A Funny Kind of Integrity
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The Evangelical Alliance claims that its report on ’Transsexuality’ is of the ’utmost academic integrity’. But is it?
Saturday 10th Februry 2001
Since the Evangelical Alliance Policy Commission booklet “Transsexuality” was published a few weeks ago, our comments on the matter have concentrated on the way in which the has EA has continually ducked advances by Press for Change to discuss their work. We’re not alone either. As we’ve pointed out previously, the EA has seemingly managed to conduct its’ entire “research” without approaching any prominent trans support organisations that we know of … and that includes well known and respected charities such as the Gender Trust.
A shroud of mystery seems to surround the whole project, in fact. Who are the report’s authors, for instance? The book doesn’t say. And that’s a serious omission in a work that so often refers in the footnotes to the publications of a single body, the “Parakaleo Ministry”, whose views it quite clearly echoes. What is the relationship between the authors of the book and some of the publications they refer to in evidence for their arguments?
In a recent report by the “Church Times” an EA spokesman, Iain Taylor, defended the document though, claiming:
“This is a report of the utmost academic integrity, and the authors do not feel that there is anything missing from it”
So maybe it’s time to put that statement to the test, as we now open the covers and probe the contents for the first time.
On this occasion I’m going to look at just three crucial aspects that the reader needs to know in order to sum up any book of this kind: its’ motivation, its’ reasoning integrity, and the proposition which it puts forward.
What I’ll illustrate is that:
- Far from being truly concerned with what is best for trans people, the book has a transparent political motive borne of the convictions of its’ un-named authors, who start with their minds made up and select their evidence accordingly.
- The reasoning of the book towards that predetermined goal is intellectually corrupt … using some of the oldest tricks in the book to define the other’s argument and motivations, to misquote and selectively quote authorities on the topic and (most outrageously of all) to mix opinion with scientific result without properly distinguishing the two.
- The book’s proposition is wickedly irresponsible … criticising on the one hand a treatment that works, yet failing to subject its’ own substitute treatment proposals to the same degree of scrutiny. It offers a treatment approach that has failed over and over in the past without adducing any evidence to suggest that it has found a way to make this work.
So let’s start with that motivation:
The Book’s Motivation
There is an impression running through the book that the motives of the authors are purely compassionate, concerned ultimately for the welfare of those people placed firmly at the end of the microscope barrel. The writers say that they “deeply reget any hurt caused to transsexual men and women by any unwelcoming or rejecting attitudes on the part of the church” (p85). The Foreword by Joel Edwards (the EA’s General Director) claims the book to be “no anti-transsexual polemic” and concedes that “…any attempt to grasp a contentious issue such as this is bound to offend”, claiming, “that is not the intention”. Don Horrocks, the EA Policy Commission’s Co-ordinator assures that “[the Policy Commission’s] reports are produced following a wide-ranging discussion and consultation process” which (externally) includes “reference to academics and relevant practitioners in the appropriate fields”.
Lots of reassurance and concerned tones.
On the other hand, the book’s back cover starts out with the words:
“From the steps of Westminster to our own homes minority groups are increasing their profile using equal opportunities legislation and media opportunities. Transsexuals are one such group, raising the level of debate in both secular and church circles”.
Back at the very start of Joel Edwards’ foreword, he concedes too:
“When the Policy Commission decided to submit a report on Transsexuality many of us doubted the wisdom of their choice. After all, there are many other subjects which seemed to be far more pressing for evangelicals; there was no sign of an evangelical stampede coming at us for a rapid response to the subject!”
The book’s introduction (page xi), echoes the same thought:
“Why a book on such an obscure subject”
… and then provides the answer:
“…during the past few years the issue of transsexuality has become increasingly high profile, not only in the media, but also in the political arena and in the courts [..] In response to interest group pressure, further government legislation is anticipated soon to address the subject [..] Groups of Christian transsexual people have also emerged to argue a case for acceptance of their particular lifestyle on biblical and other grounds. […] It has become such a live and contentious issue amongst Christians one that involves complex and perplexing practical and theological consequences that an investigation and response to some of the implications raised is now called for.”
So, to spell it out. The book would not have been written had it not been for the advances of organised campaign groups, such as Press for Change who (in case you’d forgotten) came into being as an act of self-defence against decades of intimidation, marginalisation and neglect, by those who happily preyed upon our vulnerability and social isolation. And those are conditions which were created by earlier generations of fear and ignorance. Forget any pretence of an idea that the authors might have a revolutionary new insight into the best way to treat the condition, which they are desperate to share in print. The book is a political form of response to what is seen as an ideological challenge to the EA’s view of the world.
