that he could "come out" as Caitlyn Jenner. I don't think anyone is actually happy that there exists such a thing as gender dysphoria. No one is going to be upset if it suddenly is the case that every biological boy has a male gender identity and every biological girl has a female gender identity. It is not being celebrated that anyone experiences gender dysphoria. What is being celebrated is that some of those who do have the courage to do something about it and that a great many people treat them with tolerance.

  • Doug Shaver

    1. What determines reality: facts or feelings?

    Reality is the facts, and our feelings are irrelevant to what the facts are. But so are the pronouncements of any authority. Nothing is a fact just because someone says so, even that someone is everyone.

    2. What do the terms man and woman mean?

    That depends on context. Biologically speaking, a man is a male human and a woman is a female human. And biologically speaking, females produce eggs and males produce sperm. Socially speaking, we humans can make anything more complicated than it needs to be, and that has happened in matters of sexual identity. And social realities are no less real than biological realities. Whatever has observable consequences is a real thing.

    3. Is it hateful to be attracted to one sex but not to transgendered people who identify as that sex?

    I see no reason to think so.

    4. Will parents be guilty of child abuse if they fail to “transition” their children who identify as transgender?

    I doubt it.

    5. Will a culture that celebrates transgender identities tolerate evidence that such identities are harmful?

    A culture that is actually intolerant of evidence that contradicts any of its dogmas has problems far worse than anything that might result from the acceptance of unconventional behaviors. The same is true of any group that accuses its ideological adversaries of not tolerating evidence when those adversaries simply disagree about what the evidence actually proves.

    I happen to be highly skeptical about much of what people who call themselves liberals or progressives are saying about people who were born male and wish they were female, or vice versa. They have taken certain secular doctrines about human nature and declared them to be scientific fact while giving little or no attention to the intellectual rigors of genuine science. In this respect, of course, they are neither more nor less guilty than many of their conservative adversaries.

    The bottom line is this: we should not mock or dehumanize people who have gender identity disorder. Someone struggling with this disorder requires counseling, appropriate medical intervention, and an empathetic ear that is willing to listen. But we also shouldn’t celebrate the mutilation of healthy bodies or facilitate the destruction of masculinity and femininity.

    I have considered myself a conservative for a very long time--not always, but the older I get and the more I learn, the better conservatism looks. But it seems to me that one of the fundamental principles of conservatism is that we must be receptive to the lessons of history. And one clear lesson of history is that we are at grave risk of committing great evils when we infer pathology from anomaly. Nobody is sick just because they are different from other people.

    Most of us are wary of people who differ from us. That wariness tends to generate fear and suspicion, and in many situations even hatred. These tendencies are natural. Evolution seems to have hard-wired them into our brains, and liberals are making a serious mistake when they ignore this or try to deny it. But we do not have to act on all of our genetic impulses. We often have good reasons to act against them, and one such reason is the knowledge that a particular difference in behavior is no threat to us.

    I firmly disagree with that song from South Pacific, "You've Got to be Carefully Taught." We are not born racists, but it does come naturally to us. If anything has to be carefully taught, it is the wrongness of racism. But it has long been taught in modern society, and most of us have learned it well--so well that nowadays, it's racism that looks like an aberration. Racism is still in our nature, but we can get over it, and most of us have gotten over it. Or at least we have made considerable progress toward getting over it--a lot more progress, certainly, than many liberals would give us any credit for.

    I was in my late 20s the first time Bruce Jenner became famous, and I had to check Wikipedia to remind myself what he was famous for. All I could remember was that he was an athlete of some kind, and I wasn't even sure about the decade. I was guessing that whatever he did was during the late 1960s.

    Whatever . . . At the time, he was unambiguously a man. Now he says he's a woman and pleads with us to talk about him accordingly. I'm supposed to think that I'm perpetrating some kind of injustice by continuing to use masculine pronouns. Maybe I am, maybe I'm not. I don't want to have that argument in this thread.

    Everybody who, for whatever reason, is dissatisfied with having been born male or female is, before they are anything else, a human being to whom we are morally obliged to extend certain considerations. We are not morally permitted to make them suffer just to suit our convenience or to express our disapproval of the choices they make when those choices present no hazard to our own welfare. And they will suffer if we presume, without clear and incontrovertible scientific justification, that their choices are attributable to cognitive dysfunction.

