How Catholic Bishops Can ‘Follow the Science’

Last week, the U.S. bishops met in Orlando for their spring assembly. There they unanimously voted to update the Religious and Ethical Directives for Catholic Health Care to focus on the “moral limits to technological manipulation of the human body.” This is especially necessary, as there are reports of Catholic hospitals offering so-called “gender reassignment surgery” and engaging in acts that mutilate the human body instead of healing it.

However, some critics said that the bishops should have held off on voting in order to examine the “science” justifying these practices. Theologian M. Therese Lysault says, “The Congregation for the Doctrine of the Faith has not yet issued a statement on transgender health care. I would guess that this is due to the fact that the issue is so new.”

Other critics have raised similar concerns. Bryan Massingale, an openly gay priest who teaches moral theology at Fordham, says, “The hierarchy has had comparatively little time to absorb and reflect upon the findings in the human sciences about the complexity of gender and sexuality.” Fr. Daniel Horan even wrote an article entitled “Recent transphobic statements from bishops make truth claims without facts.”

And just what are these “scientific facts” that overturn what we’ve known about men and women for thousands of years?

Lysault, Horan, and Massingale don’t say, but if they were pressed on the question, I bet they’d appeal to things like brain scan studies that show that a person who identifies with the opposite sex has a brain that resembles those of the opposite sex. They would say this shows that a person may not belong to the sex he was “assigned at birth.”

But sex isn’t assigned at birth, as if it were a role in a company being designated to people. It is discovered at birth, and even before birth, through blood tests and ultrasounds.

Many of these arguments conflate intersex cases, involving things like ambiguous genitalia and rare sex chromosome makeup, with transgender identity, which almost always manifests in someone who has identifiable male or female genes and anatomy.

Even in intersex cases, it is still possible to determine if someone is biologically male or female. For example, people with one X chromosome and no Y chromosome are female; they have Turner syndrome, which can lead to developmental and sterility issues. The same complications can arise for men who have Klinefelter syndrome, which occurs when they inherit more than one X chromosome (e.g., XXY or XXXY). Having an extra Y chromosome, or XYY, can cause men to have learning disabilities.

In some cases, corrective surgery may be necessary to address malformed organs in a person who is intersex. However, it is not possible to use surgery to turn a man into a woman. All you have following such a procedure is a mutilated man who claims to be a woman. One New York Times editorial—from a man who underwent vaginoplasty, which replaces the penis with a “front hole” that constantly tries to heal itself—makes this point well in its title: “My new vagina won’t make me happy.”

Even if there were a handful of hard cases where we weren’t sure if an individual is male or female, that wouldn’t disprove the sexual binary everyone else belongs to, just as the rare case of a breathing person with no measurable brain activity doesn’t disprove the fact that life and death are “binary” realities. There is no third option outside “alive” and “dead.”

Those who say “science proves transgenderism” have shown only that some people who have identity disorders, gender-related or otherwise, may also have identifiable brain abnormalities. The fact that a man’s brain may be similar to the average woman’s brain in some respects doesn’t prove that he is a woman. People with dissociative identity disorder (also known as multiple personality disorder) have brain abnormalities. The same is true of people with Cotard’s delusion, who think they are dead. But those people are a single, living person in spite of cerebral abnormalities that cause them dysphoria.

Finally, these arguments indirectly prove that sex is biological because the claim that a man’s brain resembles a woman’s brain when he considers himself a woman shows that there is a difference between “transgender women” and “biological women.” They both aren’t simply “women.” The only way one could make this claim is if there is already a reference class called “biological women” that can be grouped together for brain scan experiments.

Catholic physicians should provide compassionate care to those who seek to change their sex as well as to those who have undergone so-called “reassignment surgery” and realize they were mistaken about their gender identity and now want to “detransition.” But they should never promote mutilation of the body in order to appease a culture that has lost its grip on the reality of our having been made “male and female.”

Pope Francis put it well when he called gender ideology in a 2023 interview “one of the most dangerous ideological colonizations.” In a 2016 interview, he said,

Today children — children — are taught in school that everyone can choose his or her sex. Why are they teaching this? Because the books are provided by the people and institutions that give you money. These forms of ideological colonization are also supported by influential countries. And this is terrible!

Let’s pray that the U.S. bishops heed Pope Francis’s warnings and work to keep Catholic hospitals a place where having a functioning reproductive system is never considered a “pathology” to be destroyed at the hands of those who serve the ideologues of the day instead of the timeless wisdom of the ages.