I've been tied up a lot the last couple of weeks so haven't been around much. Here's my take on this topic though.
It seems to me that there are several aspects that get tangled up on a subject like this one:
- One of these is the ethical validity of gender change.
- Another is the practicalities.
- A third is the personal impact.
- A fourth is the social consequences.
The first may have no time dependencies other than the fluctuating debates about right and wrong. The others are all time dependent in the sense that what is possible or OK or wanted may well change over time.
It seems to me that when these issues remain tangled, any debate about them just slips and glides about between them without any convergence towards a consensus, because the ground is not stable on which the discussion takes place. My personal views on these are fluid, I must admit, and I think that, for me, this is the right place to be. Partly this is because I'm not an expert in much of it, and I'm on a learning curve. Partly it's because this seems to me to be true about society as a whole too. A dash of humility would not go amiss for me before I run up a flag on the judging function flagpoles.
I'm not at all clear what the ethical position should be. I'm a Christian, and as has been pointed out there are scriptural references that are suggestive, but the situation and the capabilities we have now were inconceivable, and were not considered, at the time the Bible, the Koran and many other sacred texts were written down. What's more, there are things that were proscribed in the Bible, for example, that are no longer proscribed to Christians today - usuary for example, and a whole range of what was previously thought of as unclean foods such as pork. St Paul put a lot of effort and personal risk into challenging Jewish Old Testament Law obligations in terms of their applicability to Gentile Christian converts, and won that debate. That's not just something for 2,000 years ago but a process that must continue as we develop capabilities that were unthought of when the scriptures were written.
The second and the third perspectives are closely related. The basic situation as far as I understand it is where we have someone who was born with a particular genetic sex, but has the mind and mental outlook of the opposite sex. Perhaps it isn't always as black and white as that, so there will be folks who are somewhere in between. Whatever, the consequences can be very considerable mental and emotional stress, maybe an intolerable identity problem, and a desperate need to rectify things if possible. There are clearly two possible lines of resolution - one is for someone with this problem to become reconciled to the sex they were born with, and the other is to change their physical form to be congruent with the gender of their mental outlook. These are not symmetric possibilities - the first requires significant wise and compassionate support if it is pursued, the second requires similar support but carries a very considerable degree of physical risk because the medical interventions seem to be problematic and the end point is a compromise. Neither of these options is risk free - it's just that the risks are different and neither can guarantee success. Perhaps what makes the situation very complicated is that there will be folks who present with this problem but it is a symptom of something else rather than because it is at the root of their mental state.
This I'm sure is just scratching the surface of these two perspectives, but it seems clear to me that they have nothing to do with the ethics of sex change. There are ethics involved, but they are the similar considerations as those around any life-changing medical and psychiatric interventions, particularly if it concerns children and teenagers. The medical interventions are to a significant degree irreversible, at least at present - it takes the judgement of Solomon to choose wisely for a 15-year old,say, who may change their mind at 21. Yet is that any more challenging than not helping someone through a physical gender change when they are young enough to carry it through and who then regrets that just as much at 21? I only thank goodness that I don't have responsibility for advising anyone about such a change, and we should not forget the serious obligations we place on such professionals.
I don't think the fourth perspective, the social consequences, are always dealt with calmly and rationally. The media tend to pick up on extreme examples of things going wrong and sensationalise them, but maybe those situations do lend themselves to point towards what safeguards should be in place. I came across an article recently about a woman and her 10 year-old daughter who went swimming and were in the collective female changing room at their local swimming baths. Two trans women came in and stripped off among the women in there - the woman's daughter was horrified, embarrassed and frightened about being naked in front of what looked like two men and her mother was frightened and furious. They dare not use that facility again as a result. Of course this is exceptional, but it does highlight that we need to have social rules that find the right balance between folks so that fear, shame and anger don't become the dominant factors on how this plays out and gets resolved. I think it's reasonable to expect it will take a generation to evolve such rules.
On a broader note, it's fun to play with some thought experiments. Suppose that we had red and blue pills that changed our physical sex to female and male respectively, with no adverse physical or psychological consequences? It wouldn't be a real physical change but you would find yourself for a time in your chosen gender in a Matrix-like virtual world analogue. I remember once having a dream where I was a young mother fleeing from danger with my three children, and we were hiding in a very beautiful Central American country - it's the only time I dreamt like that, but it was fascinating. I guess many folks would like to try the other side. Mind you, I have to laugh a little at the emotional energy that goes into the real life discussions about this topic, because they seem to be very narrow sighted - I mean would I want to swap the problems of being an old man for those of an old woman, or vice versa? It adds a whole extra dimension to the thing lol .....