The Self-Interested and the Silent: (De)Classifying Gender Confusion

The world is talking about Caitlyn.

This transgender celebrity has caused everyone to think about the nature of personal identity, what it means to be a man or woman in society and what ethical practices bring reconciliation to issues of incongruence. Caitlyn has managed to stir up a global discourse that involves everyone from journalists, social activists, celebrities and pastors. In or out of the public square, Jenner has either inspired or provoked you.

Yet there are some who have chosen to remain oddly silent on the issue. According to Dr. Colin Ross, they are the psychiatrists and surgeons.

In his controversial article entitled, “Ethics and Gender Identity Disorder,” Dr. Ross argues,

Gender identity disorder is unique among all DSM-IV-TR diagnoses. It is the only disorder in which treatment is designed to confirm, reinforce, and validate the belief that is the basis of the mental disorder (165).

Generally speaking, psychiatrists give diagnoses and treatment for pathological symptoms. For example, Dr. Ross recounts interviewing a normal-looking woman who said she was sure she was so ugly and deformed that people crossed the street to avoid passing her on the same sidewalk. He made a diagnosis of dysmorphophobia, a delusional disorder, and prescribed an antipsychotic medication. He did not advise her to get plastic surgery.

In another case, a woman came to him who washed her hands over 100 times per day because of her excessive fear of germs and contaminants. He diagnosed her with obsessive-compulsive disorder. He did not teach her new hand-washing techniques.

In all these cases, according to Ross, the abnormal behavior or belief is considered a symptom of a mental disorder that is corrected, not validated.

Yet, when it comes to the belief that one is a man trapped in a woman’s, psychiatrists take a radically different approach.

Gender dysphoria is officially classified as a mental disorder by the American Psychiatric Association. However, Dr. Ross claims gender dysphoria is the only diagnosis in the system in which the treatment agrees with the disorder. He writes,

If a woman told a psychiatrist that she was a gorilla, this would be classified as a ‘bizarre delusion’ according to the text for schizophrenia. If she said she was the last Neanderthal left on earth, this also would be a bizarre delusion. But if she tells him she is a man trapped in a female body, the psychiatrist agrees to have her body fixed (168).

Gender dysphoria is the only diagnosis in the system in which the treatment agrees with the disorder

In order to proceed with the sexual reassignment surgery, the psychiatrist must agree that the patient’s mind is correct and the body is mistaken. In that case, it is the ethical course of action and the right of the person to pursue the corrective surgery. If this is true, there is no mental disorder involved and gender dysphoria should no longer considered a genuine medical condition. Gender reassignment surgery would be no different from preferential cosmetic surgery and the psychiatrist’s services would be no longer needed.

Yet if there is no evidence that gender reassignment is a necessary medical procedure, insurance companies are no longer obligated to cover the costs any more than they do for a nose job. At the end of the day, the focus is more on the financial interests and less on understanding gender and personal identity.

Ross is not denying there are those who experience deep incongruence, nor is he saying gender reassignment is wrong per se; he is simply calling out flaws in the logic of the diagnosis held by those who want to have their cake and eat it too.

Ross’ insights call out a long-standing contradiction that has managed to fly under the radar for decades at the expense of many who are trying to navigate issues of identity. But before Christians add this information to their stash of ammunition against those like Caitlyn Jenner, we must ask ourselves if we allow our own contradictions to fly under the radar.

In my previous article I argued that there is an inconsistency between the common Christian view of human nature and our ethical practice for issues of gender dysphoria. In order to no longer harbor our own contradiction, we must be willing to rethink traditional understandings of human nature that are more culturally informed than biblically taught.

Be willing to rethink understandings of human nature that are more culturally informed than biblically taught

Those whose god is politics, money and power do not have the freedom to be honest interlocutors in the discussion Caitlyn Jenner has begun.

Christians do.

As we seek to have a helpful and reconciliatory voice based on the truth and authority of the scriptures, let us be neither self-interested nor silent.