John Haldane, Professor of Philosophy at the University of St Andrews, Scotland, Distinguished Professor of Philosophy at Baylor University in Waco, Texas, and the current Chair of the Royal Institute of Philosophy in London, was a participant in a public debate recently held in Sydney on the question of whether “society must recognize transgender people’s identities”.

As the topic has particular significance for healthcare practitioners, in particular psychologists, psychiatrists and others working in youth mental health services, we invited Professor Haldane to address a seminar hosted by the Plunkett Centre at St Vincent’s Hospital on the implications of this discussion for the medical profession.

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At the outset Professor Haldane pointed out that the current debate about “transgenderism” is not about how a decent society should respond to those rare individuals with “intersex” biology. The question of what is appropriate treatment and care for people with this condition is certainly an important one for the medical profession.

But that question is not central in current discussions of transgenderism. In fact, Haldane had just one thing to say about the challenges for the medical profession in their treatment and care of these rare individuals: surgical treatment should not be even considered let alone offered until the individual was able to give his or her genuinely-informed consent [1].

Indeed, as Haldane pointed out, whilst it is true that some people identify themselves sexually as other than what is given biologically, one of the main issues of contention is whether or not “gender dysphoria” is a medical condition.

During the seminar, Haldane identified and explained a key issue in the current public discussion: whether, on the one hand, human beings are sexually differentiated into two genders, male and female, or, on the other hand, the gender of an individual is entirely a matter of choice.

In what follows I set out both the claim that gender is a matter for choice, and Haldane’s refutation of that claim.

Claim: Gender is different from biological sex

Haldane pointed out that the recent discussion of transgenderism had thrown up two new terms: “cisgenderism” and “transgenderism”.

The term “cisgenderism” refers to the phenomenon whereby one’s gender is fixed – by oneself or by others – as the same as the gender one was assigned at birth. The term “transgenderism” refers to the phenomenon whereby one’s gender is fixed as different from the gender one was assigned at birth.

As Haldane pointed out, embedded in these two terms is a shared assumption: that there is a fundamental difference between an individual’s sex and his or her gender. Sex is taken to be a discoverable fact of biology. Gender is taken to be a chosen assignation.

The story goes as follows: At birth, adults take a look and discover that the new-born child has either male or female biology.[2] Adults then choose which gender to assign to the child. If the child has male genitalia, they assign male gender. If the child has female genitalia, they assign female gender.

Mostly, this assigning of gender is uncontroversial. The child with male genitalia grows up feeling comfortable with the gender that was assigned to him. The child with female genitalia grows up feeling comfortable with the gender that was assigned to her. In this way, most of us are “cisgender”: we grow up comfortable with the gender which was assigned to us at birth. But note that the assigned gender was a matter of the adults’ choice, a choice which may be rejected later by the individual concerned: thus the phenomenon of transgenderism.

Cisgenderism and transgenderism share this assumption: that gender is assigned, not discovered, at birth. The use of the terms “cisgender” and “transgender” implies a rejection of Freud’s idea that biology is destiny. They both say that biology is not destiny, that we should distinguish anatomical (or physiological or sexual) identity from gender identity.

In addition, so the story continues, in the current debate, anatomy is not what matters. A person’s anatomical identity is not his or her gender identity, and the claim that it is is no more than a cultural convention. Chosen gender identity is key to personal identity. What matters is what gender you choose to associate with: you might be cisgender or transgender, depending on which assignment you make.

(Once again, Haldane reminds us, it is important to note that there are cases of genuine sexual ambiguity; there is a small group of people for whom the matter of sexual identity is a real and significant problem. But transgenderism – as a social movement – is not about them.)

Reply: Human beings are sexually differentiated into male and female

In replying to this claim, Haldane re-asserted the traditional idea that human beings are sexually differentiated into male and female, but insisted on the importance of how that idea is understood. It is a generic statement, that is, a statement about the genus, or kind, of creature a human being is. But there are at least three different kinds of generic statements: “essential”, “contingent” and “normal”.

Consider the following generic statement: “Human beings use tools.” If you think that using tools is a part of the essence of what it is to be human, then were you to come across someone who does not use tools, you would have to say that he or she was not a human being. But that seems too strong. For we do come across people who are not tool users.

Or, again, take the generic statement: “Human beings are language users.” If you think that using language is a part of the essence of what it is to be human, then were you to come across someone who does not use language, you would have to say that he or she was not a human being. Once again, it seems wrong. There are people who do not speak.

On the other hand, Haldane pointed out that if you think these features have nothing to do with the kind of creature a human being is, that they are accidental features that human beings just happen to have by chance, that they are merely contingences, that too seems wrong. It is too weak. For there does seem to be some serious connection between being a human being and using tools and speaking a language.

The most reasonable view, says Haldane, is to think of these properties not as essential features, not as contingent features, but as normal features of a human being, part of the nature of what it is to be a human being, but which admit of exceptions. Normally, human beings are users of tools, but some are not. Normally, human beings are language users, but some are not.[3]

The same, Haldane argued, can be said of gender identity. A specific gender identity, connected with biology, is not an essential feature of human beings, for it is a fact that there are people whose biology, and thus gender identity, is uncertain. Nor is gender identity merely an accidental feature of human beings, changeable at will. Rather, biology and thus gender identity is normally discovered at birth. We take a look and can confidently say: “That is a boy” or “That is a girl”.[4]

To conclude. Michael Jackson, who underwent skin bleaching and nose reshaping, seemed to think that he was a Caucasian who happened to have been born into the wrong body. Rachel Dolezal, an American girl born to white parents, who became president of the National Association for the Advancement of Colored People (NAACP) in Spokane, said that she “identified” as African-American. Her parents said that she was profoundly confused, but she said: “For me, how I feel is more powerful than how I was born.”[5]

Activists in the current debate insist that gender identity is similarly – always and everywhere – a matter of how an individual happens to feel.[6] Against this, John Haldane argued, we need to recover – and to hold on to – the idea that gender identity is – normally – discovered at birth.

Bernadette Tobin is director of the Plunkett Centre for Ethics, a joint centre of St Vincents & Mater Sydney and Australia Catholic University, in Sydney. This article has been republished with permission from Bioethics Outlook, a publication of the Plunkett Centre for Ethics.

Footnotes

(1) In this regard, the experience of Dr John McHugh at Johns Hopkins Hospital in the United States is telling. Dr McHugh was the first to do re-assignment surgery in 1960s. He later abandoned it because five or six years after having undergone the surgery, the individuals so treated seemed to show no significant improvement and exhibited the same kind of distress as did those who had not had the surgery. In addition, Dr McHugh came to think that the surgery itself might be a form of “mutilation”.

(2) On the whole and by and large. In this discussion, Haldane was not talking about those rare individuals with genitalia which is ambiguous (or “intersex”).

(3) In Aquinas’s thought, which he picked up from Aristotle, they are “proper to” or “proprium”, that is, predicable properties of the members of a kind but which do not constitute part of the definition of that kind.

(4) Indeed, Haldane added, that human beings are heterosexual is neither essential nor contingent but “proprium”.

(5) The Guardian, online Australian edition, 14th December 2015

(6) It is important to note that Haldane was not talking about those rare individuals with genuine gender dysphoria. He was talking about ideas found in the current movement dubbed “transgenderism”.

Bernadette Tobin

Bernadette Tobin is director of the Plunkett Centre for Ethics, a joint centre of St Vincents & Mater Sydney and Australia Catholic University, in Sydney.