The Psychopathology of “Sex Reassignment” Surgery Assessing Its Medical, Psychological, and Ethical Appropriateness
Richard P. Fitzgibbons, M.D., Philip M. Sutton, and Dale O’Leary
Spring, 2009

Abstract. Is it ethical to perform a surgery whose purpose is to make a male look like a female or a female to appear male? Is it medically appropriate? Sexual reassignment surgery (SRS) violates basic medical and ethical principles and is therefore not ethically or medically appropriate. 

(1) SRS mutilates a healthy, non-diseased body. To perform surgery on a healthy body involves unnecessary risks; therefore, SRS violates the principle primum non nocere, “first, do no harm.” 

(2) Candidates for SRS may believe that they are trapped in the bodies of the wrong sex and therefore desire or, more accurately, demand SRS; however, this belief is generated by a disordered perception of self. 

Such a fixed, irrational belief is appropriately described as a delusion. 

SRS, therefore, is a “category mistake”—it offers a surgical solution for psychological problems such as a failure to accept the goodness of one’s masculinity or femininity, lack of secure attachment relationships in childhood with same-sex peers or a parent, self-rejection, untreated gender identity disorder, addiction to masturbation and fantasy, poor body image, excessive anger, and severe psychopathology in a parent. 

(3) SRS does not accomplish what it claims to accomplish. It does not change a person’s sex; therefore, it provides no true benefit. 

(4) SRS is a “permanent,” effectively unchangeable, and often unsatisfying surgical attempt to change what may be only a temporary (i.e., psychotherapeutically changeable) psychological/psychiatric condition. 

National Catholic Bioethics Quarterly 9.1 (Spring 2009): 97–125. 

6 Things You Need to Know... about sex change surgery

1. The suicide rate is five times higher for people who have had sex change surgery than for the rest of the population.
2. Changing genders has never been proven to be a reliable treatment.

3. The founder, Dr. John Money, was an advocate for pedophilia as “beneficial” in showing love.

 4. Dr. Money believed you were not born a transsexual. You learned it.
5. Dr. Money’s tested his theories on the Reimer twins (whom he sexually abused) and his “treatment” was responsible for their deaths.
6. Dr. Money covered up how ineffective his treatment was for over 40 years.

Who is Dr. Money?
Dr. John Money pioneered sex change surgery in the 1960s at Johns Hopkins.

Why do transgenders report regret years after the surgical gender change?
Not because of physical problems with the surgery itself, but because surgery did not treat the original problem. Surgery simply was not effective as a long-term treatment.

Surgery or not—it’s a long-standing controversy.
Think twice. It “looks like” fun and excitement; it could end in regret or worse, suicide. For some, regret comes very quickly within the first few months; for others regret comes years later, but it comes all too often.
Once the surgery is done, you’re pretty much stuck with what you've got. Going back to your original equipment isn’t an option any more.

This one medical doctor, John Money, set in motion an inexhaustible controversy that continues today between activist groups for gender change as a treatment and psychologists and medical doctors who prefer to have more objective findings showing that gender change treatment is beneficial and psychologically effective.

Articles referenced
“Gender Gap: What were the real reasons behind David Reimer's suicide?,” John Colapinto, June 3, 2004, Slate,

Asscheman, H., L. J. Gooren, and P. L. Eklund. "Mortality and Morbidity in Transsexual Patients with Cross-Gender Hormone Treatment." Metabolism 38, No. 9 (1989): 869–73.