How to live a good and happy life in Catholic Thought with the transgender position
I recently submitted the following essay to my university. Feedback from my assessor are in italics and brackets:
In my previously submitted essay, I started off with examining the competing views on the human person of transgender experience. This examination is important, because what we understand about the human person ultimately impacts what we understand about the good life. Catholic Thought supports the Aristotelian-Thomistic position that the human person includes both the body and soul to the exclusion of others (psychosomatic unity), and that the soul is the one and only substantial form of the body (forma corporis).[1] My essay proved that this view has the stronger argument.
In addition to what was argued, in the Aristotelian-Thomistic sense, gender distinction does not stem from the soul at all, rather, it stems from the sexed body. If gender stems from the substantial form or from an accidental form of the soul, that would make male and female human persons distinct species.[2] Further, if the soul is innately male or female, then intersex conditions should not occur in human persons, and by this logic, those who a gender-fluid, or non-binary in their gender identity, should be intersexed, but this is not necessarily the case.[3] What generally occurs instead is that the chromosomal gene, Sex Determining Region on Y (SRY) causes dimorphic differentiation of the gonads in the foetus, leading to dimorphic endocrine regimes that lead to the dimorphic development of secondary sex characteristics.[4]
However, such an argument tends to lead to the argument that human persons of transgender experience should just learn to self-accept and protect their natal body for communion and stewardship purposes, in order to live a good life. This is cold comfort for people like myself, where years of counselling and psychotherapy has not worked. In 2020 I blogged part of my childhood experience with gender dysphoria as follows:
“Medicine should be used to alleviate dysphoria, not to disguise a person’s sex, at least that’s been my experience. I base my happiness on not getting distracted by dysphoria, ie getting on with finding meaning in life like everybody else, nor do I care about other people’s opinions or perceptions… I wish I never experienced gender dysphoria (this is what actually makes me very sad). If I didn’t experience it 24/7, I would’ve “be[come] a man” as I was told to do growing up… I have no capacity to ever understand what it means to not have gender dysphoria, ie be cisgender. Ever. I never had that capacity to begin with, and I never will. Transition was a last resort because I wanted to stop being miserable, and stop being so unhappy. If I could’ve avoided transition, I would’ve. Ultimately, no one can give me happiness, only I can.”[5]
Psychological development gives rise to dispositions and inclinations, whether potential or actual. Transgender science remains controversial but the consensus is that both biological and environmental factors drive gender identity.[6] Although there is no direct Magisterial teaching on a considered moral theological response to the transgender experience[7], this essay will nevertheless attempt to argue how to live a good and happy life in Catholic Thought, for people like myself who are undergoing or have undergone gender transition, including medical transition.
Noting that “biological sex and the socio-cultural role of sex (gender) can be distinguished but not separated”[8], men and women tend to wear different clothes, in any given culture, and time in history. If a man dresses as a woman, this can be considered indecent and/or offensive, and Deuteronomy 22:5 points this out. St Thomas Aquinas elaborates that the virtue of someone wearing attire that corresponds to their role or status is truthfulness[9], and not doing so is sinful, also because crossdressing may be sensuously pleasurable.[10] However he also argues that crossdressing is not sinful if it is necessary, either to “hide oneself from enemies, or through lack of other clothes, or for some similar motive”.[11]
If St Thomas was alive today, it would be interesting to know whether he would have thought that crossdressing to alleviate gender dysphoria is not sinful. Whilst I do not speak for other trans women, I can confirm that I do not crossdress, in the male-to-female sense, to attain sensuous pleasure. Because of the emotional pain that I have experienced from unalleviated dysphoria, it could be figuratively argued that I am crossdressing to hide myself from my psychological enemy.
