Austin Ruse rightly praises Ryan Anderson’s new book, When Harry Became Sally: Responding to the Transgender Movement, due out February 20. The book is an authoritative compendium of arguments on transgenderism, exposing much of the “science” and “medicine” that pretends sex is a state of mind.
My favorite argument from Anderson’s forthcoming book is, however, what I would call “medicine, form, and function.” The popular press, which wants to make transgenderism no big deal, rarely discusses the sometimes multiyear process of “transitioning” (and never discusses, as Ruse points out, those who regret it). “Transitioning” involves both social and medical steps. It usually begins with cross-dressing (which society is supposed to approve by playing along and celebrate with neo-pronouns. It then moves into medical phases, starting with hormonal treatment (and, in the case of children, “puberty blockers” to inhibit normal biological sexual development; treatments that raise ethical questions about medical experimentation on kids). Finally, “transition” ends by outright mutilation: amputation of a healthy penis, mastectomy of healthy breasts. (The politically correct term now is “gender confirmation surgery” in order to affirm that “gender identity is not a choice.”) Finally, in the medical equivalent of a Weimar Cabaret, surgeons attempt to create faux sexual organs, “penises” or “vaginas” according to the “proper” sex.
I want to comment on those faux organs.
“No matter how technically advanced the plastic surgery becomes, it doesn’t create an actual sex organ, but a mere simulacrum. The result is not integrated into the organism as organized for reproduction, and it cannot fulfill the function that is central to the organ’s definition. … Plastic surgery on the reproductive organs, no matter how ‘realistic’ the result may appear, does not create the organs of the opposite sex.” A penis is not interchangeable with a bionic erector set and, as Anderson quotes Christopher Tollefsen, “‘One cannot make a vagina … simply by creating an orifice in a particular place….’”
An ancient adage affirms “form follows function.” The human body is an integrated organism designed to work in a particular way. Religious people may attribute this integrated functioning to God’s Will expressed in creation, but the relationship of hearts to circulation, lungs to respiration, stomachs to digestion, and genitalia to reproduction is not a theological truth or even a philosophical alternative. As Anderson points out elsewhere, a heart that does not pump blood properly is not a “different” heart; it is a failing heart. A healthy person is one in which organs exercise their functions in the integrated human person.
That is why a simulation of a vagina or a penis does not make them vaginas or penises. The depression or extension a plastic surgeon makes in “transgender transitioning” is an ersatz organ. It is, literally, a “blob of tissue” because it does nothing other than provide an outlet to release urine. We have to maintain that function or people would die. But these faux organs do not have a reproductive function. They are “genitals” that do not generate. “Transitioned” persons are sterile.
As Pope Benedict XVI observed in Caritas in veritate (no. 51): “The book of nature is one and indivisible,” one that involves “integral human development.” That is why the first sin shrieks through Adam and Eve across four levels: it breaks their relationships with God (Gen. 3:10), each other (Gen. 3:12), creation (Gen. 3:13-19), and within themselves (Gen. 3:7).
Our times seems, on one level, to be more sensitive to the human integral unity. We speak about “holistic medicine.” We recognize psychosomatic unity. We more consciously reach for “natural” or “organic” food.
On other levels, though, integrity doesn’t seem to bother us. A transplant surgeon who grafts a four-valve organ into the center of one’s chest that he called a “heart” but which doesn’t pump would be called a quack. So why celebrate a doctor that makes a “genital” that doesn’t generate? We recognize that respiration, circulation, and digestion are essential to a human body that functions as it should. Fertility is also a natural and normal human function. So why have we allowed fertility to be treated as an “optional extra”—good if we like it, bad if we don’t?
This strange exceptionalism has permeated “medical” practice for more than half a century. Its expression in cases of transgenderism is but a variant on attitudes born of accepting contraception and abortion. For if we can hormonally dope our bodies to suppress their natural and normal fertility just because we want to and technically can, why can we not do the same because we think we are the ‘wrong’ sex? The common thread uniting both is the notion that the natural and normal healthy functioning of the body—almost constant post-pubertal fertility in men, periodic post-pubertal fertility in women—is something abnormal. What is healthy notionally becomes neutral in theory and bad in practice when it clashes with our wants. Which is why much contemporary gynecology has degenerated into wish fulfillment.
(I picked the verb in the last sentence deliberately. Is it not telling that, in normal language, we treat the lack of generativity or the impoverishment of generation something negative and pejorative?)
And what are the implications for our psychology? Erik Erikson points out that one of the higher stages of normal human psychological development is “generativity,” i.e., moving beyond concern for one’s self and even one’s peers across generations to those who do not yet even exist, to take responsibility for those who are yet to be. Generativity decisively gets me out of me.
That challenge to “get beyond myself” that parenthood poses is answered every time a young parent gets up in the middle of the night to feed a baby, a middle aged parent calms a kid awoken by a bad dream, an older parent waits up for the child that comes home from a date. It struck me very clearly in a “letter to the ethicist” which appeared in The New York Times. The author, who of course checks the box by announcing she is “pro-choice,” complains that a child she gave up for adoption decades ago with the understanding that the twain was sundered recently contacted her. Now an adult, the child wanted to connect with her biological mother, who rather regards her as “a distant, long-ago acquaintance. I was not overwhelmed with motherly love when she hugged me or when I heard her voice.” The ethicist admits that motherhood creates “obligations,” which she reduces to making sure one’s child is taken care of, at least by passing the child along to somebody else on particular terms. Both mother and ethicist are dissatisfied that the terms of confidentiality have been broken.
We should be solicitous of confidentiality lest we deter mothers from availing themselves of adoption, but in this case we are now talking about two adults. While parenthood’s responsibilities can be delegated, it seems to me that parenthood itself cannot be resigned: like virginity, “there’s no going back.” What struck me most about the woman writing this letter is that, decades later, when the burden upon her seems to be primarily one of memory, she is still so absorbed in her “I” that her reaction to her child is unhappiness, despite the fact that her daughter seems to have had the chance to grow up right. (I treat a related aspect of this question when I question “what Dudley’s mother might tell him.”)
This ambiguity about fertility is also operative in modern medicine. Medical professionals who acknowledge that fertility is not a pathology nor pregnancy a disease are increasingly marginalized in their profession. The Trump Administration’s decision to create an office in the Department of Health and Human Services to protect the conscience rights of medical professionals has been derided as a sop by the president to social conservative cultural warriors (despite the Obama Administration’s failure to enforce conscience rules and its absolute bludgeoning of conscience through Obamacare mandates to pay for abortifacients). The most risible argument came from two writers who maintain that the problem with the new office is that the Trump Administration will probably fail in its duty to protect the “conscience rights” of abortionists to practice their trade. California already is defending a case before the U.S. Supreme Court to force pro-life people to make referrals to abortionists. There is already a strong push among “ethicists” to do the same as a matter of “professional responsibility.”
There is a reason why God’s first blessing on the newly created male and female is fertility (Gen. 1:28). As St. Irenaeus observed, Gloria Dei vivens homo—“the glory of God is man fully alive.” Which includes his share in the Divine power to share life through the gift of fertility.
Yet that truth remains under contemporary assault, first but not just from a contraceptive mentality that, in the end, is hostile to sex, sexual differentiation, and the truths they imply. It is telling that modern “medicine,” prescinding from objective measures of health and integrity and separating form from function, offers us a society of persons rendered, to all practical purposes, voluntary castrati.