And just to underline that political flavour … just in case the reader should wonder about the motivation of groups like ours (the people they wouldn’t talk to) … a definition of OUR objectives is supplied over and over …
By Don Horrocks, in the EA’s press release:
“Transsexuality is yet another of those issues where ’sound science’ is ignored, derided or subverted by a determined lobbying group with ready access to often ill-informed sections of the media and members of the government”
By Iain Taylor, quoted in the Church Times (2nd Feb):
“[they are] highly political organisations, at the extreme wing of the issue. This is a bunch of people, who have, quite frankly, become obsessive about their particular position. There is no way that they would invite the EA to contribute to their reports, so we took the view that we would not give them a platform.”
And in the book itself:
“[single-issue lobby groups] prefer spinning a story for the media to pursuing debate within the scientific forum…” (pp14-15)
Whether the arguments in the rest of the book were sound or not (and, as we’ll see in a moment, they are not), it is this clear display of what the authors are muttering beneath their breath which causes one to question the whole collection of arguments which they then put forward.
No book is going to cover and weigh every piece of available opinion and evidence on this topic to arrive at a rigorously deductive conclusion. That’s what keeps a controversy going. If it were easy to put the points in order and draw conclusions then someone would have done so and we could all agree. There is a difference between books and papers which genuinely set out with an open mind to try such a feat, however, and those which begin with a conclusion that they only want to justify. The EA quite clearly shows, in this case, which approach they have taken.
So now let’s move on to the “academic integrity” of the content itself.
The Book’s Reasoning Integrity
At first sight, and especially if you are not familiar with the subject matter and the history of transsexual research and treatment, the book may look like a pretty thorough and impressive investigation, backed up by plenty of seemingly authoritative reference in the footnotes and bibliography.
The first clue that all is not well comes just from examining that bibliography though, which is partial to the point of wilfulness. With the exception of a reference to David Horton’s 1994 book, “Changing Channels”, which is OUT OF PRINT, none of the other eight publications invite the reader to consider alternative views on the topic under discussion. Four of the eight come from the “Parakaleo Ministry”, which appears to be the chief advocate of the practice of persuading vulnerable transsexual people to revert. Similarly, the book has only one organisational address to refer to. Which one? Ah … you guessed.
Iain Taylor, again in the same Church Times article, defends this partiality:
“There is no way that [those who question the book] would invite the EA to contribute to their reports, so we took the view that we would not give them a platform.”
Indeed. Press for Change didn’t consult the EA when submitting our reports to the Government. We didn’t consult the Women’s Institute either … or the Test and County Cricket Board … or the Flat Earth Society. We didn’t need to consult with those organisations because we weren’t setting out a proposal to challenge their rights to equality in our society, and we weren’t proposing to interfere in the relationship between any of their members and the doctors who might, for any reason, need to treat them. We did consult with hundreds of trans people over the course of many years though, and through the two way discussion mechanisms which we have set up to continually enable those people to have their say.
Let’s move on to the process of point making and justification which underpins the integrity of a thesis, however.
Here it is difficult to know where to start, for after a single reading my copy of the book was so covered in post-it notes and highlighter that I felt the need to highlight the highlights. It is a book riven with selective and questionnable quotation on the one hand, and downright inaccuracy on the other. One or two special examples really stand out though…
The FIRST example concerns the curiously contradictory way in which the book cites the opinions of Professor Louis Gooren when it suits the argument, and trashes his team’s work when it doesn’t.
The book cites Professor Gooren’s publications no fewer than eight times, and I’m sure he’ll be flatterred by all that well-deserved attention. The Professor holds the world’s only chair in Transsexology at the Free University Hospital in Amsterdam, where he heads a multidisciplinary team of endocrinologists, psychologists and surgeons, performing the very sort of medical reassignment treatment which the EA so-strongly abhors.
On page four, for instance, the authors (to be as charitable as possible) start out by appearing to misunderstand the Professor’s approach on the topic of viewing transsexuality as a sort of intersex. The book is very hung up on this topic, it seems … apparently because they mistakenly seem to think that we are. When PFC talks about intersex conditions it is from the perspective of enlightening people about the fact that such physical differences occur in nature with quite astonishing regularity. It’s a point that calls into question the EA’s literal interpretation of Genesis … that there are ONLY man and woman in creation. The professor, in various texts (including his expert witness statement in the case of Elizabeth Bellinger- Appendix A of the Interdepartmental Working Group’s official report) LIKENS the circumstances of transsexual people to those with physically recognisable ambiguities of sex differentiation. That is, in his professional view, there are similarities that put trans people and those with all manner of physical conditions in the same SEA, if not actually in the same boat. The condition CAH is not the same as the condition AIS … nor are either of them the same as Kleinfelter’s syndrome. Semantically these are all referred to as “Intersex” though, and on occasions, therefore, Louis has been known to observe that you could therefore go a step further and put “trans” into the same bag as well. However, others put more store by keeping the boundaries of the medical term where they are and we respect that. It’s not worth losing friends over a semantic.
