Wednesday, November 2, 2022 – AlbertMohler.com – Albert Mohler
When you look at how culture changes, how morality changes, you also have to look at things such as this. How do medical practices change? And as we’re seeking to understand what is taking place at the most basic level, in other words, we’re not just looking at the headlines, we’re asking what caused that headline? What had to happen for this event or this controversy, this policy actually to become even plausible? When did someone start talking about this, and how did some kind of radical way out there idea all of a sudden become a matter of common medical practice, or even what’s defined as standard medical care? And how does this feed into the great moral revolution or the great revolution in morality taking place all around us?
Well, on LGBTQ issues and on a host of other issues, it is clear that the medical establishment is taking sides. And overwhelmingly, the medical establishment is taking sides by siding with those who are enthusiast for the LGBTQ revolution, and they are medicalizing it. Now, as you’re looking at this, one of the things to note is that medical debate is largely disappearing. It hasn’t entirely disappeared, and this points to something else, and that is how the professions work in our society. When you look at the major professions, the easiest to imagine in the secular context are medicine and law. You look at medicine and law, what makes a profession a profession is that it defines itself, it licenses it itself, and it regulates itself. It sets the rules by which the profession and the professionals in it are to operate. So if you can establish what is the best practice in the law, you can change the entire society.
If you can change what is considered to be the best practice when it comes to something like medicine or medical treatment or health policy, you can also change the entire nation. You can change the entire culture. But there’s more to it than just that. Because as you’re looking at the professions and as you’re looking at how moral change takes place, and as we’re going to see, this plays out right in the headlines of our day, as you look at that, you recognize it’s even more complicated and the reality is even more powerful. And so what I mean to say is this, you start with doctors and you start with redefining medical practice, best practices, or best medical care when it comes to the medical profession. But the medical profession doesn’t pay for itself. Someone has to pay for it. And one of the big players when it comes to paying for medical care is the insurance industry.
But it’s not just the insurance industry. It is also federal and state governments when it comes to state taxpayer supported healthcare, Medicare, Medicaid. But not only that, all kinds of economic transfers between governments and between government and medicine. You’re looking at medical research being a part of this as well. My point is this, you are looking at a major moral agenda being redefined in medical terms and being presented to the public and to patients as if this is now settled medical practice, when what it represents more than anything else is a transformation in the society in moral, even more than in medical terms. Now, you’ll often hear people say, look, you need to trust the experts. You need to trust the science. You need to trust the medical doctors when it comes to the practice of medicine. And to some degree, we have to do all of those things.
But what exactly does that entail when that argument is made against all right reason, or even in light of say rather inexplicable developments? So look at it this way. If you take the two big therapeutic organizations, the American Psychiatric Association and the American Psychological Association, in just a matter of about 24 months time, both of those organizations didn’t just change their position in the early 1970s when it came to gay male identity and activity, they completely reversed themselves. And by the way, both of those organizations simply reversed themselves in the course of about a three-day meeting. And again, they didn’t just change their understanding, and that leads to best practice, it leads to insurance payments and all the rest, massive influence on the larger culture, they didn’t just change it. They absolutely reversed themselves. For example, the American Psychiatric Association before, at an annual meeting, they completely changed their position they considered homosexual desire, homosexual orientation, and homosexual behaviors all to be forms of psychiatric unhealth.
And that unhealth came with specific diagnoses and all the rest. But in the course of one meeting, all of a sudden it changed into an absolute reversal. Now it is no longer a matter of psychiatric unhealth to be a male homosexual or to practice homosexuality or to be driven by homosexual desire, but rather, it is now unhealth to be unsettled about that fact about oneself. As even some of the medical practitioners at that meeting conceded, they weren’t going to leave without some kind of diagnosis that they could bill their patients and thus, the insurance companies for. But as you ask the question, how could there be such a fundamental change in the entire sexual morality of Western civilization, you can’t answer that without medicine. Now, that takes me to two issues of our current concern. Our concern just this week, medical articles or articles in major medical journals that are indicators of the direction that this sexual and moral revolution in our society will be taking.
Because as Wesley J. Smith, writing for the National Review points out, what starts in a medical journal doesn’t stay in a medical journal. And by the time you read it in print in an established medical journal, this is an argument that is already somewhere gaining traction. And you can look back at almost every one of these major developments and see the first signal of this to the larger culture was a published article in a peer-reviewed medical journal. Two of them will have our consideration today. The first of them comes from an author, Dr. Richard Rowland, who’s a lecturer in value theory, that’s a subdiscipline of philosophy, at the University of Leeds in England. And his article that was published in the Journal of Medical Ethics is entitled Integrity and Rights to Gender-Affirming Healthcare. Now, the reason that I want us to take a much closer look at this article and the argument is because this isn’t going to be limited in any way to LGBTQ issues. This is a major proposed redefinition of what it means to be human and to possess human rights.
The language and the ideas behind this article are going to turn out to be absolutely fascinating. First of all, you have the Orwellian phrase, gender-affirming healthcare, which means, in this context, either hormonal or surgical treatments in order to transform the human body, which is still, by the way, genetically and anatomically very clearly male or female, into something that instead supposedly aligns with an individual’s perceived gender identity and, in this case, is put into what is intended to be positive language as gender-affirming healthcare. The article begins with the acknowledgement that thus far, the moral justification for this kind of surgery or medical treatment has been grounded on one of two claims. Number one, the first claim is grounded in the assumption that the gender dysphoria, as it has been defined, and by the way, billed for, behind this is actually a disease and that an individual deserves, as a matter of right, treatment for a medical disease.
