Psychiatry’s New Normal: ‘Transgendered’ Persons

The American Psychiatric Association drops ‘Gender Identity Disorder’ from its official classification of mental illnesses, as the drive for acceptance of sex-reassignment surgery advances.

Chaz Bono, daughter of '60s pop singers Sonny and Cher, was granted a new name and gender change by a California court in 2010.
Chaz Bono, daughter of '60s pop singers Sonny and Cher, was granted a new name and gender change by a California court in 2010. (photo: Noel Vasquez/Getty Images)

BOSTON — The term “gender identity disorder” has been eliminated from the new edition of the American Psychiatric Association’s official guide to classifying mental illnesses, known as the DSM-5.

Whereas previously a man who “self-identified” as a woman (or vice versa) could have been classified as mentally ill, now the DSM-5 uses the term “gender dysphoria,” which means it is only a mental illness if you’re troubled by this self-identification. Elated activists in the “LGBT” community had lobbied the APA for the change for years.

And this month in Massachusetts, students, parents and teachers are reacting with concern to a recent policy document from state Commissioner of Education Mitchell Chester stating that public schools should allow students to choose which bathrooms and locker rooms they use on the basis of their “gender self-identification,” not their anatomy.

The move follows on the heels of a federal judge’s order last September that Massachusetts provide a “sex change” operation to a male prison inmate.

The United Nations, too, weighed in on the issue recently, when a General Assembly anti-discrimination resolution included “gender identity” on the same level as race, creed, religion and sexual orientation.

But the Catholic Church continues to hold up a very different understanding of the permanence of an individual’s biological sexual identity.

Just before Christmas, Pope Benedict XVI, delivering his 2012 address to the Roman Curia, characterized the rejection of innate male and female sexual identities as a denial of God. Pope Benedict stated, “The profound falsehood of this theory and of the anthropological revolution contained within it is obvious. People dispute the idea that they have a nature, given by their bodily identity, which serves as a defining element of the human being. They deny their nature and decide that it is not something previously given to them, but that they make it for themselves.”

Benedict XVI’s comments reinforced the judgment delivered a decade ago by the Vatican’s Congregation for the Doctrine of the Faith, while he was serving as its prefect: that the sex of a person who undergoes hormone replacement therapy and/or gender reassignment surgery (a so-called “sex-change” operation) remains unchanged.

Therefore, the CDF ruled, it is forbidden to alter baptismal certificates of a “transgender” person, and such persons are not eligible to be ordained priests or enter religious life.


Media ‘Transgenders’

Beginning in the 1950s with the first well-known such individual in the United States, George/Christine Jorgensen (1926-89), stories of “transgenders” and “transsexuals” have periodically appeared in the media, often in a favorable light. In 1982, for example, an episode of the popular The Love Boat television series, “Gopher’s Roommate,” featured MacKenzie Phillips; one of the lead characters comes to accept the new sexual identity of his former male roommate who has had a “sex change” operation.

Societal acceptance of “transgenders” has grown further in recent years, increasingly presented as a normal variant of human behavior. In 2011, Chastity/Chaz Bono, the nation’s best-known “transgender,” performed in the male partner’s role in ABC’s Dancing With the Stars. More recently, media outlets carried the story of Gabrielle Ludwig, the first “transsexual” to play in college basketball as both a man and a woman.

“Transgender” is an evolving and multifaceted term, but it is generally applied to a person who, despite his physical biology, chooses to identify himself as a member of the opposite sex. Some of those who believe this complete a two-year process of hormone replacement therapy and gender reassignment surgery, thereby becoming physically as well as psychologically “transgendered.” 

The goal of such procedures is to make a person appear as a member of the opposite sex; the surgery removes a person’s genitalia and substitutes artificial genitalia of the opposite sex. The newly adopted “genitalia” does not function, however, and the patient has been effectively neutered rather than undergoing a functional “sex change.” Moreover, the genetic identity of an individual undergoing such medical procedures remains entirely the same as it has been since the moment of his or her conception as a new human being.


Who Seeks Surgery

Calculating the number of Americans who have undergone a “sex change” can be difficult, as many opt to travel overseas, where the procedure is cheaper. In government-run health-care systems, the numbers are easier to track. The United Kingdom’s National Health Service, for example, reported that, during the period 2000-2010, 853 men had sex-change operations, as did 12 women, out of a total population of approximately 60 million.

“Sex changes” were traditionally pursued almost exclusively by men, but that is changing, believes Johns Hopkins psychiatrist Paul McHugh. McHugh opposes “sex change” operations and led the successful effort to shut down Johns Hopkins' Gender Identity Clinic, which performed such surgeries, in the late 1970s. Said McHugh, “It’s becoming a fad, a craze, particularly among young people.”