It is therefore rather odd that EA’s book puts a rather different spin on the professor’s views by using his words to imply a firm position that transsexuality most certainly is NOT anything like these other cases at all. We might all agree that there is a qualitative difference between conditions which can be “seen” (even if it needs a high power optical microscope to see them), and those which are more elusive. Nevertheless, the Professor might be forgiven for raising his eyebrows when one of his published statements on the daignosis of transsexuality itself (the absence of physical factors) is used to argue, looking glass fashion, against the idea of looking at all the syndromes together.
Nevertheless note that here, on page four of the book, Professor Gooren’s standing as an authority is rock solid enough to quote favourably.
Further into the book, on page 16, Gooren’s work is quoted again, this time as an alternative opinion on the epidemiology of the trans condition. Again, so far so good.
But then, on page 19 it all starts to go pear-shaped. Quoting this time the collaboration with his colleagues (J.N. Zhou, M.A. Hofman, L.J.G. Gooren and D.F. Swaab, A Sex Differencein the Human Brain and its Relation to Transsexuality, Nature 378 (1995), pp.6870), the authors state the opinion:
“Despite media interest focusing on them, the strength of studies that claim transsexual people have a different brain structure is very limited. The allegation of supposed biological differences has been used to argue that transsexual behaviour is a result of innate, physical factors that are not chosen by the individual. Claims made by Dutch authors[9] that a specific part of the brain (the bed nucleus of the stria terminalis) is femalesized in maleto female transsexuals are based on studies of the post-mortem brains of transsexuals who were prescribed hormones of the opposite sex. But the differences found in these brains may have been caused by the hormonal medications, and may not have been present prior to the chemical manipulation. In addition, as is well known, the structure of the brain can alter after new experiences and behaviours,[10] and these brain structures may well have altered as a result of the specific behaviours adopted by the subjects” (p19)
Now this is not quite rigorous enough as a critique in itself, since the researchers being critiscised here actually set out to eliminate the very factor being cited and went on to strengthen that aspect of their argument in subsequently published follow-up work. Nevertheless, the main point is that the Professor’s work is good enough to quote reverentially when it suits the authors, even when they have such contempt for it in other quarters. The authors of the BOOK are rather more sure of their own views, however, when they immediately go on to venture that:
“It is unlikely that any similar research will ever be able to show differences in the brain structures of transsexuals that clearly evidence causality”
… Just as it is therefore presumably just as likely that no-one can ever prove the opposite, or prove that the whole affair is determined by environmental events during childhood. The authors are selective about whose views they subject to such scrutiny though.
Just to compound this gradual slide from reverence to mockery, however, the authors (on page 22) go one further, getting hung up on semantics:
“One authority in the field has advanced the argument that transsexuals have an intersex condition of the brain.[16] An intersex condition, however, exists when the techniques for identifying sex are inconclusive due to ambiguity of the genitalia, and not because of brain characteristics. Accordingly, on the usual understandings”
And the authority in reference [16]? Why Professor Louis Gooren, of course, in his Closing Speech to the Council of Europe’s 23rd Colloquy, “Transsexualism, Medicine and Law”.
Let’s remember the words of the EA’s press release too, introducing this book:
“In such cases the so called scientific ’expert advice’ cited by lobbyists is frequently pseudo (i.e. misreported or over-claimed). It is often presented by figures apparently qualified to speak, but who are almost inevitably partisan supporters of the movement in question. In many cases these people are not even regarded highly by their professional colleagues (many of whom are nevertheless afraid to speak out for fear of being classified as politically incorrect). But when this so-called evidence is subjected to rigorous scientific scrutiny, it does not stand up to claims made for it - and this is certainly the case with our research into transsexuality.”
If it’s not this particular “expert” which they are referring to, then it is hard to find another whose work is so comprehensively examined within the book. So what are the EA inferring about the Professor’s scientific integrity?
Fear not though, for redemption is close at hand. Between pages 22 and 23, the Professor is back in the authors’ good books again, quoted favourably in support of the view that it’s all psychological really:
“Experts cited by transsexual groups have suggested that, transsexualism could be a body image disorder rather than being an expression of a pseudohermaphroditic development”
The expert? L.J.G. Gooren, Concepts and Methods of Biomedical Research into Homosexuality and Transsexualism, Journal of Psychology & Human Sexuality 6(1) (1993), p.14.
