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At the press conference on his return flight from Azerbaijan, Pope Francis spoke on, among other things, the topic of transsexuals. He told the story of a girl who, even as a child, had felt herself to be a boy. After the death of her mother, “he” had undergone surgery. “He” had then married and written to the pope, asking whether “he,” “with his wife,” could visit him. “He”—these are the pope’s direct words—“who had been a she, but is a he” (lui, che era lei, ma è lui). The individual in question then told the pope about his old parish priest, who would always invite him to confession and communion when the two crossed paths. “Life is life, and one must take things as they come,” said the pope.

Even if his remarks to journalists dealt not with anthropological matters but with pastoral considerations, essential questions with regard to pastoral practice remain open. Some remarks on this score should therefore be permitted.

Transsexuality is a cause of great suffering, above all for the people in question, but also for their family members and especially for their children. Hormonal or surgical means can sometimes lessen this suffering, but they cannot entirely remove it. Studies show that transsexuals, even after sex-reassignment surgery, have a higher-than-average rate of psychological disturbances and suicide attempts, and an almost twenty-times-higher-than-average rate of suicide. Moreover, there are ever more cases of persons requesting reversal surgery.

The phenomenon of transsexuality has been instrumentalized by gender activists for the sake of promoting their socio-political goal of relativizing the dichotomy of the sexes. (This instrumentalization is fundamentally absurd, since transsexuals, with their strong desire to belong to the other sex, precisely confirm the dichotomy of the sexes). They now go so far as to say that the the primary criterion for defining sex is subjective feeling, and so they euphemistically speak of sex-reassignment surgery as “gender confirmation surgery.”

The haste with which even young people at the age of puberty are led to surgical measures is worrisome. It is no credit to the current state of medical and psychological science that it has no way to grapple with a deep-seated disruption of identity, other than with hormones and knives. The drastic surgeries and the lifelong doses of hormones can accomplish nothing more than a kind of artificial sex. A transsexual man will always be a woman who has been surgically made into a man; a transsexual woman will always be a man who has been surgically made into a woman. In this respect, the pope’s choice of words should have been a little more careful.

The suffering of those who feel themselves to be transsexual can be so great—to the point of making them suicidal—that from the perspective of the Church one can hardly categorically forbid surgical and hormonal measures to reduce their suffering, as a last resort after attempting other measures. The proscription of self-mutilation must here be weighed against the good of reducing suffering.

It should go without saying that one should accompany these people pastorally, address them in their desired manner, and integrate them into the life of the Church. For in the end the human soul has the capability to turn to God directly, independently of its experience of sexuality. To support this relationship with God is the foremost pastoral task.

There is no specific obstacle here to the reception of the sacraments of confession and communion, even if particular spiritual guidance is required, so that one may entrust the unnaturally assumed, psychologically desired sexual identity to the mercy of God, rather than claiming it as a kind of right of self-determination, as is promoted today. It is necessary to accept that it is impossible to change one’s personal identity on one’s baptismal certificate.

However, when it comes to the matter of the marriage of transsexuals to what is now the “other sex,” it must be maintained that this cannot be treated as marriage in the proper sense, either according to natural law or in the understanding of the Church. Here it is not possible to contract a valid sacramental marriage, as the Congregation for the Doctrine of the Faith has already established in an unofficial directive from the year 2000.

Since, with a view to human sexuality, from the Catholic perspective there are only two forms of life that correspond to human nature and human dignity (namely, active sexuality within a marriage between a man and a woman, and abstinence), the Church has no authority to legitimize active sexual relations of transsexuals without the intention of abstinence through the bestowal of the sacraments of confession or communion.

In accordance with the Church’s sacramental regulations (cf. inter alia “Sacramentum caritatis,” Art. 29), it is appropriate to entrust these things in humility to the mercy of God, without anticipating this mercy by bestowing the sacraments. (Cf. also my more complete analysis.)

Christian Spaemann is a psychiatrist and columnist for

This article was translated from the original German by Pater Edmund Waldstein, O.Cist.

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