. For Jones' view, see David Albert Jones, "Gender Reassignment Surgery: A Catholic Bioethical Analysis," 330332. Minor edits for style are included. The distinction between primary and secondary sex characteristics as it relates to Catholic teaching on the creation of the human person is also ethically significant for addressing what I believe are some erroneous views about the involvement of Catholic health care in the treatment of gender dysphoria. "37 The Sweden cohort study concluded that "surgery and hormonal therapy alleviates gender dysphoria" but that these therapies are "apparently not sufficient to remedy the high rates of morbidity and mortality found among transsexual persons." Even when he referenced the "destruction or . The diocesan committee on gender seems to be taking its task seriously. For an explanation of the physiological functions of testosterone and estrogen respectively see "Male Reproductive Endocrinology,", David Albert Jones, "Gender Reassignment Surgery: A Catholic Bioethical Analysis,". We've rounded up the best online transgender support groups so you can find the right one for your needs. Partly because the interpretation of the principle considered by Jones did not take into account the ontological significance of the sex characteristic distinction, it focused on treatment that affects the reproductive organs. The members are parts united and bound together in their very physical essence. He concludes that as a result of this fact the principle of totality cannot be used to justify what he calls "serious and lasting harm at the level of function," which he does not define.59 The assumption behind this claim is that only physical objects have the nature necessary to be parts of the whole that is the person as considered in the principle of totality. When untreated, gender dysphoria is associated with depression, anxiety, suicidality, and substance misuse. Home - Person and Identity Project The Congregation for Catholic Education makes an important distinction that bishops, ethicists, theologians, and leaders of Catholic health care would do well to consider: "If we wish to take an approach to the question of gender theory that is based on the path of dialogue, it is vital to bear in mind the distinction between the ideology of gender on the one hand, and the whole field of research on gender that the human sciences have undertaken, on the other. They exist only for the sake of the total organism and have no other end than that of the total organism. This analysis explores a theological and ethical justification for treating adults with a diagnosis of gender dysphoria within Catholic health care in light of Catholic teaching. Rather, the order of nature, through empirical and metaphysical methods, may be understood as encompassing both the "order of biology" and the "order of existence" comprehended in its ontological dimension and its relationship to God the Creator.14. Thus, even though biologically there may be slight or great variation among the primary sex characteristics of individuals, these characteristics are still ontologically integral to God's creative act of individual persons as female and male, not in their potency for difference among individuals but in the way they delimit the kind of being into which an individual is created. If you need immediate support in a time of crisis, please contact Trans Lifeline - 877-565-8860 or the Trevor Project Lifeline - 866-488-7386. "39, INTERVENTIONS INVOLVING SECONDARY SEX CHARACTERISTICS AND THE PRINCIPLE OF TOTALITY, Given Catholic teaching on the creation of the human individual examined here, and the relevance of the primary/secondary sex characteristics distinction for understanding what is ontologically integral and what is not integral for the creation of the individual person as female or male, certain interventions as direct treatment specifically for gender dysphoria in adults can be ethically justified. A strong desire to be rid of one's primary and/or secondary sex characteristics because of a marked incongruence with one's experienced/expressed gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics). There follows brief sections on our transcendent purpose, our wounded human nature, gender. This view also does not entail that everybody's gender identity is called into question. As a result of this problem, there is a risk that the principle of cooperation in general will be misconstrued as the prohibition of any association with wrongdoing. The first is the composite unity of body and soul by which a person exists. This is the approach that I will use in the analysis below regarding the moral status of treatment options within Catholic health care. Interventions on secondary sex characteristics directed to the good of the whole of the person are proportionate means to remedy the lack of psychological and emotional cohesiveness and even suicidality. Though foreseeing and intending can be related in specific actions, they arise from different powers of the soulforeseeing from the intellect, and intending from the will. The object, intention, and circumstances of such actions are directed toward the treatment of the dysphoria by means that do not undermine the sexual identity component integral to the body/soul unity of the person. Gender dysphoria I am pleased to see that our diocese is working on what Father Thom Hennen calls the "challenging puzzle" of gender dysphoria. Thus, the teaching on the creation of the human person as male or female qua ontological reality is not informed or advanced by any scientific evidence