All of which goes to show that Louis Gooren is a good deal better at keeping an open mind and entertaining all possibilities than those quoting his work!
None of this provides the “downright inaccuracy” which I promised you though, so let’s move on and now look at another pet subject of the authors, the so-called Joel/Joella case.
In this, it is immediately apparent that the closest that the book’s authors have come to the case is through their reading of the newspapers. Mostly, the book quotes the right wing tabloid “The Daily Mail” as its preferred newspaper of record. On page 58, however, it is the broadsheet Guardian whose misreprorting of a particularly interesting case becomes the lynchpin of an argument which is doomed from the start.
The Joel/Joella case concerns a child with XY chromosomes, who would (by the authors’ arguments) have been a “boy”, had it not been for the fact that they were born with a particularly severe condition called Cloacal Extrophy … in which the abdomen is only partly closed and (in this case) the genitals (or what there was of the child’s penis) were totally malformed. The true story is that the doctors of the time first recommended that the child be registered and raised as a boy (in accordance with the chromosomes, gonads and what penile material there was). Weeks later, however, they had a change of opinion and recommended that the child … a male in every sense … be raised as a girl and be surgically reassigned to support this. We know these details well, because Press for Change legal experts became closely involved in the arguments which then followed to try and get the Home Office to change the child’s birth certificate to say “Girl”.
This is not how the Guardian’s report of the matter is presented by the book’s authors though.
First, in the footnotes of page 58:
“Where a girl was misidentified and registered at birth as a boy, but was allowed to change her birth certificate ten years later. Described by experts as a medical mistake. See, for example, The Guardian, Wednesday, 2nd December 1998”
(You can actually READ that article in PFC’s web site library)
Then, on page 66, under “The Question of Intersex”:
“A definitive medical intersex condition, such as occurred in the Joel/Joella case cannot in our view be considered as in any way comparable to the transsexual claim of wanting to be recognised as really a man in a womans body or vice versa”
“It appears that in the intersex state of Joel/Joella what was encountered was purely a failure of medical discernment”
Now this is odd however, because there was nothing “Intersex” about this particular child’s circumstances. The child’s chromosomal, gonadal and genital characteristics were all concordantly male. The child had a deformity which the doctors (some might say recklessly) chose to deal with in a radical fashion … on the basis of a form of intervention which has subsequently been dramatically discredited. So, either the authors of the book are negligent in taking their references from a newspaper report alone, or are they are trying to hoodwink the reader by (to quote that press release and Don Horrocks again), “Hijacking the terminology to obscure the facts”
And these are, as I promised, just two examples of the lack of intellectual integrity, rigour and accuracy which pervade the book.
A different author, seeking to find the truth rather than to prove their conviction, might easily have spotted and eliminated such obvious howlers, to produce a better reasoned contribution to what is, undoubtedly, an important debate. If you start from a biassed position, however, there is only one place you can go.
Transsexual people have nothing to fear and everything to gain from a thorough and intellectually rigorous appraisal of their position. It seems that, until now, the people left to lead the call for that have been trans people themselves though. Ironic, therefore, that we should be so wickedly misrepresented as partisan by the authors of this particular book.
However, that’s not the only way in which things are turned on their head …
The Oldest Trick In The Book
Both of the examples which I’ve taken to demonstrate the flaws in the book’s evidential integrity relate to medical research or opinion in some form or another. The reasons for picking on this aspect of the content rather rather than the rest is because I’m not a theologian or religious ethicist. Neither do I believe that it would be fair to challenge the EA’s right to develop views in ways defined by their convictions and belief system. If you believe in Genesis so literally as to place its translation above practical observation then the only place for deconstruction of the resulting conclusions is among those who wish to debate within the same constraints. For the rest of us, the translated Bible may well offer words to the effect that “God created man and woman”, and the Evangelical Alliance may argue from there that…
“It does not teach, as some allege, that maleness and femaleness are two poles between which is a spectrum or ambiguous blend of human sexuality.” (p48)
…Nevertheless, a discussion about what to make of the reality of all those people who self-evidently ARE somewhere between God’s poles belongs among those prepared to debate within the same closed system of argument.
To return to the consideration of those medically related references in the book, however, the main reason for critiscising them is not because I or Press for Change think the medical arguments to be important (see below), but because (ironically) the Evangelical Alliance DEFINE that we do:
To quote again from the EA’s Press Release on the book’s publication:
“The study concludes that there is no convincing scientific evidence to support the view - assiduously promoted by transsexual lobby groups - that transsexuality is a caused and determined medical condition”
and Don Horrocks, specifically:
“Transsexuality is yet another of those issues where ’sound science’ is ignored, derided or subverted by a determined lobbying group” […] “In its place they seek to elevate research that is at best dubious and which often has no factual basis.”
