The Morality of 'Sex Change' Operations
by Fr. William P. Saunders
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?
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.
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'Straight Answers' reproduced with permission from Arlington Catholic Herald
. Copyright © 1993-2004 Fr. William P. Saunders. All rights reserved.