A Philosopher's Blog

Man(ning) & Woman

Posted in Ethics, Law, Philosophy, Politics by Michael LaBossiere on August 23, 2013
A TransGender-Symbol Plain3

A TransGender-Symbol Plain3 (Photo credit: Wikipedia)

In a somewhat unusual turn of events, Private Bradley Manning claims that he identifies himself (or herself) as a woman named Chelsea Manning.  He has also expressed the desire to undergo gender re-assignment, beginning with hormone therapy. Given that I hold to a rather broad conception of liberty, I believe that Manning has the right to change his gender and that this is morally acceptable. In fact, if physically being a man is problematic for him, then he certainly should take steps to make his physicality match his conception of his identity. His body, his choice.

One rather obvious obstacle that Manning faces is a lengthy prison term for his role in leaking secrets to WikiLeaks. Being in prison, he most likely will lack the funds needed to pay for hormone therapy. Even if he had the funds, there is also the matter of whether or not the Army would provide such services. As it stands, the Army apparently does not provide such services.

Manning’s attorney, David Coombs, has asserted that if the state fails to provide Manning with the therapy, then he will try to force it to do so. Interestingly, Manning’s case is not unique. In Virginia, a prison refused to allow a prisoner to undergo gender reassignment surgery. In Massachusetts, a federal judge ordered the state to pay for a convicted murder’s sex change operation. These matters obviously raise some philosophical concerns.

As noted above, I believe that an individual should be free to change his or her sex. I base this on the principle that what concerns only the person is a matter in which the individual should have complete authority. So, if Manning wishes to change his sex to match his claimed gender, he should be allowed to do so. This is something I see as a negative liberty—that is, no one has the right to prevent Manning from exercising his liberty in this matter. However, I do not see this a positive liberty—that is, no one else has an obligation to provide Manning with the means of exercising this freedom. As such, if Manning has the funds to pay for the process, then the Army should allow him to do so. The same would also apply to civilian prisoners.

One obvious concern is that prisons are sex-segregated. As such a person who has a sex change would complicate matters. Obviously, a person with a sex change should not be kept locked up with those of his or her previous sex. However, there might be legitimate concerns about locking up the person with members of his/her new sex in terms of safety. However, it seems likely that such matters could be addressed with minimal problems. As such, as long as the prisoner can pay for her own operation, then this should be allowed.

The next point of concern is the matter of whether or not the state should pay for hormone therapy and sex-change operations. On the face of it, the answer would seem to be an obvious “no.” However, it does seem worth considering the matter a bit further.

In general, prisoners tend to lack financial resources to pay for their own medical treatment. After all, a typical prisoner will not have a significant source of legal income nor adequate savings to cover major medical expenses. Since letting a prisoner suffer or die simply because she lacks the means to pay for treatment would be wrong (the state has responsibility for those it incarcerates), it certainly seems acceptable for the state to pay for legitimate medical care for prisoners. As such, if a prisoner needs an appendix removed, it seems right for the state to take care of this rather than let the prisoner die. However, if a prisoner is displayed with her breast size and wants implants, then this is hardly a legitimate medical need and hence the state would not be obligated to pay for such surgery—even if the person’s self-image involved large breasts and the person was very upset about not having said breasts. Thus, the general principle would be that the state should provide legitimate and necessary medical care but is not obligated to provide all medical services that prisoners might want.

Assuming that the above is acceptable, the remaining question is whether or not hormone therapy and sex-change surgery are medically necessary procedures (on par with removing an infected appendix) or if they are not (on par with breast implants).

On the face of it, a person who believes that his gender does not match his physical sex is not in a dangerous medical situation. Being a man or a woman is not, it would certainly seem, a life or health threatening situation. Using the example of Private Manning, he will not become ill or die if he remains a man. As such, the state would seem to have no obligation to foot the bill for sex-change operations any more than it is obligated to pay for breast implants or tummy tucks. After all, one’s body not matching one’s self-image is not a serious medical condition.

However, it can be argued that such a situation is a legitimate and serious medical condition. That is, the person’s mental health depends on a sex-change as much as a person’s physical health might depend on having an infected appendix removed. As such, the state should pay for such procedures.

