At First Things, there is a translation of an article by Christian Spaemann, a psychiatrist and the son of the German theologian Robert Spaemann, about the Holy Father’s recent comments on individuals who identify as transgender or transsexual. It seems that our old friend, Pater Edmund Waldstein, O.Cist., translated the piece for First Things. Dr. Spaemann’s essay is well worth reading and considering in full; however, he makes one point that is sure to cause controversy:

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.

(Emphasis supplied.) We note that Pater Waldstein, at Sancrucensis, has stated that he is not sure that he agrees fully with the point, but Spaemann’s essay (and some other writing on this subject) have given him reason to consider it more seriously. And, indeed, given the increasing prevalence of issues related to persons who identify as transsexual or transgender, such consideration is merited.

You may recall that the Holy Father has been outspoken and steadfast in his opposition to what he calls, somewhat vaguely, gender theory. However, it must be said that the Church’s magisterium on this subject is a little vague. (In distinction to the clear, unchanging teachings of the Church for persons who suffer from same-sex attraction.) Nonetheless, there is one pope who laid the groundwork for this discussion. You may think that it’s St. John Paul II with his Theology of the Body, which is occasionally mentioned in this context. But you’d be wrong.

None other than Pius XII—the mild, saintly man who has been defamed posthumously as the embodiment of all that is reactionary and oppressive in the Church—laid the groundwork for a serious consideration of the question in the light of the magisterium in a 1953 speech to a convention of Italian urologists. It is, we note in passing, a crying shame that Pius’s extensive magisterium on scientific and medical matters is not more widely discussed in the Church. Just as Papa Ratti was a prophetic voice on matters of morality, so too was Papa Pacelli a prophetic voice on matters of science. We have only found this speech in French on the Vatican website, and we have not found a good translation anywhere. To spare you the combination of machine translation and our desultory Latin and our comical attempt at French several years ago, we present the relevant passage of the original:

La première question, vous Nous l’avez posée sous la forme d’un cas particulier, typique cependant de la catégorie à laquelle il appartient, c’est-à-dire l’amputation d’un organe sain pour supprimer le mal qui affecte un autre organe, ou du moins pour arrêter son développement ultérieur avec les souffrances et les dangers qu’il entraîne. Vous vous demandez si cela est permis. 

En ce qui concerne votre diagnostic et votre pronostic, il ne Nous appartient pas d’en traiter. Nous répondons à votre question, en supposant que tous les deux sont exacts. 

Trois choses conditionnent la licéité morale d’une intervention chirurgicale qui comporte une mutilation anatomique ou fonctionnelle : d’abord que le maintien ou le fonctionnement – d’un organe particulier dans l’ensemble de l’organisme provoque en celui-ci un dommage sérieux ou constitue une menace. Ensuite que ce dommage ne puisse être évité, ou du moins notablement diminué que par la mutilation en question et que l’efficacité de celle-ci soit bien assurée. Finalement, qu’on puisse raisonnablement escompter que l’effet négatif, c’est-à-dire la mutilation et ses conséquences, sera compensé par l’effet positif  : suppression du danger pour l’organisme entier, adoucissement des douleurs etc. 

Le point décisif ici n’est pas que l’organe amputé ou rendu incapable de fonctionner soit malade lui-même, mais que son maintien ou son fonctionnement entraîne directement ou indirectement pour tout le corps une menace sérieuse. Il est très possible que, par son fonctionnement normal, un organe sain exerce sur un organe malade une action nocive de nature à aggraver le mal et ses répercussions sur tout le corps. Il peut se faire aussi que l’ablation d’un organe sain et l’arrêt de son fonctionnement normal enlève au mal, au cancer par exemple, son terrain de croissance ou, en tout cas, altère essentiellement ses conditions d’existence. Si l’on ne dispose d’aucun autre moyen, l’intervention chirurgicale sur l’organe sain est permise dans les deux cas. La conclusion, que Nous venons de tirer, se déduit du droit de disposition que l’homme a reçu du Créateur à l’égard de son propre corps, d’accord avec le principe de totalité, qui vaut ici aussi, et en vertu duquel chaque organe particulier est subordonné à l’ensemble du corps et doit se soumettre à lui en cas de conflit. Par conséquent, celui qui a reçu l’usage de tout l’organisme a le droit de sacrifier un organe particulier, si son maintien ou son fonctionnement cause au tout un tort notable, qu’il est impossible d’éviter autrement.

