Don’t Assume We Should Change the Body to Match the Mind

When a person’s mind conflicts with his body, which should we help him to change? While speaking at the ERLC National Conference last month, Denny Burk said:

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.

But as Burk explains, our society takes the opposite view when it comes to “Body Integrity Identity Disorder”:

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….

It turns out that “John” has a condition that pychiatrists call “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….

We consider it wrong to amputate healthy limbs—it’s considered a mutilation of the body, out of bounds for respectable doctors, even if the would-be amputee desires it.

Burk then makes the obvious connection to those who desire sex-reassignment surgery:

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? …

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 the problem here damaged limbs or a damaged mind? Does the body need adjusting, or does the thinking? … 

Over the last few 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).

Why, only when it comes to gender disorders, do we accept the idea that the body must be changed to fit the mind? As with those who have Body Integrity Identity Disorder, shouldn’t we rather do what we can to help the suffering person adjust his gender identity to fit his body? Shouldn’t responsible doctors likewise refuse to amputate their healthy body parts?

As it turns out, even if it weren’t problematic for doctors to agree to these surgeries, we may not be doing people any favors by removing their healthy body parts at their request. I’ve posted before about “Why the First Hospital to Do Sex-Reassignment Surgeries No Longer Does Them,” and this week Stella Morabito compiled a number of stories of people who greatly regretted their surgeries here. The stories are tragic.

We ought to have a great deal of compassion for those who have gender disorders. As with those who suffer from Body Integrity Identity Disorder, we may not be able to provide relief through changing their minds. But that doesn’t mean we should assume relief would be provided through mutilating their bodies. 

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Amy K. Hall