The Theology of Changing Apparent Sex

[victorthomas]

The problem is that while such people exist, they don’t seek out sex reassignment surgery.

Could you cite your source for that, Zoe?

Every transsexual person ever examined has shown cross-sexed neurology, regardless of whether they’ve been on homones or not.

And for that statement as well.

Like you, I’m not a professional, but I do consider myself pretty well-versed in this subject. Unless you’re making the argument that “abnormalities” in the nervous system/brain structure, even if there are no “abnormalities” in the internal and/or external genitalia, qualify as intersex conditions, I’m not sure of the accuracy of this second statement. (N.B.: I use quotation marks around “abnormalities” in an attempt to avoid the value-judging connotation of that word, not because I think that differences between trans and/or intersex people and cisgendered people don’t exist.) At present, the APA recognizes that there are indeed people who have a cross-sexed gender identity without having a physical intersex condition, and these people are classified as having Gender Identity Disorder, which will not be given to someone who has an intersex condition (see the Diagnostic and Statistical Manual IV-TR). Problems with the G.I.D. diagnosis aside, the reality is that it’s what psychologists and psychiatrists use at this point in history, so I don’t think the Vatican is being unreasonable in talking about people in that situation because, according to the APA, they do exist. Not that I agree with just about anything the Vatican says about such people…

The other thing that I find frustrating about this Vatican document is something you allude to in your statement that I copied first above – there are many transgender people, even some who transition socially and hormonally, who opt not to have sex reassignment surgery, for a variety of reasons. In this document and almost all other Catholic writing I’ve found on the subject, the authors seem to understand being transgender as having an insatiable desire to have SRS, which is simply inaccurate. The real “symptom” is an insatiable desire to live one’s life authentically, which for trans people means living in the opposite gender role from that into which they were born (or assigned at birth, in the case of intersex people). For many, SRS is a means to that end. I hope that someday Catholic thinkers can see this, and weigh the problem of “mutilation” against the problem of a lifetime of inauthenticity.

There’s no simple answer, to be sure, but what is equally sure is that this is a more complex question than many make it out to be.

 

[Theresa_Frances]

In the same way, a person must prove capable of the sacraments rather than having a right to them. Just as we would not like to see blind people handed out driver’s licenses, so we cannot permit just anybody under a variety of circumstances to marry or be ordained. I know someone who was denied a Catholic marriage because she could not show that she was a practicing Catholic–basically because she is *not *a practicing Catholic. But then why should the Church perform a rite which would put a sacramental seal on her marriage?

HTH!

Defining the requirements to prove one capable of receiving the sacraments seems in theory to be a matter of simple check list but in reality it is much more complicated. Especially in the area of gender and gender identity. This forum is full of threads that continually debate the issue of whether gender is a matter of anatomy at birth or a function of a person’s self realization of whether they perceive themselves as male or female. I was raised in an environment of absolutes where there was no departure from Church teaching, obedience to authority, and as you can imagine, physical determination of gender. It created a sense of self loathing until I began to educate myself to the full spectrum of the issue and thankfully was referred to psycholical counseling and medical professionals who helped me and my parents understand the nature of my issues and that gender transition would provide a resolution to the depression and anxiety I experienced as a result of my gender identity issues. It is hurtful to be considered to not be a woman in the eyes of the Church when I feel I acted in a responsible and moral way in dealing with my situation. As noted in these threads, there is no other known medical treatment for this situation. As I mentioned, the environment in which I was raised and my parents’ sense of right and wrong would have made us the last family to take the actions we did. However, in light of a prayerful, thoughtful and honest assessment of my situation considering my age, and the prospects of leading a happy life we hopefully acted in the right manner.

 

[Zoe_Brain]

Unless you’re making the argument that “abnormalities” in the nervous system/brain structure, even if there are no “abnormalities” in the internal and/or external genitalia, qualify as intersex conditions

That is exactly my argument, yes.

If you define “Intersex condition” as meaning “having a body neither wholly stereotypically male nor wholly stereotypically female”, how can it be anything else, at least, in a biological sense?

Just look at the title of this paper:
Male–to–female transsexuals have female neuron numbers in a limbic nucleus. Kruiver et al J Clin Endocrinol Metab (2000) 85:2034–2041

Or this presentation to the recent APA annual meeting:
Transsexuality as an Intersex Condition Prof Milton Diamond, Ph.D.

Or this ruling from the Australian Family Court in 2003:

At paragraph (272): ‘In my view the evidence demonstrates (at least on the balance of probabilities) that the characteristics of transsexuals are as much “biological” as those of people thought of as inter-sex’.

Or… you get the idea.

Yes, this does mean that the diagnosis in the DSM-IV-TR 302.85 “Gender Identity Disorder in Adolescents or Adults” and the ICD-10 F64.0 “Transsexualism”, both of which are excluded by Intersex conditions, may not in fact exist: or at least, only exist in cases where the patient does not desire body modification by hormones or surgery.

The correct diagnosis in the DSM-IV-TR would be 302.6 “Gender Identity Disorder Not Otherwise Specified”, which does not exclude cases with Intersex.

This is a somewhat controversial (to say the least…) position. Heretical, even. But the evidence from hard, objective tests such as MRI scans leaves no other option.

There is a huge set of problems with regarding Transsexuality as a purely psychiatric situation. The first is that there is no “exit condition” - once diagnosed, the patient can never be regarded as cured, even if they become perfectly functional after treatment, or indeed are perfectly functional before it. The second is that the symptoms don’t conform to the definition of a mental illness in the DSM-IV-TR itself. The third is that while a patient may be competent to make informed decisions about surgery in other areas than the ones affected - such as having an appendix removed - they obviously cannot give informed consent to the one treatment we know works, genital reconstruction, because they’re deemed “mentally ill” with a serious disorder in this area!

The diagnostic criteria for children are far too broad - children can be diagnosed with 302.6 “Gender Identity Disorder in Childhood” even if they have no wish to be the opposite sex! All that’s needed is that they not conform to prevailing social custom for gendered behaviour.

This whole area is a Kludge. An inconsistent mess based on false premises and debunked assumptions, that’s only been retained as it gives a path to treatment that saves lives, and improves quality of life drastically.

 

[victorthomas]

Thank you for the clarification, Zoe. If that’s the argument you’re making, then I agree with you.

I also agree with the many problems with the DSM-IV diagnosis of Gender Identity Disorder that you list (as well as with the ICD definition of Transsexuality – I didn’t realize until after I posted that you’re in Australia, where the DSM probably isn’t the main diagnostic tool, no?). However, I include the caveat that, in the American healthcare system, at least, a diagnosis is required in order to obtain medical intervention for just about anything, especially if it is going to be reimbursed by insurance. Taking G.I.D. out of the DSM means that it *needs *to go somewhere else, and I’m not sure there’s enough support in the medical community to reclassify it (as, say, an intersex condition, and therefore a medical disorder, as you suggest).

 

[ifigoup]

I talked to a theologian called Dr Susannah Cornwall in a lecture in Glasgow ans she was talking about a Catholic priest who was defrocked and had his vows annulled when he revealed he was intersex. I think the issue though was he wanted to live as a female and there is no such thing as a female Catholic priest. It sounded though like the RC church was quite uncompassionnate to him. I think the priest was called Sally Gross (after he changed his name, don’t know about before.) Dr Cornwall said Sally Gross had written about how in Genesis Jews believe man was created hermaphrodite before being male and female. I said in the thread on intersexuality she has a new book coming out, Sex And Uncertainity in the Body of Christ, about intersexuality and theology, if you are interested in these issues.