The obvious counter is that if the state is obligated to ensure that prisoners are not suffering from factors that would negatively impact their mental health, then it would seem to follow that the prisoners should not be in prison. After all, prison is intended to be a place of punishment and that is supposed to cause mental duress.

Another obvious counter is that a person who believes their gender does not match her physical sex might be suffering some duress, but it seems odd to claim that this suffering creates a medically necessary situation. That is, that the person must have her sex changed in order to be in good enough health to serve her punishment sentence in prison.

I will freely admit that I do not know the extent of the suffering a person who believes that her sex does not match her gender might experience. If it is the case that this is a medically serious situation that creates a medical necessity on par with other conditions that the state treats, then the state should treat that condition. However, this does not seem to be the case. Thus, while a person has every right to change his sex, there seems to be no legitimate reason why the state should pay the bill for a prisoner to get a sex-change.

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11 Responses

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  1. ajmacdonaldjr said, on August 23, 2013 at 3:25 pm

    What about suicide?

    “Given that I hold to a rather broad conception of liberty, I believe that Manning has the right to commit suicide and that this is morally acceptable. In fact, if psychic pain is too intense and problematic for him, then he certainly should take the steps necessary in order to end his life and psychic pain. His body, his choice. I base this on the principle that what concerns only the person is a matter in which the individual should have complete authority.”

    What about abortion on demand?

    “On the face of it, a pregnant woman with a healthy pregnancy who doesn’t desire to be pregnant is not in a dangerous medical situation. Being a woman with a healthy non-life threatening pregnancy is not, it would certainly seem, a life or health threatening situation. She will not become ill or die if she remains pregnant. As such, the state would seem to have no obligation to foot the bill for an abortion any more than it is obligated to pay for breast implants or tummy tucks. After all, one’s being pregnant not matching one’s desires is not a serious medical condition.”

    State funding for suicide and abortion on demand?

    “However, it can be argued that such a situation is a legitimate and serious medical condition. That is, the person’s mental health depends upon suicide and abortion as much as a person’s physical health might depend on having an infected appendix removed. As such, the state should pay for such procedures.”

    • Michael LaBossiere said, on August 24, 2013 at 4:25 pm

      Although I am opposed to suicide in cases where a person is giving in to defeat, I do believe that people have the right to self-abuse to the point of destruction. I would do my best to convince a person not do so (in almost all cases), but I do not think we have the moral right to use compulsive force to keep a sane person from suicide. People who are mentally incompetent at the time and are such that we have reason to believe they would not kill themselves if they were competent could justly be stopped. But, if they can show competence, then we have no moral right to stop them.

      Abortion is more problematic. As a general rule, I oppose killing anything-that is my default and I apply it to bugs on up. However, I do allow for people to destroy other living creatures out of need. For example, I can kill a deer for food in order to not die, I can justly kill an attacker to save myself or others, and so on. I have made arguments that abortion can be warranted on similar lines. To use an analogy, we generally accept killing soldiers in war and the death of a certain number of civilians as the cost of war-even when they individuals are not bad people. This is justified on the grounds of achieving our legitimate ends (security, territory, resources, and so on). So, if such killing is morally warranted, then abortion can be warranted on the same grounds. That is, someone must die in order for the ends of another person to be met.

      Now, someone who rejects the principle that allows killing of the non-evil to achieve even legitimate ends, then abortion can be rejected on similar grounds. But this requires being pro-life for real. That is, rejecting all killing of people (even as collateral damage) who are not evil enough to individually warrant their destruction.

      • ajmacdonaldjr said, on August 24, 2013 at 9:36 pm

        Regarding suicide, would you wish the state to outlaw it? Meaning: should the state teach, via law, that suicide is not a good but an evil? since the state is tasked with promoting good and restraining evil? Is it wrong for the state to place suicidal people in straight jackets in order to restrain them from the evil act of harming themselves? Because this occurs in jails, prisons, and state-run mental institutions every day. Is suicide an evil? or is suicide a good? Should the state and society not promote the good and restrain the evil?

        You seem to be equating liberty with license, which is a grave error, especially as regards the function of the state.

        Abortion on demand – that is: elective abortions which are medically unnecessary – isn’t the same as defending against attackers and killing soldiers and civilians during war. The child in the womb is not a violent aggressor, nor does the simple presence (= being) of the child growing naturally in her mother’s womb ipso facto constitute “the occupied womb as battlefield”.

