After decades, perhaps even more than a century, of proving that women and men can do almost all of the same things, it seems to follow somewhat that sex or gender would have little significance. And yet, despite the reality that we can do many of the same things, women and men retain significant biological differences that do not change regardless of medical treatments and wardrobe changes.

No matter how we physically change ourselves or how hard we try to hide who we are, science betrays us. Every cell in our body reveals that we are either male or female. To my mind, this points to a significant reality which cannot be escaped: the sexually differentiated body matters. These are real aspects of our being that cannot be changed.

In an effort to cloud the significance of sex, theorists and activists introduced the term “gender.” This refers to one’s preference of sexual identity and expression or desire rather than to one’s biologically determined sex, suggesting something radically fluid about sex. Written in 1928, Virginia Woolf’s “Orlando” is an early fictional account which played with this theme. The character Orlando lives in different time periods, as a man or a woman, depending on how he dresses and chooses to reveal himself. While the term “gender” was not yet used, undeniably, biological sex and sexual identity were portrayed as something fluid, more to do with culture and nurture than nature.

In response to the scientific reality of biological sex, gender became a term to indicate that one’s biological sex was not determinant of sexual identity and expression.

Sexual Differentiation

And yet it seems that we cannot ignore the reality of sexual differentiation. Over the past few years, we’ve all seen headlines about men giving birth. However, if we read beyond the headlines, we see that these men were actually women who began to identify as men, even undergoing medical interventions such as hormone therapy to suppress feminine aspects of their bodies and develop masculine aspects — for example, stopping menstruation and growing facial hair. But these women never had hysterectomies. So their reproductive organs remained intact. In most cases, they eased off on the hormone treatments so that their bodies were able to resume their normal functioning, unimpeded. Thus they were able to get pregnant, most often using some form of assisted reproductive technologies. Unless it’s news that a woman can get pregnant, there was no news.

More recently, the headlines proclaimed a first-ever: a transgender couple had given birth to their own child. In reality, this couple was a man identifying as a woman and a woman identifying as a man, both of whom had retained their original sexual organs. The only difference between them and a heterosexual couple is that they each identify as the opposite sex. In biological terms, they are exactly the same as a heterosexual couple.

People who identify as a gender other than their biologically determined sex are described in clinical terms as having gender dysphoria. In an effort to correct the dramatic and even traumatic disconnect that these individuals experience, the medical community frequently recommends that the individual physically transition to the sex or gender with which they identify, calling this process gender reassignment. This transition can be as simple as changing one’s exterior appearance, including clothing. Typically, it involves additional medical procedures so that the physical body takes on the appearance of the type of sexually differentiated body the individual identifies with. Nevertheless, as more cases of transgender men giving birth surface, the stark reality remains that the changes are, in fact, cosmetic, even if they are outwardly very convincing.

The Fall 2016 edition of The New Atlantis, a journal dedicated to technology and science, covers the various aspects surrounding sexuality, gender and gender dysphoria. The lead authors, Dr. Lawrence S. Mayer and Dr. Paul R. McHugh, experts in epidemiology and psychiatry, respectively, reviewed research from the biological, psychological and social sciences. In general, they found that for those suffering from gender dysphoria, the data does not support the current treatment models of gender reassignment. In fact, individuals undertaking this treatment suffer higher negative outcomes in every area from anxiety to substance abuse to suicide.

One study found that individuals who had undergone sex-reassignment surgery(ies) had a much higher rate of suicide than the general public. They were five times more likely to die by suicide and approximately 19 times more likely to attempt suicide, hardly indicators of successful treatment.

A recent estimate suggested that about 0.6 percent of U.S. adults identify with a gender that is other than their biologically determined sex. Keep in mind, too, that this is not simply a matter of an individual identifying as the opposite sex. Iterations of gender are multiple and complex according to various markers. Facebook for example, offers more than 50 options for users, clearly reflecting and responding to a significant societal reality.