But then this author points out that is quite stigmatizing, and this is not where the contemporary medical community is. This is not where the LGBTQ community is. This is where the conversation was a matter of just a few years ago, but now we are going to be abandoning this language, because it is stigmatizing to say that this kind of gender identity issue or this kind of transgender profile or identity is somehow rooted in some form of disease. That has to be abandoned. But the author then says there is a second natural way of grounding rights, and this is “in rights to have the harm one is experiencing mitigated. Trans and non-binary people have very high rates of suicide and severe depression, and gender-affirming healthcare mitigates this depression.” Now as you’ll notice, there are two different arguments that are cited here and, by the way, they’re cited in order to be transcended by the new argument that this author intends to bring.
But the two arguments that are to be discarded are either that gender-affirming healthcare, as it is defined here, is necessary in order to overcome a disease, or is necessary in order to mitigate harm. Both of these, this author says, are too limiting, too stigmatizing, we need to get past them, there is a more basic right at stake. And that’s where all of us would have to ask the question, what would such a right be? And this author, and again, this is an article in a peer-reviewed medical journal with a lot of influence, his argument is that this so-called gender-affirming healthcare, and remember what that is, it has been referred to as sex reassignment surgery in previous days. Again, you know what we’re talking about. His argument is that the rightful moral and philosophical medical grounding to justify such procedures and treatments would be this, the right to live with integrity.
That’s right. He says that the most basic right here is a right to live with integrity. That sounds interesting. Here’s how he makes the argument, “To have or live with integrity in the relevant sense is for there to be a congruence or fit between the commitments, projects, or principles that are constitutive of one’s identity or identity and one’s actions. One acts with integrity on this picture whenever one acts in line with one’s ideal of the kind of person one should be and the kind of life that one, but not necessarily everyone else, should live.” Now at this point, we face a very interesting intersection, the intersection of the medical establishment and the legal establishment, and this takes us back to the year 1992, that’s 30 years ago, and a case that came before the Supreme Court of the United States. The majority opinion in that case was written by Justice Anthony Kennedy.
Anyone watching the court understands why Anthony Kennedy would have been the writer of this majority opinion. Justice Kennedy offered, way back in 1992, what he saw as the argument for the individual’s right to define his or her own self existence. He wrote in 1992, “At the heart of liberty is the right to define one’s own concept of existence, of meaning, of the universe, and of the mystery of human life.” Justice Kennedy would later, in 2003, write the majority opinion in the case known as Lawrence v. Texas that struck down all state so-called anti-sodomy laws. And Justice Kennedy would repeat himself. In the exact words of the late Justice Antonin Scalia, he referred to this as the famed sweet mystery of life passage that, in Justice Scalia’s words, “ate the rule of law.” Now this is fundamentally important, because Justice Scalia says, look, if there are rights, those rights have to be grounded in reality.
They also, by the way, would have to be grounded in terms of American public life in the text of the United States Constitution. But of course, the Constitution of the United States doesn’t even come close to granting or recognizing, on the part of every single individual American, a right to define existence in our own terms. And there’s another reason for that. It is not only constitutionally implausible, it is, just to state the very least, in truth and in time, in space, and history, impossible. The cosmos does not come to terms with our own self-understanding. We’ve got to come to terms with the cosmos. But we do understand why all of a sudden we are at this intersection, because the entire ideology of the transgender movement is about the cosmos having to come to terms with me, rather than about me having to come to terms with the cosmos.
And in this sense, the entire cosmos comes down to one physical body and what should and shouldn’t happen with that one physical body. The right to define existence in one’s own terms and to demand that the universe come to an alignment with that conclusion, that is exactly what is behind this medical journal article. It’s exactly what is behind the ideology of the transgender revolutionaries as now transformed into the practice of modern medicine. It is increasingly what is driving our legal culture. And given the way the professions work in the United States and in other economically advanced nations, the professions will all come into an alignment. And pretty soon, if you stand outside this ideology, you are going to be considered an enemy of the state and an enemy of human happiness. By the way, you’re going to love some of the arguments that this professor offers for his understanding of personal integrity as the basic human right.
He says this, “If we understand ourselves as doing something wrong, in some not necessarily moral sense, by refraining from doing something we want to do, this is good evidence that doing that thing is necessary for us to act with integrity.” Now what I want you to note in that is that it’s not only some form of circular reasoning, but beyond that, there are no limitations here whatsoever. There is no limitation in which someone would say to someone else, look, your claim of personal integrity and to live by integrity in this case is simply unacceptable. It simply is wrong. It does not comport with reality. This isn’t going to work. But here’s something else the Christian worldview helps us to understand, and it’s a basic issue that underlies so much of what we’re dealing with here, and that is this, if rights are authentic, then they are given to us by God.
They are revealed in nature, but they are given to us by God. They are given to us by God, and God, in giving them to us, does so within limits. God made every single human being in his image. He has given to every single human being certain, you know the language of the Declaration of Independence, unalienable rights. But nonetheless, God has put those rights in a context and morality, the morality of the entire culture around us, and you can just go to the 10 Commandments as the most basic set of such commands, they limit our personal autonomy. They would limit behaviors, identities, and beyond that, social practices that would be defined here as one’s right by one’s own sense of integrity.
Another very interesting aspect of this, this writer clearly acknowledges in this article that this is basically a secular alternative to, wait for it, religious liberty.