A Bioethics Perspective on Sex Reassignment Therapy Laura Purdy Professor Emerita Wells College April 2015 Why might one want to look at the bioethics of Gender Identity Disorder (GID) or transsexualism? The need for humility is great, 1 the terrain slippery and hazardous. 2 The difficulties start from the outset with the question what to call the condition, 3 given that the DSM-IV description of the transsexualism (“Gender Identity Disorder,” or GID 4 ) implies that it is a disease, which some activists vehemently deny. 5 The worries connected with this issue appear to be at least somewhat reduced now that “Gender Dysphoria” has been substituted for GID in the recently published DSM-5, 1 See C. Jacob Hale, Suggested Rules for Non-Transsexuals Wring about Transsexuals, Transsexuality, Transsexualism, or Trans________. Accessed August 16, 2011, at hp://sandystone.com/hale.rules.html. 2 Alice D. Dreger, The Controversy Surrounding The Man Who Would Be Queen: A Case History of the Polics of Science, Identy, and Sex in the Internet Age. Arch Sex Behav 2008; 37: 366-421; for related problems, see Tia Ghose, Chronic Fague Sciensts Get Death Threats, The Scienst, August 23, 2011. 3 I use the terms interchangeably, deliberately to underline my view that it is possible to reach useful conclusions without taking a stand on whether the condion is a pathology. 4 American Psychiatric Associaon, 1994. Diagnosc and Stascal Manul of Mental Disorders. (SM-IV), p. 823. 5 Dreger writes: “. . . as long as they talk of any kind of transsexuality as a paraphilia, I think it is unlikely Blanchard’s theory will find anything like general acceptance among politically conscious trans people who, understandably, are sick and tired of being treated as if they suffer from a pathology” (p. 416). More generally, activists are concerned about viewing gender nonconformity, rather than distress caused by it, as pathological. (See GID Reform Weblog, by Kelley Winters, 2013, http://gidreform.wordpress.com/category/dsm-5-2/ , accessed 9/3/2013.) See C. Jacob Hale, Suggested Rules for Non-Transsexuals Wring about Transsexuals, Transsexuality, Transsexualism, or Trans________. Accessed August 16, 2011, at hp://sandystone.com/hale.rules.html. Alice D. Dreger, The Controversy Surrounding The Man Who Would Be Queen: A Case History of the Polics of Science, Identy, and Sex in the Internet Age. Arch Sex Behav 2008; 37: 366-421; for related problems, see Tia Ghose, Chronic Fague Sciensts Get Death Threats, The Scienst, August 23, 2011. I use the terms interchangeably, deliberately to underline my view that it is possible to reach useful conclusions without taking a stand on whether the condion is a pathology. American Psychiatric Associaon, 1994. Diagnosc and Stascal Manul of Mental Disorders. (SM-IV), p. 823. Dreger writes: “. . . as long as they talk of any kind of transsexuality as a paraphilia, I think it is unlikely Blanchard’s theory will find anything like general acceptance among politically conscious trans people who, understandably, are sick and tired of being treated as if they suffer from a pathology” (p. 416). More generally, activists are concerned about viewing gender nonconformity, rather than distress caused by it 1