There can be no doubt that an individual diagnosed with gender dysphoria faces innumerable challenges that most people will never face. This is a real diagnosis. As such, it requires evidenced-based treatments, not policy-driven treatments driven by popular opinion or special interest groups.

Imagine if we had allowed public opinion and lobbyists to determine how we address the link between tobacco and lung cancer. We’d probably be smoking at “Mad Men” levels and wondering why we get lung cancer. Instead, when policy was informed by science and medicine, the tobacco companies began to be held responsible for the consequences of the product that they were literally pushing onto the American people.

Similarly, with gender dysphoria, we have to find treatments that actually help the person live a healthier, happier life. Documented negative outcomes not only contradict any illusion of happiness, but could also be conceivably identified as unethical medical practices. After all, the Hippocratic oath requires the doctor to “do no harm.” Encouraging the medical community to engage in practices that result in substantially increased rates of suicide, not to mention other adverse responses, therefore seems gravely unethical.

We are one of the richest and most gifted countries in the world; we ought to be able to come up with better treatment, treatment that is life giving and life affirming.

As a theologian and an ethicist, when I review scientific articles like the one referenced here, I rely heavily on an accurate and comprehensive presentation of the studies and/or the issue. One of the things that jumps out at me is that the failure of the current gender-reassignment practices point to an undeniable reality about the human person, the one with which I began this article: sex matters, body matters.

Sexual difference and complementarity find their roots in the biblical creation stories in Genesis. Crosiers

There’s a tendency to think that because the Catholic Church values celibate vocations that we somehow denigrate sex. In fact, the opposite is true. We understand that sex has more to do than with genital activity. It permeates the entire human person. Otherwise, those gender-reassignment surgeries would be yielding far better outcomes.

Being a man or a woman is not about what we do or what we look like, it’s about who we are. Everything we do should be positively influenced by our sexuality.

Similarly, because the Church has eschewed sexual activity outside of the marital bond, there exists the same tendency to think that the Church does not look kindly on sex. In fact, the opposite is true. As one of my young high school students, arriving at a point of discovery and acceptance of these teachings, once said, “I think I get it.… It’s because sex is so good and beautiful!” Exactly. When we cherish something or someone for its or their innate goodness, we want to protect, not expose.

If I own a beautiful car, I want to take care that the car is kept in good shape, that it’s free from vandalism and so on. All the more so with our children, spouses and other loved ones. We don’t want to see them hurt, in need, unhappy. So, too, with sex. It is good and beautiful, meant to create not only new life but the union between the married couple. It is meant to generate various forms of pleasure. In fact, St. Thomas Aquinas, not one to revile the passions, surmised that the pleasures of sex would have been even greater in the Garden of Eden before the Fall because the passions would have been perfectly in accord with reason or reality.

“Great Mystery”

Perhaps a key to further understanding the Church’s insistence on the body can be found in St. John Paul II’s Letter to Families (1994). Specifically, he addresses the contemporary anthropological crisis in light of the dramatic reality of marriage which St. Paul calls a “great mystery” in Ephesians 5:32 (see Letter to Families, No. 19).

The aspect of mystery reveals itself in at least two ways. First it points to the covenantal reality of the relationship between Christ and the Church: Bridegroom and Bride. But the mystery is extended when St. Paul speaks to husbands and wives in terms of Christ and the Church. In other words, marriage, which we experience in and through our sexually differentiated bodies (not just minds as Shakespeare beautifully wrote), points to the reality of marriage between Christ and the Church. Christ’s maleness is absolutely essential for this spousal relationship, as is the Church’s femaleness.

St. John Paul II notes that our contemporary understanding of spirit and body has moved from the Christian view of a body and soul that are deeply united to a dualism, dating at least back to the time of the philosopher René Descartes, who lived in the 17th century. While gender scholars would identify this dualism even in Plato, it was nevertheless not a dominant view until Descartes, who centered all of his reality and even being in the mind or the soul with his famous maxim, “I think, therefore I am.”

