I know a man who had a "sex change" operation and is
now a "woman." What moral teaching does the Church give on
this subject?
—A reader in Roseville, California
Before addressing the morality of "sex change" operations, or
what is more formally termed "sexual reassignment," we need
to first call to mind the fundamental moral foundation
governing this issue. Each person is a precious human being
made in God's image and likeness with both a body and a soul.
Vatican II's "Pastoral Constitution on the Church in the
Modern World" asserted, "Man, though made of body and soul,
is a unity. Through his very bodily condition he sums up in
himself the elements of the material world. Through him they
are thus brought to their highest perfection and can raise
their voice in praise freely given to the Creator. For this
reason man may not despise his bodily life. Rather he is
obliged to regard his body as good and to hold it in honor
since God has created it and will raise it up on the last
day" (No. 14). St. Paul also reminds us that our bodies are
temples of the Holy Spirit (1 Cor 6:19), and therefore we
should not degrade our bodily dignity by allowing the body to
participate in the act of sin. Moreover, such sin hurts the
body of the Church. For this reason, the Church teaches,
"Except when performed for strictly therapeutic medical
reason, directly intended amputations, mutilations, and
sterilizations performed on innocent persons are against the
moral law" (Catechism, No. 2297).
Given this
foundation, we can address the issue of sexual reassignment,
which is a type of reconstructive surgery whereby a male is
altered anatomically to resemble a female, or vice versa.
Transsexual surgery coupled with hormonal treatment and
psychotherapy are used to treat the disorder
transsexualism or gender dysphoria syndrome, "a
condition in which there is apparent psychological and social
identification with attributes of the opposite sex" (Meyer,
"Psychiatric Consideration in the Sexual Reassignment of
Non-Intersex Individuals" in Clinics in Plastic
Surgery, 1974). The Diagnostic and Statistical Manual
of Mental Disorders, published under the auspices of the
American Psychiatric Association, lists five symptoms of
transsexualism: (1) a sense of discomfort and
inappropriateness about one's anatomical sex; (2) a wish to
be rid of one's own genitals and to live as a member of the
other sex; (3) the disturbance had been continuous (not
limited to periods of stress) for at least two years; (4) the
absence of physical intersex or genetic abnormality; (5) and
the lack of cause due to another mental disorder, such as
schizophrenia.
Without question, the causes of these symptoms
and their diagnosis is extremely complex. Nevertheless, once
a person has made the decision to pursue a sexual
reassignment, eventually radical surgery is performed which
involves for a male, castration and the construction of a
pseudo-vagina, and for a female, mastectomy and hysterectomy,
and the construction of a non-functional pseudo-penis and
testes (confer Colin Markland, "Transsexual Surgery" in
Obstetrics & Gynecology Annual, 1975). Obviously,
such procedures involve a radical and grotesque mutilation of
the body. No transsexual surgery will ever be able to
duplicate completely the anatomy or the functioning of the
opposite sex. A male transsexual will never be able to
ovulate or conceive; and a female transsexual will never be
able to germinate sperm. Transsexuals will need to use
synthetic hormones continuously to sustain their change,
which in turn runs the risk of cancer.
Another moral
consideration is whether the condition of transsexualism
justifies surgery. No biological cause of transsexualism has
been identified. Rather, the cause appears to stem from
psychological development, and thereby transsexualism should
be treated with psychotherapy. Interestingly, even after
surgery, transsexuals need at least some psychotherapeutic
support.
Finally, a transsexual will never be able to enter
validly into the sacrament of Matrimony. A man who undergoes
sexual reassignment will never really be a woman, or vice
versa; rather, a man will be a man (or a woman will be a
woman), except with a mutilated body and profound
psychological disordering. Moreover, a transsexual will never
be able to consummate the marriage in the fullest expression
of love of husband and wife, and never will there be a real
openness to life and the creation of children. To destroy
organs purposefully that are healthy and functioning, and to
try to create imitation organs which will never have the
genuineness and functioning of authentic organs is gross and
lacks charity. Such surgery which purposefully destroys the
bodily integrity of the person must be condemned.
Nevertheless, individuals suffering from gender dysphoria
syndrome must be treated with compassion. They need spiritual
counseling which will help them realize the great love of God
who loves them as individuals who have been created in His
image and likeness. They need proper psychotherapy which will
help them to face realistically their human situation and the
world, and the consequences of their actions on themselves
and their relationships with family and friends. Such
counseling will also direct them to spiritual, intellectual
and social pursuits to realize their self-worth and divert
their preoccupation with sexual identity.
Just as an aside,
the question posed for this article involved the following
story: The reader is a retired family practice physician, who
still works part-time at the community hospital. His
grandchildren had a regular pediatrician. Once his daughter
(the mother of the children) asked if he would take them for
their appointment. He noticed that their pediatrician seemed
distant, pre-occupied and cold. Several months later, he was
eating lunch at the hospital cafeteria and a female physician
approached who asked if she could join him. He said, "Yes."
He then asked, "Do I know you?" The female physician paused
and said, "Yes. I used to be so-and-so, your grandchildren's
pediatrician." After a pause, the retired doctor replied, "I
have to say, You are looking well." What else could he say?
When examining this moral issue, once must not simply focus
on the gravity of the physical mutilation. Rather, one must
also focus on the devastating impact this act has on loved
ones' parents, spouses, children, as well as friends and
the community at large. Couldn't a child say in this story,
"My father killed himself to be someone else?" Therein lies
the tragedy of this heinous act.
Fr. Saunders is pastor
of Our Lady of Hope Parish in Potomac Falls and a professor
of catechetics and theology at Christendom's Notre Dame
Graduate School in Alexandria. Please note: 100 articles
of this column have been compiled in a book, Straight
Answers, and another 100 articles in Straight Answers
II. These books are available at local religious book
stores or by calling 703/256-5994 (fax 703/256-8593) or
e-mailing straightanswerswps@hotmail.com. All proceeds
benefit the building fund of Our Lady of Hope Church.
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