Transgendered Patients and the Catholic Psychiatrist
Michael Redinger, M.D., MA, Assistant Professor, Program in Medical Ethics, Humanities, & Law, Department of Psychiatry, Western Michigan University Homer Stryker MD School of Medicine
Recently, significant public attention focused on the high profile announcement by Bruce Jenner that he was transgendered and his subsequent transition to Caitlyn Jenner. The psychiatric community generally applauded Jenner and used the opportunity to advocate for increased recognition of and decreased discrimination against the transgendered community. Minority opinions argued that enabling Jenner's transition, including the medical means to increase the femininity of Jenner's appearance, was harmful and morally questionable. This minority position frequently cited Paul McHugh, former Chair of the Department of Psychiatry at Johns Hopkins, a noted Catholic psychiatrist and former member of the President’s Council on Bioethics. McHugh's argument, however, was based primarily on a selection of data demonstrating negative clinical outcomes for those who undergo sex reassignment treatments. Lacking was a nuanced philosophical perspective, which articulated how transgenderism should be conceptualized within the field of mental health. This paper will supply that perspective. I will present a conceptualization of this issue rooted in a Catholic anthropology, and in contrast to a Cartesian dualism – which often serves as an unquestioned assumption in psychiatric practice. By doing so, I will argue that transgenderism, properly understood, should be conceptualized as analogous, in many significant ways, to other body dysmorphic disorders and will support those calling into question current treatment modalities for transgendered persons that serve to collude with, and reinforce, the underlying pathology. I will conclude with some brief guidance for Catholic psychiatrists who treat transgendered patients in their clinical practice.
Recently, significant public attention focused on the high profile announcement by Bruce Jenner that he was transgendered and his subsequent transition to Caitlyn Jenner. The psychiatric community generally applauded Jenner and used the opportunity to advocate for increased recognition of and decreased discrimination against the transgendered community. Minority opinions argued that enabling Jenner's transition, including the medical means to increase the femininity of Jenner's appearance, was harmful and morally questionable. This minority position frequently cited Paul McHugh, former Chair of the Department of Psychiatry at Johns Hopkins, a noted Catholic psychiatrist and former member of the President’s Council on Bioethics. McHugh's argument, however, was based primarily on a selection of data demonstrating negative clinical outcomes for those who undergo sex reassignment treatments. Lacking was a nuanced philosophical perspective, which articulated how transgenderism should be conceptualized within the field of mental health. This paper will supply that perspective. I will present a conceptualization of this issue rooted in a Catholic anthropology, and in contrast to a Cartesian dualism – which often serves as an unquestioned assumption in psychiatric practice. By doing so, I will argue that transgenderism, properly understood, should be conceptualized as analogous, in many significant ways, to other body dysmorphic disorders and will support those calling into question current treatment modalities for transgendered persons that serve to collude with, and reinforce, the underlying pathology. I will conclude with some brief guidance for Catholic psychiatrists who treat transgendered patients in their clinical practice.