“Dr. Laub, I just got back from the Vatican and have a report on Sex Change Canon Law from the Pope.” – Sep. 17, 1967
The call I had been waiting for came from a Seminary Ph.D. student who had gone on a pilgrimage to the Vatican one and a half years ago from Menlo Park. I had sought him out with a very important request for the Pope and he was kind enough to relay the message. Would the Pope provide a decision on the morality of sex change reassignment surgery? I had already arrived at my personal moral sense of the matter, but the Pope’s weight in the world could help me convince others of what I already believed. Yes, it is right to help a fellow person become their whole self by matching their physical reality to their psychological reality. The Pope agreed.
Of course he first formed a committee to explore the question and decide on Canon Law where there had been none. I was not surprised by the decision. I had done some legwork of my own to know the truth of the matter prior to requesting insight from the Pope. I did not know much about Transgender Identity Disorder when my first transgender patient came to me. Part of my exploration into the subject included forming an interdisciplinary committee, researching what existed in treatment, and contacting the local authority on Catholic morality, Father Robert O’Reilly.
Father O’Reilly was adviser to the Archbishops of Los Angeles and San Francisco. He was member of the Jesuit Elma Institute in Los Gatos. I explained to him what I understood to be a medical condition where a person’s physical expression of gender was not reflexive of their mental gender identity. Psychology had failed these patients. No amount of electroshock therapy or cognitive therapy could cure them. Dr. Ayers at the University of Alabama “treated” many patients with electroshock therapy unsuccessfully. Father O’Reilly agreed that if the patient was not psychotic, and gender reassignment surgery was medically indicated, than yes, it is right to treat them. He then suggested I contact a Seminarian traveling to the Vatican in order to get a formal response from the Pope.
As mentioned, I was also exploring the scientific and academic premise for this treatment during this time. The first patient who came to me introduced me to the work of Dr. Harry Benjamin who firmly believed that gender identity disorder was a real condition. I reached out to Dr. Benjamin, who was very enthusiastic about partnering. He offered to send me 3 patients, at his own cost. He came to Stanford to do the grand rounds himself.
I teamed up with Psychology Resident Norman Fisk to create a multidisciplinary committee to determine the appropriate treatment for Gender Identity Disorder (30285). We put together a team of lawyers, psychologists, plastic surgeons, gynecologists, urologists, and others to discuss the topic during a monthly meeting. As mentioned we began by talking to patients. Then Norman and I visited everywhere in the world where patients were being treated already: Amsterdam, Casa Blanca, John Hopkins. Finally, we determined which patients would receive treatment, based on a 3 page psychological assessment created by Dr. Fisk.
The more I learned about Gender Identity Disorder, the more I gained the sense that we were embarking on a hugely significant journey. We were now truly in the ranks of the Noble Laureates who walked the Stanford Halls. We were making history by establishing a treatment that would help people who had nowhere to turn. Not only that, but we were establishing the norms by which others in our profession could do the same.
As the Pope’s Canon Law decision explained it, we were helping make people whole. He based this decision on two Catholic Principles, the Rule of the Whole Person, and the Destiny of the Parts. These ideas describe how a person’s parts add up to create the whole, they are assigned by God and are part of his destiny. However, a person is only whole when the mind and body are not dissonant. If there is a disconnection between the two, it must be remedied in order for the person to be whole. Science had failed to change the mind to fit the body, so it was now acceptable treatment for the body to be changed to fit the mind.
After speaking with patients and treating our first few cases, the multidisciplinary committee continued its work establishing a treatment plan for Gender Identity Disorder by spreading the word to other medical communities. We traveled and discussed with medical students. In some of these conferences, we would get questions about the morality of surgery reassignment as treatment for Gender Identity Disorder. These were usually accompanied by questions related to the words in the Bible. I countered these with the assurances from the Vatican that our path was righteous, however, I can admit not all minds were changed. In spite of this, the progress we made broke a barrier and we were able to treat a group of people who had been neglected by the medical community. This was some of the most fulfilling work of my career.