    Conservatism, with good reason, places great value on normalcy and conformity to social norms. But conservatives greatly err when they suppose that all deviance or nonconformity is pathological. It often is, but not invariably. Each instance must be separately judged by its reasonably predicable consequences, and I see no bad consequence in treating Caitlyn Jenner like a woman.

    Is Caitlyn really a woman, or a man begging to be treated as if he were a woman? I really don't know, and it is not apparent to me that I need to know at this moment in history. Whichever is the case, to borrow Jefferson's phrase, it neither picks my pocket nor breaks my leg. I would ask Jenner's liberal advocates to feel the same way toward my ambivalence.

    • Again I appreciate your comments. My responses are generally more personal than yours I guess. I don't feel for instance I want to get involved in what Rimmer and the evil overlord called the ugliness of this post. But you have risen above that. There are perhaps always cognitive biases on both sides on 'the' 'a' argument. The difficulty is that I don't believe we are yet ready for 'anarchy'. And from my study of Marxism and Facism, (I even acted in Brecht dramas in the early 60's, the compliance of 'the individual' could be considered more? contributative to events than the 'general orthodox position' Is this latter statement merely a question of where to put the emphasis. I have just read Robert Bales', letter for instance. My son is the 'doctor' who is fighting the fight against the use of Mefloquin, even in Guantanamo. We forget that there can indeed be 'many causes' to consider. But then, is not 'cause and effect' another 'metaphysical' concept. I guess in centuries to come, they will find as much conflict in my use of concepts, as I find today within the concepts of Catholicism.......???? Yet, I keep hoping for more scientific erudition on EN, and find now that perhaps, unknown or unadmissable to them, they indeed have their own 'metaphysic'. They perhaps have not read: Prologemna to any Future Metaphysics. Yes, we still do have many different 'mythologies', even within the 'secular state'. I want to keep reading your remarks. Take care.

    • danainnyc

      "A culture that is actually intolerant of evidence that contradicts any of its dogmas has problems far worse than anything that might result from the acceptance of unconventional behaviors."

      You have summed up the problem with most religious cultures generally and Trent Horn's version in particular. Brevity and truth are a rare combination. Plaudits and a poaching alert because that line will be remembered.

  • Kraker Jak

    Welcome to Bizarro World. What next? If one has....the money and privilege..trans race?....or perhaps someday even trans species?

    https://libertarianalliance.wordpress.com/2014/07/17/if-we-can-be-transgender-why-cant-we-be-transracial/

    http://tsq.dukejournals.org/content/1/1-2/253.full

  • 1) the differences between gender, sex, species, and abilities are significant, which is why they are approached differently. Transgender issues should be assessed on their own facts. A gender identity that is in conflict with one's anatomy is not a delusion. Gender is not determined on the basis of genetics or anatomy. What gender is, is highly debatable, it is, in my view a mixture of social construction and body chemistry.

    2) Jenner's sexual reassignment did not transform him into a svelte and sultry individual. Her wardrobe choices and so on did. She could play gender in this way before surgery as well.

    What a "man" and "woman" is, is not easily definable. It is very complicated. Gender is a role we play. A very serious role to some. certainly saying only women who act traditionally feminine are real women is sexist, but there is nothing sexist in women enjoying these things, so long as they enjoy them and are not doing so out of social pressure.

    More to come.

  • teomatteo

    I am a man. There I said it. i'm free. but...if i absolutely do not want to be a woman. Have no interest in being a woman. Would never think about such a stoopid thing. Am i sexist? Did i just speak a hate crime? a bigot?
    On another note.... I'm poor... not real poor but certainly not rich... but... i wannna live rich, i wanna spend rich, i believe i'm rich.... i'm rich! (ah.. but dont ask me for money)

    • No you did not commit a hate crime or make a sexist comment. You made a trans-phobic comment, and you are free to do so just as you are free to make racist comments if you wished.

      The opinion that some people who are men and have an interest in being a woman is "stoopid" in this curt manner, in this context, betrays your ignorance of the subject and is perjorative towards a marginalized group that deserves protection from such treatment.

      Transgender people do not want to be another gender. The may not even subscribe to this notion of gender. People who have sexual reassignment feel that their gender is in conflict with their anatomy. In the case of Caitlyn Jenner, she always was a woman, but her genetalia and hormones were in conflict with her identity. The surgery is designed to fix this and is done according to a lengthy process, counselling, hormone and so on.