The quotes on ’sound science’ are theirs, by the way … and note the singular reference to the lobby GROUP at whom the accusation is pointed (i.e. Press for Change, since there are no others in this debate in the UK!).
Now this is important, because it constitutes the use of one of the OLDEST TRICKS IN THE BOOK in order to first define your opponent’s argument, then attempt to demolish it … thus implying to the naive observer that your argument is the more objective!
Unfortunately for the Evangelical Alliance, there is no substance to this claim in respect of Press for Change … and since we publish literally everything we have said (and all our references) on our web site, any reader is at liberty to go and check for themselves. PFC’s own original (June 1999) submission to the Government’s Interdepartmental Working Group, for instance, makes no direct reference to medical aetiology at all (apart from pointing out the Medical Viewpoint publication as a resource on that aspect of the topic). Our arguments for social and legal recognition of trans people’s rights to equality do not rely on any sort of “proof” for the legitimacy of our existence. It is self evident that trans people exist and therefore, following a line of humanist tradition going back at least as far as the founders of the U.S. Constitution, we assert that it is equally self-evident that trans people were created equal to all others.
[Readers who are interested in reading EXACTLY what PFC and others have presented to the UK government, will find all the submissions we know of in our special section on the Government Working Group. (All submissions except the EA’s own, incidentally, which they have refused repeated requests to disclose).]
The Press for Change web site nevertheless TALKS about medical research of course, and the archives of the UKPFC-News service also contain contemporary postings relating to announced research in this and related areas. It would be absurd and working with one arm tied behind our backs if we didn’t, of course … because it is the most vocal opponents of trans people’s treatment and rights who are keenest to use counter arguments in this field when it suits them. The Evangelical Alliance are no exception to this:
In their press release on the book:
“…the Alliance reaffirms the longstanding view that the causes lie mainly in the area of developmental psychology”
and in the book itself:
“….the body of evidence for transsexuality having a psychological cause is significantly greater and long-standing in contrast to the biological research”
(p22 - Referring to a Lancet “Crucible” article which we’ll come back to below)
In this context, therefore, it is only natural that a lobby group like PFC would point those interested in the debate to the full range of arguments. At no point do we (nor any of the researchers indirectly accused by the EA) make any more claims for such research over and above what it is reasonable to conclude. All we invite people to consider is that whilst it may not be possible now (or perhaps ever) to prove that there is a definite physiological causation for the human experience of cross-gender identification, the questions raised by lines of research in this area challenge the assertion of the opposite. However, as we’ve said above, it is not necessary to prove why trans people exist (whether beyond reasonable doubt, or on the basis of probabilities) in order to accept that they DO. That being the case we leave medical argument to the doctors, with whom we have sufficient arguments as it is, without wanting to become in any way dependent upon them for authentication of our existence. Oddly, the EA seem to have completely missed this dimension of the relationship between trans people, medicine and the state.
[For anyone who wants to follow up this argument further there are plenty of examples of the debate on PFC’s web site, and especially within the archives of our campaigner forum. See http://www.pfc.org.uk//pfclists/forum-arc/200102/msg00067.htm for the most recent example by PFC Vice President, Claire McNab, illustrating the way in which the lobby’s leaders try to encourage individual campaigners, new to the arguments, away from a scientific dependency]
In summary, the entire scientific debate around the causality of transsexualism is one that is conducted by others, not the leading trans rights lobby in the UK, Press for Change. Whilst others place such store by the science it is inevitable that we must ensure that people are aware that there is a question mark over the aetiology (just as there are question marks over many other conditions). It is those opponents and sceptics who preach scientific certainty. Nevertheless in the documents which define our case to the UK government there is a marked emphasis upon dealing with the reality of trans people’s existence in society … a set of issues which the Evangelical Alliance seeks to diminish by concentrating on the validity of our existence rather than upon the fact that we are there.
For the Evangelical Alliance to caricature the position of Press for Change and the body politic of trans people in the way that it seeks to do throughout its literature suggests, at best, that they have simply failed to understand the sophistication of the people they are studying. And as we continually repeat, this major error could have been avoided simply by a preparedness to talk, and to let us help to correct their misconceptions.
There is ONE very good reason for people like the EA having such an unhealthy interest in a developmental causality, however … and that brings us to the final part of this analytical essay …
The Book’s Proposition
The Evangelical Alliance position on the treatment of transsexual people derives, as they quite openly state, from their own religious convictions. To quote from the opening paragraph of chapter 3 on page 14:
“The evangelical perspective on transsexuality is adopted primarily from the witness of Scripture. Christians believe that science will ultimately, if accurate, confirm Gods revealed truth if correctly understood. Scientific research requires examination, but is not of greater authority than Scripture in finding a Christian ethical basis for transsexuality.”