Such people believe that their psychological and social problems would be alleviated as a member of the opposite gender. McHugh compared it to entertainer Michael Jackson’s attempt to make himself “more Anglo,” by such drastic physical measures as reducing his nose to such a small size he was forced to wear a mask. McHugh continued, “It corrupted his relationship with doctors, and they gave him the medicines that killed him.”

While minors can be given harmful hormones intended to cause them to develop secondary sexual characteristics of the opposite sex, state laws currently protect them from genital mutilation; hence, they have to wait for adulthood to have surgery.


Suicide Is Common

But medical data suggests surgery can’t resolve the underlying conflicts that are in play.

“Transgendered” persons frequently suffer from severe emotional and psychological trauma. Nearly half of “transgendered” persons attempt suicide, and about a third are successful. Many abuse drugs or alcohol.

A 2003 study of 324 “sex change” patients in Sweden, which McHugh cited, found that the procedure did not help them with their emotional and psychological problems. It reported that such patients “have considerably high risks for mortality, suicidal behaviors and psychiatric morbidity [diseased state] than the general population.”

Some “transsexuals” regret their decisions to become “transgendered” and return to their original sexual identity. Walt Heyer, age 72, a male-to-female “transsexual,” lived as a woman for eight years. He regretted his decision and reverted to his identity as a man.

Heyer grew up in Los Angeles. He was sexually abused by an uncle as a child, and his grandmother, for inexplicable reasons, cross-dressed him. In 1981, he began the “sex change” process and had his genitalia surgically removed in 1983. (See photographs of the different phases of his life here.)

He recalled, “My family thought I was nuts. It is very painful to watch a family member who is delusional, has psychiatric issues or is dealing with depression opt for surgery that is unnecessary.”

His marriage ended, and his daughter wouldn’t speak to him for eight years. Heyer remarked, “I think it is important for a ‘transgender’ to be rejected, because, as in my case, it helps him to see reality.” (He notes that since his reversion he has enjoyed a “terrific” relationship with his daughter.)

His son’s reaction was different. Heyer recalled, “My 13-year-old son told me, ‘I know who you are inside; you can’t fool me.’ He knew his dad was struggling, and he hoped I’d get my life back together again.”

Heyer, like most “transgenders,” never had same-sex attraction and never engaged in homosexual activity. When he self-identified as a woman, he socialized with male homosexual transvestites whom he described as feminine, flamboyant and vulgar.

He explained, “It is a misconception that most ‘transgenders’ are homosexual.”


Permanent Consequences

After working in the psychiatric field for a time, Heyer began to believe that he made a mistake: “I was overcome by delusional disorder and needed to get in touch with reality. I realized it is not possible for anyone to change his gender.”

The process of reversion to being a man, he said, simply was to “acknowledge that you were never a woman, you’ve been permanently mutilated, and you’ll never again be able to function again in the same way as a man.”

He stressed, “There’s no going back. [The surgeon] has mutilated you in the cruelest way, never considering that such a surgery might not have been necessary.”

McHugh agreed. He said, “A reversal is not easy. You can’t replace what’s been cut off.”

A “sex change,” Heyer continued, leads “down a road of terrible pain.” The better option, he opined, is psychiatric treatment to help someone struggling with a gender-identity issue. Heyer himself received consolation by becoming a Christian and “finding the truth in Christ.”

Dr. Denise Hunnell, a fellow with Human Life International, agrees that surgical interventions can’t change an individual’s innate sexual identity. “God made us one way, male or female; it is not a choice we make,” she said.

Like Pope Benedict, she is distressed by attempts to eliminate gender differences. In an article published by Zenit news service, she cited the example of a school in Sweden that is adopting policies in an attempt to raise “genderless” children. Students, for example, are not referred to as boys and girls, but “friends.” Male-female romance stories, such as Cinderella, are banned.

“The desire to change one’s sex is a disorder,” said Hunnell, who has an undergraduate degree in biochemistry and psychology and served as a family physician with the U.S. Air Force. “It’s a self-loathing. ‘Transgendered’ persons have a problem with who they are.”

Normalizing “transgendered” persons harms the family, she said, denying the complementarity of man and woman. She said, “If you deny the need for complementarity, you deny the basis of the family structure. You also open the door to other alternatives, such as having three or more persons rather than one man or woman.”

She concluded, “We want to treat ‘transgendered’ persons with dignity and compassion. However, true charity dictates that we don’t facilitate disordered behaviors. Accepting such behaviors is not true love.”

 Register correspondent Jim Graves writes from Newport Beach, California.