      Saying transsexuals are "stoopid" is like saying Catholics are idiots because they believe in a sky pixie. It's a perjorative mischaracterization of what they believe in a smug and curt way.

  • Haven't people realized yet the importance of 'asking the right question'!!!!

  • 3 No it is not hateful to lack attraction for anyone. It is hateful to discriminate on the basis of gender, and transgender is a gender identity. Not sure what the website meant, but in my experience people can identify as men or women or trans. People who have transitioned may identify as men or women, and it would be hateful to treat them as less than human because of this.

    To close one's mind and consider trans folk "gross" or something would be hateful. But to keep an open mind and just date who you feel attracted to is fine.

    4) I'd have to look into this but I would be very cautious about having reassignment surgery on children. But if the medical community finds that this is something that is important for the health of a child, yes, there could be consequences for parents who fail to address it. I wouldn't treat it differently than any other medical treatment. However, I am very skeptical that such a procedure is ever contemplated for children.

    But it certainly has occurred. Hermaphrodite children have been surgically assigned a sex, sometimes with negative consequences. What should happen, as much as possible is that children should be allowed to express gender as they wish. This is not an issue that parent really need to be involved much with, beyond educating children that they may face abuse if they express gender in non traditional ways.

    5) of course an inclusive society should be open to evidence that sex reassignment can be harmful. But as you note this is not a finding of the study. It is not heads you win, tails you lose, it just is not something that can be inferred from that study. You need to compare trans people who do and do not have the surgery. Very hard to control for.

  • VicqRuiz

    Must one be forced to either affirm or to oppose?

    I personally think that those who identify as transsexual are subject to a personality disorder, and I would not raise a child of mine as the gender opposite from that of his or her birth.

    But I have learned over the years that "things that Vicq Ruiz disagrees with" is not the same as "things which should not be allowed".

  • Trent's concluding comments are offensive to me. When people have reassignment surgery they are not mutilating their genitals, nor are they destroying their masculinity or femininity.

    One's gender does not depend on one's sex organs, though they are very involved in it as are hormones and culture. People with male sex organs can dress and behave and genuinely be feminine, and vice versa.

  • William Davis

    In general I thought this article reminded me of a bull in a china shop with regard to how it handles delicate issues.
    Otoh, I agree with Paul McHugh from John Hopkins that sex reassignment surgery should not, at this point, be considered a treatment for gender identity disorder. There is not nearly enough evidence to support it as a treatment, especially not enough to allow medicare to pay for it. I'm libertarian enough to for allowing it, and if eventually there is enough evidence from people who pay out of pocket for the surgery to consider it to be a valid treatment, then my mind might change. In the mean time the conservative in me is appalled by the waste of tax dollars when we're still running such a deficit...Guaranteeing people basic medical care doesn't lead to this, in my opinion.

  • I also want to say that I do not see what this issue has to do with the dialogue between atheists and Catholics. My position on gender has nothing to do with my athiesm. And, there is nothing in this article from a theist or Catholic perspective. Rather it seems implied that gender reassignment is somehow innapropriate from a Catholic point of view. That it should be okay to treat trans folk negatively based on their gender expression. But this is never said.

    Like articles on abortion and homosexuality, what we have here are secular objections to trans, which, I would say are easily diffused. Whereas what I think really underlies this is a view that trans tendencies are sinful as they are unnatural. As if God assigned us each a clear gender and we should act that role in ways traditionally associated with that gender.

    This is not the case. Not all humans are born with one set of sex organs. Sometimes people are born with sex organs that never feel right to them, despite the fact that they are being socialized into that gender. This is how these folks naturally are.

    Others, have distinct sex organs, and do not have any wish to change them, but do not identify as one or the other gender and may express different roles. Other than the harm from prejudice against this kind of non-traditional expression, I fail to see anything wrong with expressing gender however you wish.

    • Michael Murray

      This website is often a confusing intersection of Catholicism and conservative US politics.