        Legitimate ends (security, territory, resources, and so on) do not apply to abortion on demand because the desire to be un-pregnant, which results in killing an innocent human being, is not a legitimate reason to kill a human being. To say a woman can legitimately kill an innocent non-aggressor in utero child simply because she does not want this human being to exist, as it is naturally doing, is no different than saying a black supremacist can legitimately kill a white person simply because she doesn’t wish white people to exist and is legitimately doing what she can to make the town or nation she lives in un-white by killing every white person she wants to kill. A better argument would be to say the child in her mother’s womb is the property of the woman – my body and everything within it is my property – even though this make the human being within her womb the property of the woman, which I think is wrong.

        If a woman’s desire to be child-free is legitimate then infanticide and the killing of children (under 18) by their mothers would also be legitimate. My child my property. In these cases the state dare not call this evil nor should it interfere by restraining this private individual property choice-action because it is evil but should instead promote this choice-action as a positive good for the liberty = license state.

        • Michael LaBossiere said, on August 27, 2013 at 3:03 pm

          From a legal standpoint, I am fine with suicide being legal. Just as I am fine with being morbidly obese being legal. From a moral standpoint, I think both are wrong. However, I do not hold that morality should always define legality.

          As far as abortion goes, I do agree that having an abortion that is completely unnecessary is clearly wrong. However, this raises the question of what counts as necessity and when such needs warrants killing. For example, suppose that a very poor 14 year old girl is impregnated and lacks the means to pay her medical bills and certainly will not be able to provide for herself and her child. Naturally, the budgets for social services have been chopped by the right, so she will be in rather rough shape. Perhaps this would warrant an abortion. Or, as another example, imagine a talented and bright but poor young woman who is about to go off to college on a full scholarship, but her boyfriend’s condom breaks and she gets pregnant. He is an 18 year old kid who pulls down minimum wage at Big Burger. Does her need warrant an abortion? Perhaps.

          The reason I use the example of people who are poor is because our society does not do a very good job of enabling women in those situations to be able to have the child and also have their desired life (such as going to college). Now, people can do it-I have had students who had unplanned pregnancies complete their degrees and graduate. But, it is quite a challenge and there is not much in the way of help from the folks who cry out that they are pro-life while also slashing support for mothers and children in need.

          So, I suppose my position would be this: abortion could be made illegal, provided that we are willing to provide women who get pregnant with support in accord with our imposition on them. I’m not talking about just handing them cash, but things like day-care for working mothers and students, medical support, quality food for impoverished children and so on.

          • ajmacdonaldjr said, on August 27, 2013 at 4:51 pm

            You say “I do not hold that morality should always define legality” but what other options are there? Immorality? Expediency? Efficiency? Power? Plunder? Gain? What sorts of laws are not based upon morality? Besides immoral “laws” so-called?

            You say “As far as abortion goes, I do agree that having an abortion that is completely unnecessary is clearly wrong” (meaning: medically unnecessary) but then you make an exception to this by saying that if poor women can’t afford to care for their child they can abort their child? So, in fact, you don’t believe a medically unnecessary abortion is “clearly wrong” because you allow broad exceptions to this, which lawyers could drive trucks through (such as mental health exceptions, economic need exceptions). You actually endorse abortion for convenience and abortion as method of post conception birth control, or so-called: abortion on demand, which means: any time, for any reason, and without apology.

            I agree our society should support pregnant women – socially, morally, and financially – but the fact that the federal government doesn’t support them as much as it should doesn’t affect the morality or immorality of the act of hiring someone to kill a healthy, innocent child and dispose of the body. There are plenty of private organizations that help pregnant women in need. There is no lack of help for them in our society. Lack of federal government aid doesn’t equal lack of societal aid. Adoption is also an option, and there’s help for this too.

  2. Douglas Moore said, on August 23, 2013 at 5:01 pm

    First, let’s not ignore human capacity in humans for self-deception. I do not believe that there is a gender identity crisis in Manning’s case. It could be more properly termed an existential crisis expressing itself in sexual aberration. Perhaps his angst regarding his sexuality is real, but this is not the root of the problem, it’s merely a symptom of the problem.

