Focus philosophy: Transgenderism, conceptual and ethical aspects

Abstract

Context

Usually, a person’s identity is defined in terms of their physical characteristics. A “man” is someone who looks like a man; a “woman” is someone who looks like a woman. Our spontaneous criteria are a person’s physical appearance, silhouette and mannerisms. “Man” is a gender assigned to “males” based on physical features: XY karyotype, increased body hair and muscle mass, deeper voice, testosterone dominance, penis, testicles, sperm, etc. “Woman” is a gender assigned to “females” identifiable by a different set of traits: XX karyotype, breasts, estrogen dominance, vulva, clitoris, vagina, ovaries, etc. These different elements are now being debated and called into question in the case of gender dysphoria.

Methodology

The theme addressed here is analyzed from a philosophical and ethical perspective. Attention is paid both to the form, dealing with the notions of sex, gender, transgenderism or transexualism, and to the substance, by mobilizing philosophical and ethical principles that enable us to reflect on the notion of identity.

Results/discussion

Society posits that gender identity (man, woman) is a matter of biological characteristics (male, female). From a transgender perspective however, a person’s true identity depends on their personal experience. Nobody is better placed to know whether a person is a man or a woman than the person themself, because gender arises from internal bodily experience. Contrary to conventional wisdom, a transgender individual doesn’t necessarily change sex but asserts a different gender from the one assigned to them by society based on biological criteria. Moral dilemmas arise from the moment the transgender person wishes to benefit from a treatment whose effects are dangerous and irreversible. In this case, decisions depend on the therapeutic alliance, physicians being obliged to not perform acts whose efficacy they consider doubtful. Interventions on a healthy body should only be considered if they are based on a firm will and reiterated over long time scale. They can only be covered by health insurance on the basis of a medical indication.

Conclusion/outlook

The issue of transgenderism is increasingly being raised in relation to children, an audience for whom caution is particularly important. Their brain is still developing and their desire may evolve so that they no longer feel out of step with their anatomical characteristics. According to the Hippocratic precept, in medicine it is important above all not to harm.