  • William Davis

    One major problem with Christian morality with regard to sexuality is that it was developed with no regard for intersex people. I hear "God created us male and female" a lot, but 1 in 1500 people, that's completely false. Some (more rare) have functional version of both genitalia. In these cases, I don't think anyone would object to a surgery that would allow only one copy to remain (depending on whether they decide to male or female, if they aren't sure they are well equipped to deal). All of this talk of "natural order" leaves out the biological fact that gender and sex are very messy concepts. The fact that God (assuming the existence of such a being) allows intersex people to be born should tell us how concerned he is with human sexuality...

    http://www.isna.org/faq/frequency

    To me, the long term Christian obsession with sexuality is somewhat strange and misplaced.

    • danainnyc

      I agree with most of what you've written but for naturally occurring hermaphrodites I thinks it should be made absolutely clear that they are to be left unaltered until they are able to decide for themselves. Their sexual difference should be treated like a heart condition that must wait for maturity to be repaired if that kind of matter-of-fact quality is possible in this strange Puritan/pornographic hybrid culture of ours.

      I have always found the "natural order" argument bizarre. Cause Nature sure loves her some homosexuals in all mammalian species and is equally implicated in spontaneous and stress induced abortions. As for your last line, the Christian obsession translates to a US Government obsession with limits on abortion, contraception and adoption. Strange and misplaced indeed.

  • Evidence of 'diversity' among the Bishops of Rome? http://www.ncregister.com/blog/edward-pentin/cardinal-mueller-warns-against-adapting-church-teaching-to-todays-often-pag The opinion of the last bishop mentioned can be contrasted with the reference to the pagan values, (was Aristotle not a pagan?) and the traditions, and the scripture of the church in contrast to what? the 'living experience' of today world? (Not quite an accurate report here of what was said, but I merely had to ask, what? was scripture not based on real, live, experience????
    They do talk about homosexuality, particularly in this article, and thus relative, by indirect reference, to the views on same sex marriage, transgender issues, etc. I assume.

  • David Nickol

    If the only difference is the terms themselves, then modern “gender ideology” is guilty of eviscerating the concepts of male and female of any objective meaning beyond “what I want to be called.”

    The issue with transgender persons is not what they want to be called. It is what they want to be and how they want to be seen and accepted. When it comes to modern "gender ideology," transgender persons don't want to eliminate the distinction between what it means to be a man and what it means to be a woman. Indeed, one of the concerns is that transgenders are too interested in reinforcing stereotypes. One might ask how many 65-year-old women want to appear on the cover of Vanity Fair as if they were about 40 years younger competing in a Miss America swimsuit competition. Hillary Clinton is only two years older than Caitlyn Jenner. Does anyone think that, as she tries to promote herself to break the "glass ceiling" and become the first woman president, that she would launch a campaign to promote herself as a "real woman" by having similar pictures in a national magazine? There is a thoughtful article in the New York Times that concludes as follows:

    While the fanfare around the emergence of Caitlyn may advance our
    acceptance of transgender individuals, it does so, in this case, at a price: the perpetuation, even celebration, of narrow and dehumanizing strictures of womanhood sustained by the fashion and entertainment industries. True liberation of gender’s vast spectrum should ask more of us than that we simply exchange one uncomfortable, oppressive identity for another.

  • The Genderbread Person is a cute infographic cartoon that's been all over social media in various forms. It succinctly encapsulates a few of the key recent developments in people's thinking on gender issues, and so it is an important contribution regarding the article's first three disturbingly uninformed questions. The only essential detail that I think the cartoon omits is that, while there are people at every degree along these scales, most people in our society are in the two largest clusters.

    The idea of some Catholics about a biological dichotomy between men and women is of course unsustainable on scientific grounds. I've also spoken with Catholics who preferred to stay faithful to Scholastic and medieval Church teachings about the inferiority of women, in the same sexist spirit as the ancient religious purity laws, and who on these grounds would categorize anyone who is not an "unblemished male" as a "woman". That's too prejudicial for most folk these days, and furthermore it's just an argument about category definitions rather than about reality.

    On the other hand, I've spoken with liberal and Trad Catholics who pointed out the doctrine that Jesus' human nature was received only from Mary, which would imply, if it were true, that either Jesus or Mary or both were intersex. One of the Catholics who is both liberal and Traditionalist preferred that Jesus be intersex whether or not Mary was, so that he could be a better representative of men and women both, in a modern, gentler update of the old Church teaching that Jesus had to be a male to properly represent humanity.

  • Kraker Jak