    Theodore Dalrymple is a former prison psychiatrist from Britain. I have several of his books, which can be found on Amazon. He also ran a private practice. After decades of “treating” prisoners and other people whom had systematically destroyed their own lives, he came to a conclusion about the majority of cases of “depression”; most cases of depression were actually people making themselves miserable by doing evil things–repeatedly having children out of wedlock, repeatedly getting into relationships with felons; repeatedly injecting themselves with heroin. We are what we do repeatedly. If we repeatedly do stupid or evil things, we are stupid, evil, or both. Interestingly, violating Natural Law makes us miserable. Dalrymple states that the postmodern way of dealing with evil, is to give evil and its results a clinical diagnosis. Depression. The term depression removes guilt from its “victim”. Depression can be treated with pills, though as Dalrymple points out, the majority of these cases could not in fact be treated with pills; pills did nothing to change these peoples’ ethos. The first step in changing a life is to admit one’s own role. Admitting fault should provide hope, because what is our fault, we have control over; what is not our fault may be beyond our control. But not in our dying society.

    So yes, Manning should be free to change his sex–on his own dime. People should always be free to be victims of their own stupidity. However, “experts” should not chime in and reinforce the false notion that somehow Manning’s behavior is the result of the conjured gender identity crisis, and nor should anyone believe (I don’t think many do), that injecting hormones into Manning will fix his problems. After all, is this crisis is real, where are all of the people who are having dog identity crisis, where are all of the dogs gone mad because of a similar issue? Where are the people who want to be changed to rocks or trees or cars? Such a crisis admits the existence of something beyond the corporeal, something that longs for something else. For scientists to admit such a crisis can exist they have to admit that something within a human can long for something a human genome cannot know exists.

    • Michael LaBossiere said, on August 24, 2013 at 4:15 pm

      True-people who end up in prison for legitimate reasons would tend to have qualities that would make them unhappy. Aristotle makes a reasonably good case that virtue is the way humans are happy and, as per Plato, doing wrong makes people unhappy.

      In Manning’s case, he might have legitimate issues-however, it is not the responsibility to fund his sex change. One might point out that his gender will not matter much while he is in prison-after all, he is not going to be able to engage in extensive gender-role based behavior.

      But, I am willing to consider that for someone being a man or woman would be a torment on par with having appendicitis. That is, it causes them to suffer in a way that can be fixed via medical means. This does seem odd to me, though. Also, there is the matter that the state does not seem obligated to pay to fix our discontents, even if they are severe. After all, if someone is terribly depressed because he is not rich or lacks a super-model girlfriend, he might really be in torment due to the lack of his success. But, it would be odd to say that the state should step in to fix his life-especially if he is in prison.

      There are people who apparently do want to be animals or animal like.

      • Douglas Moore said, on August 24, 2013 at 4:31 pm

        To demonstrate the little-understood nature of gender identity crisis and even homosexuality, here’s a theoretical anecdote: What if someone with gender identity crisis were born in an area or planet that contained no one of the opposite sex, and there were no photos, pictures, or historical references to the opposite sex. Would they still desire to be the opposite sex?

        • Douglas Moore said, on August 24, 2013 at 5:22 pm

          Those whom claim to be champions of science I suppose completely support the idea of gender identity crisis. But if someone with GIC were blown up in a terrorist attack, their DNA would tell scientists what gender they were. Not a single biological mechanism has been found that would explain GIC or homosexuality.

          Seems to me like the old diagnosis for such problems was the most correct: Insane.

  3. T. J. Babson said, on August 23, 2013 at 9:16 pm

    Once you volunteer for the military, you can’t “un-volunteer.” I’m not convinced this is a wise policy.

    Manning should have been allowed to leave the military. He made the mistake of volunteering, and then he was screwed.

    • Douglas Moore said, on August 24, 2013 at 5:02 am

      I completely agree. I’ve had this discussion with others. There seems to be a belief that without a contract, people would just run away during war or danger. But there are plenty of jobs which present high levels of danger that people stick with. Allowing people to leave when they want would serve the military and service members: The military would be populated by a higher percentage of people who want to be there, thus more effective people, and it would probably clean up some of the leadership issues the army has because leaders would have to act like human beings.


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