about the complexity of biological, psychological, and social factors that might influence an individual person's sense of gender. May we treat this patient for the pathology, knowing that it will indirectly assist gender transition? A recent article by David Albert Jones reviews the history of Catholic teaching and theological opinion on the principle of totality and its use to justify treatment of gender dysphoria.45 His review focuses on Catholic teaching and theological opinion from the 1940s to the present. They do this through a variety of means, including: faith in Christ; obedience to God's Word; the power of the Holy Spirit; godly counsel and pastoral care; prayer - their own and others; confession; forgiveness; embracing truth; and giving and receiving love and support from Christian friends and family. They are so absorbed by the whole that they possess no independence. male and female he created them'; He blessed them and said, 'Be fruitful and multiply.'19. They are also proportionate since the sex characteristics affected do not have an integral role for the body/soul unity of the individual human person as female or male. 'The purpose of the letter is to provide pastoral guidance on how the Church, its ministers and the lay faithful can accompany walk with those who struggle with their gender identity,' writes the Oklahoma City shepherd. Cecilia Dhejne, Paul Lichtenstein, Marcus Boman, Anna L. V. Johansson, Niklas Langstrom, Mikael Landen, "Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden," PLoS ONE 6 (2011): 18 at 7. It is based on the premise that Catholic teaching on the creation of the human person as being either female or male independent of a person's sense of gender is true. Follow-up studies have shown an undeniable beneficial effect of sex reassignment surgery on postoperative outcomes such as subjective well-being, cosmesis, and sexual function. .61, The fact that there is one exterior act that the patient may intend for gender transition, which intention a Catholic health care institution might foresee, does not preclude the Catholic institution from using the very same act for different purposes, both proximate and remote. Sex Change Regret: Walt Heyer has a number of books, articles, and videos on the topic at his site. Gender dysphoria - The Catholic Messenger Brief Statement on Transgenderism - The National Catholic Bioethics Center . PDF Transgender and Gender Diverse Services (transgender) - Medi-Cal Transgender Resources - GLAAD The study observed that "the incongruence between gender identity and social life and/or bodily characteristics experienced by individuals diagnosed with gender identity disorder can cause much distress that may lead to affective and anxiety problems and even disorders. Renton, WA Washington, DC 20006 How Early in Life do Transgender Adults Begin to Experience Gender And so when, as often happens, you can be of aid to souls, you must act with the conviction that thus you render a sound service to the whole man, not only to his spiritual part, for often this will contribute to the greater efficiency of the whole organism.53, Similarly, Pius describes the "physical organism" of the person as a "subsisting unity," which is the substantial unity of body and soul: "What follows with regard to the physical organism? Any consideration of the analysis provided here needs to recognize the independence of its merits from any societal ideology of this sort. See, for example, Pope Pius XII, Address to the Italian Medical-Biological Union of St. Luke (November 12, 1944), Monks of Solesmes, ed.. Pope Pius, XII, Address to a group of eye specialists (May 14, 1956), Monks of Solesmes, ed.. Pope Pius, XII, Address to a group of country doctors (October 4, 1953), Monks of Solesmes, ed.. Pope Pius, XII, Address to the Italian Medical-Biological Union of St. Luke (November 12, 1944), Monks of Solesmes, ed.. A strong desire for the primary and/or secondary sex characteristics of the other gender. It is clear that those with gender dysphoria suffer greatly and must be treated with great compassion and sympathy. "35 With respect to surgery for gender dysphoria, it is recognized that we "need more studies with appropriate controls that examine long-term quality of life, psychosocial outcomes, and psychiatric outcomes to determine the long-term benefits of surgical treatment. St. Louis, MO 63134 The Catholic provider is not perpetuating or joining in on a lie or a delusion, but rather it is treating the suffering of individuals by morally legitimate means. But, in virtue of the principle of totality, of his right to employ the services of the organism as a whole, he can give individual parts to destruction or mutilation when and to the extent that it is necessary for the good of his being as a whole, to assure its existence or to avoid, and naturally to repair, grave and lasting damage which could otherwise be neither avoided nor repaired.48, The concepts of "services of the organism as a whole" and "being as a whole" are related but distinct as they function in this text. The suffering of gender dysphoria is as much a legitimate part of the whole person as is any other type of suffering, just as virtue and vice and human behavior itself also constitute parts in the part/whole relation of the person. I have long admired Chris for being smart, motivated, and honest, and I knew that whatever Chris had to say would be carefully thought out. Gender dysphoria is different from simply not conforming to stereotypical gender role behavior.
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