The authors seldom seem to be comfortable working exclusively within that framework though, presumably concerned that a purely ethical argument based on theological deduction would fail to impress those outside their faith. As we’ll see below, the EA is not content with stating a view but wants that view actively applied to trans people. The problem with a purely deductive thesis is that it is open to challenge by others … and the people with the most at stake in challenging the EA’s particular view in this instance are transsexual people, of course. It is little wonder, therefore, that so much of the book is devoted to discrediting that other perspective by attempting to pathologise the people presenting it. If trans people are “deluded” then you don’t have to award any credit to their arguments. To establish a pathological position you need a diagnosis though. A delusional diagnosis is on shaky territory if you have the slightest possibility of a physiological reality, of course … and a physiological diagnosis is disallowed by the EA’s Genesis-derived rule book for the debate. So, it follows that the EA’s argument has to follow the assumption that cross-gender identity is a learned condition, arising from errors in nurture alone. Thus the foundations are also then laid for the assertion that the way in which to “treat” the condition is by psychological means too … and the search is on to justify that this has a basis.
This is summed up in the press release accompanying the book’s publication, which:
“…calls for a more holistic response to the treatment of the ’condition’ without recourse to unnecessary surgery and falsely raised hopes”
and goes on to say:
“Transsexuals, we believe, are ’confused’ about their identity and the correct response is an holistic one which emphasises psychosomatic unity without recourse to surgery”
and asserts:
“The study neither accepts that the condition of transsexuality is inevitable, nor that gender reassignment surgery, which cannot pretend to treat root psychological causes or address fundamental associated ethical issues, is the best treatment for a transsexual person”
On some fronts, the book itself goes even further, opening the question of whether gender reassignment surgery should even be legal:
“The issue of the legality of such surgery has never been specifically addressed in English law. Court decisions about the identity and rights of post-operative transsexuals have failed even to raise the question of whether the operations themselves may be carried out.” (p30)
But then (having suggested that that entire class of treatment should perhaps be stopped), it turns out that the alternative “holistic” treatment referred to isn’t a medical one, but a PASTORAL approach, and is not defined in specific terms as a programme but in terms of a series of negatives: courses of action which Evangelical Christians should not permit.
This actually makes the EA’s proposed policy very difficult to quote precisely, EXCEPT from the press release. To determine what it is you have to read the whole book, and especially the “Practical and Pastoral Considerations” in chapter 7, totting up the things which the book suggests individual Churches should NOT do.
For example (page 67):
“Sometimes the problem of sex/gender alienation is so destructive, or potentially destructive, of the individual that it may be considered that some limited form of intervention be recommended as a proportionate pastoral response.[13] For example, if the co-operation between a transsexual person and his/her counsellors has broken down, and suicide appears the likely result of any refusal to intervene, then forms of intervention may well be pastorally legitimated by the ensuing emergency, though subject to the usual criteria of the minimum necessary. Thus, hormonal treatment may be preferred to surgery, for example, though it should be noted that abuse of this procedure with consequent damaging side effects is not infrequent. This does not rule out the possibility that surgery may be indicated by the pastoral emergency, though the kind of indication that will count here must be extreme. Although a patient may properly decide whether or not to undergo a given treatment, it is, of course, subject to the supposition that the treatment is prima facie an appropriate response to the patients need. It is not an undetermined choice, but a personal decision as to how to proceed in the face of a situation of grave necessity.”
(Make of that what you will as a recipe for a considered therapeutic approach. It sounds more like a process of retrenched rearguard action to this reader)
To put it in a nutshell, however, the book first advocates an abandonnment of a treatment in the United Kingdom, without being able to adduce any real evidence to even suggest that the treatment doesn’t work, and then puts nothing concrete in its’ place … except a proposal which it struggles to justify from the literature. This is remarkable on many counts. Perhaps the most ironic, however, is that Japan (after fifty years of pursuing a regime in which genital surgery of any kind was illegal under anti-eugenics laws) has finally opened the door to performing the gender reassignment surgery after going through its own ethical agonies!
This is the basis on which I earlier branded the EA’s approach as “wickedly irresponsible”.
Let’s look at it in more depth though …
To set up the argument, the book’s authors first set out to make some assertions:
ASSERTION NUMBER ONE: That psychotherapeutic “cures” for transsexual feelings have not been properly tried and that there is reason to believe that they can be more successful. Quote:
“…it should also be noted that the incidence of relatively successful non-surgical adjustments in the context of psychotherapy treatment alone is in fact quite high” (p5)
The only support for this assertion is, in fact, a second-hand reference to a scientific paper:
“According to Lothstein and Levine the number is apparently as high as 70% out of 50 patients treated. As cited by Rodney Holder in Crucible, AprilJune (1998), p.94.”