(Emphasis supplied.) Given the whole scope of Dr. Spaemann’s commentary, we suspect that he is well aware of Pius’s thinking on this topic. However, it seems to us that the sixty-year-old speech of a pope to an Italian association of urologists may not be at the tips of one’s fingertips as one reads and ponders Dr. Spaemann’s point.

Digressing briefly, we note, too, that St. Thomas Aquinas’s teachings, particularly in ST IIa IIae q.65 a.1 co. & ad 3, have an important bearing here, too. However, we are more concerned with, at this opportune moment, reminding you, dear reader, that the great Pius XII left us, in his wisdom, an excellent magisterial source for discussing this topic.

As it has become more common to assess the magisterial weight of papal teachings, especially those teachings not contained in more formal documents like encyclicals or apostolic letters, we should add that it is clear that the 1953 speech was intended by Pius as a formal act of the ordinary papal magisterium. Indeed, Pius thought that this was an important intervention on this topic and part of a broader pattern of papal teachings in response to questions of the age, noting a year later in a speech to the World Medical Association,

You are fully qualified to deal with the medical, as well as the technical and administrative aspects of these questions, but we would like to call your attention to several points which pertain to their moral and juridical nature. Many of the problems with which you are presently concerned have equally been of concern to Us, and been made the subject of special discourses on Our part. Thus, on September 14, 1952, we spoke (at their request) to those who took part in the First International Congress on the Histopathology of the Nervous System on the moral limits of modern methods of research and treatment. Our remarks were linked to a study of the three principles from which medical science derives justification for such methods of research and treatment: the scientific interest of medicine, the interest of the patient, and that of the community – or, as it is commonly designated, the common good, the «bonum commune» (Discorsi e Radiomessaggi, vol, XIV, pp. 319-330). Again, in an address to the members of the Sixteenth International Congress of Military Medicine, We spoke of the basic principles of medical ethics and medical law, and discussed their origin, their nature, and their application (October 19, 1953, ibid, vol. XV, pp. 417-428). The Twenty-sixth Congress of the Italian Association of Urology, in turn, had asked us the widely discussed question: Is it morally permissible to remove a healthy organ in order to prevent the progress of a milady which jeopardizes human life? Our reply to this question was contained in an address delivered on October 8 of last year (ibid, vol. XV, pp. 373-375). And, finally, We had occasion to touch upon the questions which are of particular concern to you in the present Congress those relating to an ethical evaluation of modern warfare and its methods –in an address given on October 3, 1953, to those participating in the Sixth International Congress of Penal Law (ibid, vol. XV, pp. 337-353).

(Emphasis supplied.) And, of course, his 1952 speech to the histopathology association is a major intervention in Pius’s magisterium, providing a broader framework for medical research and treatment. The upshot of all of this is that Pius certainly thought he was exercising his ordinary magisterium to clear up questions that were vexing the medical professionals who approached him for advice.

Though we are reasonably certain that Pius was teaching for the benefit of the Church, we doubt strongly that Pius XII imagined that his comments in 1953 would be drawn into a debate like this, and we doubt more strongly that Pius XII would have considered his analysis to be a justification for something like the surgical and hormonal measures that Spaemann discusses. However, Pius certainly would have thought that he was proposing general moral principles of universal applicability, and it is in that dimension that his comments are most useful. Certainly it is, we think, difficult to have a serious discussion about these surgical and hormonal measures without having a discussion along the lines Pius indicates. It would be interesting, we think, to see someone articulate, in broad strokes, such a discussion. Elliot Milco once wrote a funny little dialogue broadly on this topic, though focusing more on the natural law than the magisterial interventions. And it is well worth reading. But, as Paul VI teaches us, the Church has the authority, given to her by Christ, to authentically interpret and guard the natural law. Thus, Pius’s magisterial action, clearly seen by him as a magisterial action, ought to be considered as part of a broader discussion of this topic.

We do not propose an answer to this question here, however. If thinkers like Christian Spaemann and Pater Edmund Waldstein have cause to ponder these matters carefully, we will not rush in to offer our opinion without weighing it more carefully. Instead we propose a ressourcement of the Church’s existing magisterium, both to point toward a resolution of these questions and to provide a hermeneutic key to current papal statement.