Biological sex should be “acknowledged” and “accepted”—but which responses to gender dysphoria might this preclude? Trans-identified people may factually acknowledge their biological sex and regard transition as purely palliative. While generally some level of self-deception and even a high level of nonlying deception of others are sometimes justified, biological sex is important, and there is a nontrivial onus against even palliative, nonsexually motivated cross-dressing. The onus is higher against co-opting the body, even in a minor and/or reversible way, to make (...) a false communication concerning one’s sex. Hardest to defend is the destruction of sexual–reproductive functions and causally downstream functions such as lactation: due to the transcendent nature of sexual–reproductive functions, an appeal to the “principle of totality” here is misplaced. This is not to say that social, and milder medical, transition is absolutely excluded even for severe unmanageable dysphoria, nor that subsequent to any transition, detransition is necessarily required. (shrink)

Issues pertaining to sex and gender continue to be some of the most hotly debated topics of our time. While many of the most heated disputes occur at the level of politics and public policy, metaphysics, too, has a crucial role to play in these debates. In this essay, I explore several key metaphysical debates concerning sex and gender through the lenses of two important areas in contemporary metaphysics: the metaphysics of essence and the ontology of the human person. The (...) goal here is not to advocate any particular position on these issues, but to show how the tools of contemporary metaphysics can help to offer a more comprehensive map of the conceptual terrain, indicating where major areas of agreement can be found and where the most important disagreements really lie. (shrink)

Society and social structures play an important role in the formation and evaluation of concepts and practices in clinical ethics. This is evident in the ways the authors in this issue explore a wide range of arguments and concepts in clinical ethics including moral distress and conscience based practice, phenomenological interview techniques and gender dysphoria, continuous deep sedation (CDS) at the end of life, the notion of patient expertise, ethically permissible medical billing practices, the notion of selfhood and patient centered (...) care in dementia patients, and the definition of minimal risk as used in research regulations. (shrink)

The papers in this issue of Christian Bioethics explore and challenge taken-for-granted ideas that inform judgments about the nature of Christian bioethics, the nature of Christian clinicians’ and healthcare organizations’ obligations, and the nature of who we are. In doing so, these leading scholars in the field address some of the most fundamental questions in Christian bioethics scholarship today.

The gulf between Christian and secular bioethics has far-reaching implications for public policy, healthcare organizations, clinicians, and patients and their families. There also are significant differences among various Christian approaches to bioethics. Differences and similarities between Christian and secular bioethics as well as among Christian approaches to bioethics are evident across three domains explored in this issue of Christian Bioethics. The first concerns different approaches to or methods for resolving ethical questions. The second concerns the ways in which understandings of (...) health and disease and human anthropology shape our judgments about what we may do in the pursuit of health or in response to disease. The third concerns how our perceptions of and regard for others affect judgments of moral worth and can influence healthcare decision-making. (shrink)

There is an emerging consensus within Natural Law that explains transgender identity as an “embodied misunderstanding.” The basic line of argument is that our sexual identity as male or female refers to our possible reproductive roles of begetting or conceiving. Since these two possibilities are determined early on by the presence or absence of a Y chromosome, our sexual identity cannot be changed or reassigned. I develop an argument from analogy, comparing gender and language, to show that this consensus is (...) premature. Language and gender imbue our body with further social meaning and so, I conclude, that just as we can learn multiple languages, so too can we learn multiple genders. Since language and gender each constitutively contribute to our wellbeing as a “second nature,” I argue against this consensus to show that the reason people who are transgender struggle to flourish is not because of a “troubled trans psyche,” but because there are conceptual, interpersonal, and institutional obstacles stacked against them. (shrink)