As a second hand reference, however, the reader is left to look up the actual context of the work being quoted themselves. The citation actually quoted here is merely part of an opinion piece in a UK medical periodical. No reference is made to the sixty year history of experimentation of various kinds upon transsexual people, during which time there was plenty of opportunity for convincing results of psychotherapeutic treatment to be produced and reproduced by the many who tried. Nor is any mention given to the ways in which such failures of method were ultimately discredited. Modern practice was only established when it was concluded that all attempts at psychological change alone led to failure, and ultimately damaged the individuals concerned. Surgical treatment came about through compassion, not zeal, and has only continued and grown in acceptance because it is successful. However, if there is such a compelling case for a reappraisal then the EA should be able to produce it before calling for change. All it can offer, however, is the quote above, recycled several times and which it doesn’t look as if they’ve actually read.
ASSERTION NUMBER TWO: That claims by trans people that they are happy after treatment (and by researchers that favourable outcomes are prevalent) are biassed because of self-interest. Quote:
“Though proponents may argue that gender reassignment is an act of mercy and compassion, and may point to statistics that allege a degree of success, nevertheless longterm statistics are lacking, and the surgery may equally be viewed as offering fleeting and false comfort to a hurting individual.” (p26)
This is not only indicates at best that the authors haven’t done their homework well-enough, but it then goes on to be downright insulting:
“Most transsexuals who undergo gender reassignment surgery are relatively satisfied and adapt reasonably well (at least in the medium term),[21] frequently presenting a very realistic impersonation of the opposite sex. For many it is a dream come true. Indeed, many who undergo gender reassignment report a shift or increase in sexual attraction that complements their new physical appearance. Suspicions are rightly raised that transsexuals will naturally be reluctant to voice regrets over their choice”
The reference here is to 0. Bodlund and G. Kullgren, (Transsexualism General Outcome and Prognostic Factors: A Five Year Follow-up Study of Nineteen Transsexuals in the Process of Changing Sex, Archives of Sexual Behaviour 25 (1996), pp.303) and supports the first part of the statement (i.e. that MOST trans people adapt REASONABLY WELL). However, the second statement is simply unsupported and overall it is worth stating that whilst there is a paucity of good follow-up research (ironically because trans people disappear after treatment and get on with their lives), the research that has been peer reviewed and published indicates, in some cases, success rates in excess of 90-95%. In Press for Change we would not present the results of out own internet-based survey as in any way scientifically controlled: our objective was to justify the case for undertaking such studies. However, with a sample of over 300 respondents (larger than most other studies put together), our figures not only indicate a high rate of satisfaction but also give the lie to other researchers’ claims that “subjects were lost to follow-up” … a measly excuse for failure to research properly.
ASSERTION NUMBER THREE: That transsexual people subsequently regret their treatment and should be counselled at any stage to revert. Quote:
“Though gender reassignment surgery is largely irreversible, at least a small number later do regret their decision” (p25)
[M. Landen, J. Wallinder, G. Hambert and B. Lundstrom, Factors Predictive of Regret in Sex Reassignment, Acta Pscyhiatrica Scandinavica 97 (1998), pp.284]
and
“In a recent documented case study, a man who became a Christian after undergoing gender reassignment surgery became convinced that he was effectively living an illusion in his assumed feminine role and needed to revert to his true masculine identity.”
and
“For the post-operative transsexual, the experience of serious remorse, trauma, and confusion following the euphoric immediate post-operative phase is not uncommon”
[S. Churcher, The Anguish of the Transsexual (Lexington: CrossOver Ministries, 1997).]
Indeed regrets and worse tragedies occasionally occur, and Press for Change has denounced, in the past, the type of poor treatment practices which can lead to such disasters. That is, after all, the justification of the one or two year “Real Life Test”, which is a time for those counselling a trans person to help them to discover whether their feelings are truly transsexual and whether their expectations and ability to cope are realistic. The biggest problem is a climate in which people presenting as apparently transsexual are driven into the hands of quack practitioners and commercial gender treatment factories by a lack of resources in more prudent establishments. It is a big and unsupported leap to assume that because the treatment hasn’t worked out for some people, the entire diagnostic and treatment system is flawed. On that basis, most common medical diagnoses and interventions would fail the test.
What the authors fail to tell the reader, however, is that the “recent documented study” relates to the founder of the “Parakaleo Ministry”, whose own publications are so widely quoted throughout the book and in the bibliography which it provides. Questions of objectivity inevitably have to be raised as a result.