From that point, St. John Paul notes that we have increasingly begun to live as de-spiritualized bodies and disembodied spirits. In other words, our created unity of body and soul has steadily been dismembered (no pun intended).

We know what happens when we leave apart any consideration of the soul from the body. That’s when it makes it possible for us to see others as objects, even raw material. That’s when we begin the litany of isms: racism, sexism and so on, resulting in a reality where we do not even know ourselves and the family becomes “an unknown reality.”

By virtue of the soul, we know who and what we are: the human person — a man or a woman, created in the image and likeness of God, even if the person is not baptized.

Body matters. It is through a body that the soul is informed and comes to know. And it is through a specifically, intentionally, sexually differentiated male body that the Second Person of the Trinity revealed God to humanity, starting as a miniscule embryo and entering the world just like all of us, nurtured and birthed by a woman. God could have chosen many ways to reveal himself to us. Instead He chose to live as a human male person, the unity of body and soul. Had He not been a man, He could not have been Bridegroom to the Church. Remember, the Church deals in stark and dramatic realities, not mere symbolism.

The reality of the creation of each of us is that it necessarily involves a sexually differentiated body, through which we are intended to experience and participate in the nuclear family and the larger families of humanity and the Church.

For those who struggle with gender dysphoria, I offer that we are seeing a profound struggle with created biological reality, one that requires effective therapies, extreme understanding and authentic love. Treatments that encourage the disconnect have been statistically demonstrated to yield negative, even fatal outcomes. This suggests that perhaps we should begin to look at means that seek to integrate the individual’s identity with his or her biologically determined body.

Gender and sex matter very greatly. Without them, we are not able to experience the reality and nature of our existence. St. John Paul further noted that they also enable us to enter into the great mystery, the climax of salvation history in Christ and the Church.

Pia de Solenni, SThD is chancellor of the Diocese of Orange, California.

Pope Francis on Sexual Difference

God, after having created the universe and all living beings, created His masterpiece, the human being, whom He made in His own image: “in the image of God he created them; male and female he created them” (Gn 1:27), so says the Book of Genesis.


And as we all know, sexual difference is present in so many forms of life, on the great scale of living beings. But man and woman alone are made in the image and likeness of God: the biblical text repeats it three times in two passages (vv. 26-27): man and woman are the image and likeness of God. This tells us that it is not man alone who is the image of God or woman alone who is the image of God, but man and woman as a couple who are the image of God. The difference between man and woman is not meant to stand in opposition, or to subordinate, but is for the sake of communion and generation, always in the image and likeness of God.

Experience teaches us: in order to know oneself well and develop harmoniously, a human being needs the reciprocity of man and woman. When that is lacking, one can see the consequences. We are made to listen to one another and help one another. We can say that without the mutual enrichment of this relationship — in thought and in action, in affection and in work, as well as in faith — the two cannot even understand the depth of what it means to be man and woman.

Modern contemporary culture has opened new spaces, new forms of freedom and new depths in order to enrich the understanding of this difference. But it has also introduced many doubts and much skepticism. For example, I ask myself, if the so-called gender theory is not, at the same time, an expression of frustration and resignation, which seeks to cancel out sexual difference because it no longer knows how to confront it. Yes, we risk taking a step backwards. The removal of difference in fact creates a problem, not a solution. In order to resolve the problems in their relationships, men and women need to speak to one another more, listen to each other more, get to know one another better, love one another more. They must treat each other with respect and cooperate in friendship. On this human basis, sustained by the grace of God, it is possible to plan a lifelong marital and familial union. The marital and familial bond is a serious matter, and it is so for everyone, not just for believers. I would urge intellectuals not to leave this theme aside, as if it had to become secondary in order to foster a more free and just society.

God entrusted the earth to the alliance between man and woman: its failure deprives the earth of warmth and darkens the sky of hope. The signs are already worrisome, and we see them.

— General Audience, April 15, 2015