Further, feminising hormone therapy has helped me develop female secondary sex characteristics, meaning that this has helped me present as a woman to society at large, therefore, me wearing female attire corresponds to people’s perception of my female role and status. Whilst it can be argued that this is deceptive on my part, appearing as a woman in male attire may socially invite enemies who will question my female-to-male crossdressing that they perceive of me. Unsurprisingly, in a letter seeking union with the Bulgars, Pope Nicholas I wrote:
“We [do not] desire to know what you are wearing except Christ… For whether you or your women wear or do not wear pants (femoralia) neither impedes your salvation nor leads to any increase of your virtue.”[12]
Of course, distinguishing human persons as male and female reflects a biology deeper than dress, and as alluded to earlier in this essay, hormone therapy and sex reassignment surgery (SRS) can affect how one distinguishes a human person’s gender. It therefore has been argued that medical transition is impermissible because it involves adopting a false gender identity.[13] However it is possible me to affirm both the Aristotelian-Thomistic view of myself, and affirm the need to alleviate my gender dysphoria, which feeds into my perceived gender identity, by medical means, in order to manage my mental health and well-being. Such an approach, focused on the medical management of the psychological enemy, is therefore not an attempt to alter the psychosomatic unity of the human person.[14]
As an analogy, human persons are generally raised by biological parents, surrounded by biologically-related siblings and other relatives growing up. Such relationships, which cannot be chosen, allow human persons to identify themselves by reference to their biological parents, amongst others. The concept of parental roles and responsibilities is founded on such biological relationships.[15]
Some children are given up for adoption to practically become, the children of the adopting parents. There is generally no biological relationship here, but for all intents and purposes, they are considered the children of these parents. The acquisition of such adoptive identity is the raison d’etre of adoption, but it is not a false identity, as it has its own social and meaningful reality, and authenticity. This of course, does not override the adopted child’s biological identity as Galatians 4:4–5 would allude to.
Whilst adoptive identity cannot be equated to transgender identity, they are both social types of identity that is different to assigned-at-birth identity. In both cases, legal and social identity can be reassigned without denying the human biology that applies, in order to allow the human person in such situations to flourish. Whereas adoptive parenthood is modelled on biological parenthood, my trans womanhood is modelled on biological womanhood. Social and essential identities do not need to be in competition — they can coexist to allow for human flourishing.
The medical management of the psychological enemy has also been argued to be inconsistent with how body dysmorphic disorders are managed. That is, medical transition has been compared with giving someone with anorexia nervosa liposuction[16] or with amputating a healthy limb as per someone’s desire.[17] However, such an analogy is not appropriate because those desiring a liposuction to deal with anorexia, or a limb amputation, are desiring a less healthy body, whereas those like myself typically desire to have the healthy, and not necessarily perfect, body of the opposite sex in response to dysphoria. Further, gender dysphoria primarily concerns gender identity, then sometimes secondarily, like anorexia, a subsequent, and potentially ongoing, dissatisfaction with the body.[18]
It therefore appears that a good and happy life for transgender people can be achieved as long as gender dysphoria is treated differently to gender dysmorphia. That is, modelling on biological womanhood enough to resolvingly alleviate dysphoria, as opposed to desiring further by means of potentially ongoing and cosmetic steps to reach a perceived perfect state of biological womanhood. It is worth noting that there are different types of hormone therapy and SRS, some more cosmetic than others that serve to treat dysmorphia, more so than dysphoria.
Pope Pius XII’s Principle of Totality is useful in navigating a human person’s gender transition to be good, and ends in the resolution of gender dysphoria. This principle gives three criteria for justifying surgery that results in anatomic or functional mutilation:
1. The retention or function of a bodily organ within the whole organism is causing serious damage or constitutes a threat to it
2. The damage or threat is unavoidable, or even substantially diminished, except by a mutilation in question and whose efficacy is well-assured; and
3. It is reasonable to expect that the positive effect will compensate the negative effect.[19]
Gender dysphoria affects human persons to varying degrees. For example, I was more socially dysphoric than genitally dysphoric growing up. My male name given right after birth, my socially-expected male dress, and my male secondary sex characteristics that developed on my face during puberty, were the main sources of my dysphoria. The retention of my male-appearing face was causing serious damage to my mind. Puberty is unavoidable, unless I was administered puberty blockers during my teenage years, and/or administered testosterone blockers and oestrogen therapy during early adulthood.
Indeed, hormonal and surgical intervention to the level necessary, has been found to frequently alleviate gender dysphoria and reduce the apparent risk of suicidal ideation. Carefully-developed guidelines for gender transition stress the importance of engagement and assessment between the patient and the doctor, and adherence to these guidelines is associated with low rates of regret and detransition.[20] Therefore, the efficacy of what I needed is well-assured.