Furthermore, the book fails to consider the implications of a ban or limits on conventional gender centre treatment programmes. The EA’s speculative ideas about making surgery illegal would not reduce the incidence of tragedies, but risk increasing it by driving people overseas … away from organised counselling and back to Casablanca, in effect … in the pursuit of the treatment which they desire. Such a proposal is therefore wholly irresponsible.
Perhaps the most bizarre assertion, is the last that I have been able to adduce from the text though:
ASSERTION NUMBER FOUR: That whatever the state of a transsexual person approaching the church for admittance … even if they are happy and well adjusted in their post-operative state, the appropriate action is to encourage them into reversion as a condition of acceptance.
This is implied on page 81:
“In some cases postoperative transsexuals attracted to the church may be unwilling ever to contemplate reversal to their biological sex. For the church to accept such a resolution could be fundamentally problematic since it would appear to involve acquiescence in what many would regard as a serious impediment to the individuals Christian restoration and wholeness.”
In fairness, the text goes on to explore the implications for congregations which find this too big a pill to swallow, although it seems to conclude that the only exception cases are threatened suicide. Nevertheless, some might be alarmed at the revelation that this book advocates counselling someone who is happy with the outcome of their treatment to revert to the state where the only evidence points to the fact that they weren’t happy. Again, in fairness, this is advocated in a section of the book where (ostensibly) the issues concern people within the Church. You could argue that if someone wants to join the Church then they also need to respect the conventions of that body … either that, or find another Church. This is not an entirely satisfactory argument, however, especially where the individual concerned is perhaps lonely or vulnerable … not BECAUSE they once transitioned, but just because the world is full of people who are lonely and vulnerable. What the EA is advocating in such cases is a form of emotional blackmail, which threatens to open a can of worms which the Church itself may not be equipped to handle. The potential for damaging abuse is clear.
In addition, however, the book is never all that clear about where the dividing line exists between what it would advocate within a pastoral setting, and what it believes should happen outside of it. The fact that the EA’s leaders and the book both address themselves to the wider context of society implies, however, that no distinction is really offered. Given the chance, it seems, the EA would be quite happy to practice in the street what they advocate within their own four walls.
Summary
Some have asked why Press for Change has shown such an interest in the EA’s views and the contents of their policy commission’s booklet … especially in view of the apparent widespread apathy on the part of the Press towards its’ publication.
To a great degree we would go along with this too … especially since this analysis has demonstrated the ease with which the book’s contents can be challenged without resort to a battle of scientific authorities. As we’ve pointed out here, the Press for Change campaign is not interested in proof of any sort of scientific “cause” for transsexuality in order to assert the fact that trans people exist and are deserving of equal treatment. Neither does the search for a “cause” provide much helpful enlightenment on the question of the most appropriate form of treatment.
The danger of the EA’s policy booklet lies in the use of its contents by those who have no background from which to understand how misleading it is though. In particular, since the main Anglican Church in the UK has so far failed to grasp this topic and form a properly informed and balanced view of its own on this topic, the EA presumably feel they have stolen a march in this respect.
The book presents itself as THE authority on the topic.
On the back cover:
“This report will prove a great asset to Churches who share the EA’s desire to face up to difficult issues. It has been produced with both integrity and compassion as well as a determination to take seriously the things that Scripture does and does not say”
[Mary Evans, Old Testament Lecturer at London Bible College]
And within the introduction:
“Our approach in this book has been to inform the Christian public about this little-known subject, analyse the issues and implications that arise from a Christian standpoint, and suggest guidelines for how a Christian response to transsexual people might work in practice. Although we principally address evangelical churches, we nevertheless consider this study should be of wider use to the Church in general since the issues and dilemmas raised entail common considerations”
It is that aspiration to “wider use” which should be the concern.
The purpose of this lengthy critique has therefore been to establish clearly that this is a controversial book. Every bit as controversial as the authors would claim Press for Change’s mission to be. This critique isn’t the counter argument. There is a place for a more even handed and open-minded book about trans issues within the Church and I personally hope that someone will step up soon and plug that void, so that the cases of people like the Rev Carol Stone or the Hospital Chaplain recently featured in press reports can be approached from a truly informed and compassionate perspective, rather than the EA’s thinly disguised attempt at these things.
Being Christian and being a transsexual person should not have to be incompatible states. Not if you believe that God is the judge of what is right or wrong and that His followers on Earth have consistently underrated His capacity for diverse and colourful creation throughout history. If you believe in a God of mercy and love, however, then there is only one judge of the choices made by a transsexual person given their circumstances … and that’s not Joel Edwards, Don Horrocks or those people with a mission in Watford.
Christine Burns
(Vice-President, Press for Change)