After ruling out biological disorders, experts recommend working on the psychological level to help the person find harmony.
Harmonious development, which contributes to and maintains personal identity, is what allows a person’s mental and psychological sex to match the sex of his or her body. But there are those who feel that they are the opposite sex of their body. It is not a matter of a transsexual physiology; rather, it is essentially a psychological distortion, a problem of a physically well-formed person’s conflict with their own sex.
Helping a person to resolve a conflict over sexual identity must be global, and should begin by ruling out biological disorders, ultimately working toward the psychological level. However, in some cases, the person opts to change their genital sex and secondary sex characteristics through physical treatments such as surgery and hormone treatments. Often, patients undergoing these treatments remain dissatisfied or end up feeling even worse than before.
How can we help people who do not identify with their own gender? Are surgeries and hormone treatments the answer to their problem?
Psychotherapy instead of Operations
According to hypotheses like that of the American psychoanalyst Robert Stoller, who outlined transsexualism’s particular clinical structure, transsexualism is due primarily to an environment that has not allowed for the structuring of a balanced personality.
Physiological factors can also have some influence, as biochemistry professor Natalia Lopez Moratalla explains in the article entitled, “Sexual Identity: Transsexuals and People with Gonadal Developmental Disorders.”
Sex therapist Lourdes Illán says these disorders should be treated with psychotherapy, since it can help overcome “the alterations that lead to transexualism,” including “feelings that caused the lack of psychosexual identification with one’s own sex. For example, in many cases, the parent of the same sex scorned the patient and the sexual condition of his sex in general – that is, the sexuality of his or her own sex.”
People who undergo so-called “sex change” operations lose their ability to procreate and to experience complete and normal sexual intercourse. Moreover, such surgical interventions impact healthy body parts, which, according to Illán, “is not permissible from an ethical point of view, and introduces new dissonances in the various components of sex (gonadal, phenotypic, and psychological), and worsens the subject’s mental state.”
In this sense, the 1995 Letter to Health Workers published by the Pontifical Council for Pastoral Assistance to Health Care Workers reminds us that “human life is both irreducibly bodily and spiritual” and indicates that “subjective feeling and wanting cannot dominate and disregard objective corporeal determinations.”
The Church document also notes that “the health worker cannot ignore the corporeal truth of the person and lend himself to satisfy desires, whether subjectively manifested or legally codified, that are opposed to the objective truth of life.”
But currently, the gender ideology that separates sexual and gender identity convinces many people that being male or female is not primarily determined by sex, but by culture. Often, sexual undifferentiation prevails.
This context influences the way children construct the ideal image of their own sex, which mainly depends on the behavior of the adults around them and their relationship with them, according to Illán.
Therefore, the therapist emphasizes the need to help boys and girls feel good about their own bodies and all those features that "mark" the sexual difference on the intellectual, emotional, and psychological level. “Achieving it implies being happy about my ‘being a woman’ or… being happy about my ‘being a man,’” says the therapist.