My gender transition has had negative effects on me, but this has been outweighed by the positive effects, and ended in the resolution of my gender dysphoria. Whilst my SRS had a positive effect, that part of my gender transition probably fails the Principle of Totality test, given that I was more socially dysphoric than genitally. Therefore it could be argued that my SRS was used to deal with apparent gender dysmorphia, which is impermissible.
This essay has demonstrated how to live a good and happy life in Catholic Thought, for people like myself who are undergoing or have undergone gender transition, using Pius XII’s Principle of Totality, to ascertain those dispositions and inclinations that are stable and deeply rooted in the human person.
(This was an incredibly personal and illuminating essay, Dana. For this, I reiterate my gratitude because it has helped me to think about this issue with greater intensity than I had previously. I thought this essay was better written than your first but I did think it could have been enhanced by being a little broader in its response to the question you raise: How to live a happy life in Catholic thought with the transgender position? I guess my own thoughts would be, when it comes to the ‘good life’, is it any different to that of a non-transgender person? Would not the sacramental life be the same? Would not the pursuit of virtue be the same? Perhaps the issue you are really addressing – and what I’ve really appreciated about your essays — is: Can you reconcile the fullness of the Catholic life with what you call the “transgender position?” I think your thoughts on this issue are going to become more and more important and, so, I would encourage you to keep up you’re writing. And, if you feel comfortable, I would be keen to read anything you write on this issue in the hope that it might help me in my own pastoral work. Well done again!)
Bibliography
Australian Professional Association for Trans Health. “AusPATH: Public Statement on Gender Affirming Healthcare, including for Trans Youth.” Accessed July 09, 2021. https://auspath.org/gender-affirming-healthcare/.
Brugger, E. Christian. “Catholic Hospitals and Sex Reassignment Surgery: A Reply to Bayley and Gremmels.” National Catholic Bioethics Quarterly 16 (2016): 587–597, https://doi.org/10.5840/ncbq201616456.
Dana Pham. “Targeting trans women for being women.” Noteworthy — The Journal Blog. June 20, 2020. https://blog.usejournal.com/targeting-trans-women-for-being-women-9565e6a47185.
Gremmels, Becket. “Sex Reassignment Surgery and the Catholic Moral Tradition: Insight from Pope Pius XII on the Principle of Totality.” Accessed July 09, 2021. https://www.chausa.org/publications/health-care-ethics-usa/article/winter-2016/sex-reassignment-surgery-and-the-catholic-moral-tradition-insight-from-pope-pius-xii-on-the-principle-totality.
Internet Medieval Sourcebook. “The Responses of Pope Nicholas I to the Questions of the Bulgars A.D. 866 (Letter 99).” Accessed July 09, 2021. https://sourcebooks.fordham.edu/basis/866nicholas-bulgar.asp.
Jones, David Albert. “Truth in transition? Gender identity and Catholic anthropology.” New Blackfriars: A Review 99, no. 1084 (2018): 756–774, https://doi.org/10.1111/nbfr.12380.
Klima, Gyula. “MAN=BODY+SOUL: Aquinas’s Arithmetic of Human Nature.” Accessed July 09, 2021. https://faculty.fordham.edu/klima/bodysoul.htm.
McHugh, Paul. “Transgender surgery isn’t the solution.” wsj.com, June 12, 2014. https://www.wsj.com/articles/paul-mchugh-transgender-surgery-isnt-the-solution-1402615120.
National Catholic Bioethics Center. “Brief Statement on Transgenderism.” National Catholic Bioethics Quarterly 16 (2016): 599–603, https://doi.org/10.5840/ncbq201616457.
National Center for Transgender Equality. “Understanding Non-Binary People: How to Be Respectful and Supportive.” Accessed July 09, 2021. https://transequality.org/issues/resources/understanding-non-binary-people-how-to-be-respectful-and-supportive.
Newton, William. “Why Aquinas’s Metaphysics of Gender Is Fundamentally Correct: A Response to John Finley.” The Linacre Quarterly 87, no. 2 (2019): 198–205, https://doi.org/10.1177/0024363919884795.
