Ending LGBTQ? Bending Gender

According to (Dr. Ann) Moir and (David) Jessel, (“Brain Sex”), there are different phases in the formation of sex and gender identification. DNA controls underlying gonadal anatomy but (primarily male initially) hormone flows govern “brain sex” (the unchanging male or female “wiring” of the brain), attitudes, puberty, and gender identification, though these flows occur at different times and the hormones come from different sources (fetal gonads, adrenals, mother, exogenous).

Some of the mechanisms are known and are controllable or reversible. Some – especially exogenous hormones during pregnancy – have already been identified and addressed. It's also clear that the involved factors and changes begin at conception but many take place later, through pregnancy, childhood, and into the adult years. Some occur before pregnancy is even confirmed. Under ideal circumstances (at least “ideal” according to the view of most people) the various mechanisms and stages would be identified when they are occurring, offering the possibility of correction, but that's not always the case yet.

Exogenous hormones can be used to affect attitudes and gender identification, and can be used to lessen the frequency of homosexuality, trans-sexualism, and similar conditions. One thing seems clear: that nurture – whether societal values, parental pressures, the acts and temptations of others – play little if any part in the process apart from legitimizing it.  (Consequently behavioral modification is unlikely to be successful.)  Members of the LGBTQ community don't get there because they have been forced to by others, but because factors in their development made them what they are.

From the medical standpoint we can sometimes regulate what will happen. But ability is not license. Ability raises a different question: should such regulation be undertaken or does it suggest a sexist view that deviation from “normal” identification (and practice) is abnormal? And that question raises many others. For example, what are “disease” and “deviation?” And where does “normal” end and “abnormal” begin? When does a desire to prevent the “abnormal” imply a devaluing of those who are already (and unchangeably) “abnormal?” Does such a policy – to correct Nature's “errors” – further stigmatize those who may already feel marginalized?

We might also wonder about whether “perversion” – which now results in an individual being placed on a public list and being labeled for life as a sexual offender – is part of the spectrum. If it is, should we try to deal with it. Castration is practiced in some countries. It is a kind of hormonal therapy, though it is rightly viewed by many as too extreme. Exogenous hormones, which are sometimes used on these individuals, are a reversible alternative.

But the implications are never-ending, both in terms of philosophy and practice. We live in a world where determination of fetal sex is possible and abortion legal. In some countries, especially China, the practice of abortion so as to have a child of the desired sex is common. Is this moral? Is it sexism? If someday, by manipulating fetal genes, we become able to change race and the parents seek to have it done, would it be racism to do so? Is society's emphasis on youth a manifestation of sexism? And by treating and rehabilitating the disabled (or differently abled as is the current politically correct jargon) are we expressing a disdain for those who are afflicted?

Perhaps we should first consider the health professions in general. Are we permitted to treat the sick. By doing so we are not only opposing the “natural” – the actions Nature has taken – but also labeling members of our population as “deviants” from health. We are separating them from the rest of us.

And the issue is even more troublesome. Every procedure has risks. What chances are we willing to take? That is especially relevant when we consider fetal procedures. To what degree may we put our children at risk? (Actually the legalization of abortion has answered this question.)

The original issue can be viewed as a model to consider when confronting all of these questions. At least I view it as such. From my perspective our obligation is to future generations, not to our own. If there are some who feel threatened by therapies that suggest that they are other than we would wish them to be, so be it. They certainly recognize the prejudice that exists in society and, presumably, wouldn't want to impose it on others if it is preventible. Criteria will have to be found, however, to identify what represents “disease” justifying therapy. I recognize two.

The first criterion – and it is the one that has governed medicine for millennia – is “sickness,” which I understand to be any condition that shortens life or makes it difficult, for the individual suffering from it, to enjoy life. To a great degree it is internal. While there may be determinable criteria that can be recognized by others, that is not always he case. Pain and psychological suffering are only obvious to the victim.

The second criterion is external. For better or worse we all have opinions about right and wrong, about normal and abnormal, about desirable and undesirable. And we have to live with others whose opinions differ from our own. We live in a prejudiced world and that is not likely to change soon. We have to accept it. And for that reason I think that therapy to minimize the number of people who differ sexually from the average is warranted. The time will come when it is possible to identify and treat those otherwise destined to be members of the LGBTQ group, and I suspect they'll be more comfortable in “normative” roles than they would be otherwise. That view is not meant as a denigration of anyone who differs from the societal model, but as a recognition of reality.

Of course such therapy (and that to deal with other “isms”) should only be available as an option. Different societies have different “normative” patterns. That is certainly true of race. Even if someday it is possible to alter race genetically, such “normative” patterns in Norway, Nepal, and Nigeria will be different. And variety will remain an important feature. Many of those who differ from the majority will wish to remain as they are. Many will desire to retain their identities and their heritages, even recognizing the biases they'll face.

But that should be a choice, not a sentence. At least in terms of differing from the “norm” or suffering from a disease, that should be an available option. For them or for those bearing them. And we should give the matter thought now. Science has gotten ahead of philosophy and law and presented us with faits accomplis. It would be better to decide what we're willing to accept before we have no choice.

Happy Valentine's Day.