In the Jan. 28, 2009 edition of the Chicago Tribune, there is a story about two sexual amputees who are suing the state over its refusal to change the “gender” designation on their birth certificates from “male” to “female.” Several important points must be made.

First, it’s reprehensible that anyone in the medical community would be complicit in facilitating a psychological disorder by amputating healthy body parts. There is a condition formerly known as apotemnophilia and now designated Body Integrity Identity Disorder (BIID) that is characterized by the desire to amputate a healthy limb. It is useful for comparison in that it is thought by many to be closely related to Gender Identity Disorder (i.e., transsexualism) which society is increasingly accepting as a valid identity that emerges from biological influences and whose behavioral manifestations are morally legitimate. Apotemnophiles, as they are referred to in some circles, identify with and as amputees and seek to align their bodies with their psychological identities through amputation of healthy body parts. “Transsexual” Dr. “Anne” Lawrence explains the condition:

Desire for amputation of a healthy limb has usually been regarded as a paraphilia (apotemnophilia), but some researchers propose that it may be a disorder of identity, similar to Gender Identity Disorder (GID) or transsexualism. Similarities between the desire for limb amputation and nonhomosexual male-to-female (MtF) transsexualism include profound dissatisfaction with embodiment.

Dr. Lawrence further explores the similarities between Male-to-Female (MtF) transsexuals and those who seek limb amputation:

Persons who want to undergo limb amputation typically experience an intense desire or overwhelming compulsion to change their bodies to match their idealized images of themselves as amputees. . . . They usually describe their feelings as developing early in life, often before puberty. . . . most emphasize that they are primarily seeking a sense of wholeness or completeness or are attempting to correct a mismatch between their bodies and their identities.

There is debate about whether BIID should be included in the DSM as a mental disease or disorder. There is also considerable debate surrounding causation and treatment with some theorizing that this condition “may in fact have a neurological basis.” American psychoanalyst Greg Furth, who suffers from apotemnophilia himself, and Scottish surgeon Dr. Robert Smith are both “committed to the position that surgery should be regarded as a viable therapeutic option for at least some individuals who suffer from apotemnophilia.” Dr. Smith, in fact, performed two elective amputations of limbs in order to align the bodies of people who experience BIID with their psychological identities as amputees. Most people recoil in horror at this decision. But it is difficult to see how amputating a healthy arm or leg is substantively different from amputating a healthy penis or breasts.

Second, these two men remain men even without their penises, even with hormone-induced or prosthetic breasts, and even with hormone-induced female-ish voices. My mother was no less a woman following her mastectomy, hysterectomy, and oophorectomy than she was before her surgeries. The disordered desire of these two men does not change objective reality.

Finally, these men are not merely asking the government to be complicit in their disordered delusion; and they are not merely asking the government and all of society to accept their delusion as reality; they are also asking the state to commit fraud. They are asking the state to affirm in a legal document a falsehood. Even these men acknowledge that they were born male. If they hadn’t been born male, they couldn’t have had a “sex-change” operation.

What almost gets lost in this disturbing article is that these voluntary sexual amputees could have had their birth certificates changed if their surgeries had been performed in the United States rather than Thailand. Already the government has been complicit in this monumental deceit and delusion by allowing them to change their “gender” designation “on their driver’s licenses, passports and Social Security Cards.” Just as the medical profession acts unethically when amputating healthy body parts in the service of a delusion, so too does the government act unethically when changing legal documents to affirm a falsehood in the service of a delusion.

A just and merciful society treats all with respect and compassion. But respect and compassion do not entail complicity in deceit. Integral to real justice, real mercy, real respect and real compassion is truth.