Tobin, Bernadette. “Gender and Personal Identity: Two Views.” abc.net.au, September 5, 2017. https://www.abc.net.au/religion/gender-and-personal-identity-two-views/10095420.
Zucker, Kenneth J., Lawrence, Anne A. and Kreukels, Baudewijntje P. C. “Gender Dysphoria in Adults.” Annual Review of Clinical Psychology 12 (2016): 217–24, 10.1146/annurev-clinpsy-021815–093034.
Footnotes
[1] “MAN=BODY+SOUL: Aquinas’s Arithmetic of Human Nature,” Gyula Klima, accessed July 09, 2021, https://faculty.fordham.edu/klima/bodysoul.htm.
[2] William Newton, “Why Aquinas’s Metaphysics of Gender Is Fundamentally Correct: A Response to John Finley,” The Linacre Quarterly 87, no. 2 (2019): 198–205, https://doi.org/10.1177/0024363919884795.
[3] “Understanding Non-Binary People: How to Be Respectful and Supportive,” National Center for Transgender Equality, accessed July 09, 2021, https://transequality.org/issues/resources/understanding-non-binary-people-how-to-be-respectful-and-supportive.
[4] Newton, “Why Aquinas’s Metaphysics of Gender Is Fundamentally Correct,” 198–205.
[5] Dana Pham, “Targeting trans women for being women,” Noteworthy — The Journal Blog, June 20, 2020, https://blog.usejournal.com/targeting-trans-women-for-being-women-9565e6a47185.
[6] Kenneth J. Zucker, Anne A. Lawrence and Baudewijntje P. C. Kreukels, “Gender Dysphoria in Adults,” Annual Review of Clinical Psychology 12 (2016): 217–24, 10.1146/annurev-clinpsy-021815–093034.
[7] David Albert Jones, “Truth in transition? Gender identity and Catholic anthropology,” New Blackfriars: A Review 99, no. 1084 (2018): 756–774, https://doi.org/10.1111/nbfr.12380.
[8] Bernadette Tobin, “Gender and Personal Identity: Two Views,” abc.net.au, September 5, 2017, https://www.abc.net.au/religion/gender-and-personal-identity-two-views/10095420.
[9] Thomas Aquinas, Summa Theologiae, IIa IIae 169 art. 1 ad 3.
[10] Aquinas, Summa Theologiae, IIa IIae 169 art. 2 ad 3.
[11] Aquinas, Summa Theologiae, IIa IIae 169 art. 2 ad 3.
[12] “The Responses of Pope Nicholas I to the Questions of the Bulgars A.D. 866 (Letter 99),” Internet Medieval Sourcebook, accessed July 09, 2021, https://sourcebooks.fordham.edu/basis/866nicholas-bulgar.asp.
[13] E. Christian Brugger, “Catholic Hospitals and Sex Reassignment Surgery: A Reply to Bayley and Gremmels,” National Catholic Bioethics Quarterly 16 (2016): 590, https://doi.org/10.5840/ncbq201616456.
[14] National Catholic Bioethics Center, “Brief Statement on Transgenderism,” National Catholic Bioethics Quarterly 16 (2016): 601, https://doi.org/10.5840/ncbq201616457.
[15] Jones, “Truth in transition?” 756–774.
[16] Paul McHugh, “Transgender surgery isn’t the solution,” wsj.com, June 12, 2014, https://www.wsj.com/articles/paul-mchugh-transgender-surgery-isnt-the-solution-1402615120.
[17] Brugger, “Catholic Hospitals and Sex Reassignment Surgery,” 587–597.
[18] Jones, “Truth in transition?” 756–774.
[19] “Sex Reassignment Surgery and the Catholic Moral Tradition: Insight from Pope Pius XII on the Principle of Totality,” Becket Gremmels, accessed July 09, 2021, https://www.chausa.org/publications/health-care-ethics-usa/article/winter-2016/sex-reassignment-surgery-and-the-catholic-moral-tradition-insight-from-pope-pius-xii-on-the-principle-totality.
[20] “AusPATH: Public Statement on Gender Affirming Healthcare, including for Trans Youth,” Australian Professional Association for Trans Health, accessed July 09, 2021, https://auspath.org/gender-affirming-healthcare/.