The Bishops are Right: How Horan and Lysaught Fail in Their Objections to the Doctrinal Note

About a month and a half ago, on March 20th, the USCCB Committee on Doctrine issued a fairly straightforward 13 page document entitled “Doctrinal Note on the Moral Limits to Technological Manipulation of the Human Body“. The article outlines some basic Catholic teachings regarding the human body and when it is and is not licit to perform medical operations on the body in light of present and future technological advancements. Towards the end of the article, the Bishops touched on the issue of transgender surgery and argued that such surgery was illicit on the basis of Catholic moral teaching.

A number of progressive Catholics were quite angry at the Bishops’ statement including Fr. Daniel Horan, OFM and Dr. M. Therese Lysaught who both wrote strongly worded pieces (here and here) in National Catholic Reporter critical of the Bishops’ document. Their criticisms were, I believe, unjustified and while heavy on criticism, were very light on argument or citation of the Church’s magisterium. Below, I will outline why many of the criticisms that both Lysaught and Horan bring miss their mark and how many of their own criticisms can be used against them.

What is the doctrinal note about?

One critique offered by Lysaught against the doctrinal note is that while the note is about transgenderism, the note fails to spend very much time talking about transgenderism and transgender people. Indeed she spends an entire paragraph lodging this complaint:

Its ostensible purpose is to provide a moral/theological analysis for Catholic health care institutions of the spectrum of medical interventions that currently comprise the clinical standards of care established by the World Professional Association for Transgender Health, or WPATH, … Yet bafflingly, neither the words “transgender” or “gender-affirming care” (as the standards are generally referred to) or any reference to WPATH appear in the document proper. The word “transgender” only appears in Footnote 34 … The terms “gender dysphoria” and “gender incongruence” each only appear once and twice respectively, three quarters of the way through the document. Thus, on just a surface level, the document is bizarre: Transgender persons do not appear in a document about transgender persons and their medical care.

This is mystifying.

On the contrary, I don’t think that anyone fairly reading the doctrinal note and its title which is “Doctrinal Note on the Moral Limits to Technological Manipulation of the Human Body” would make such a critique. The doctrinal note is not entitled “A Catholic analysis of WPATH Standards of Care for Transgender Individuals” or “A Doctrinal Note on Gender Dysphoria” or any such thing. Why isn’t transgenderism mentioned more often? Because the doctrinal note is not just about transgenderism. What is it about? Well, as the title indicates, it is about the far more broad topic of technological manipulation of the body. Such a category includes transgenderism to be sure but also include genetic engineering, cybernetic enhancement, plastic surgery etc. The Bishops do provide “moral/theological analysis for Catholic health care institutions” regarding the broad topic of manipulation of the human body. They spend the first 3/4 of the note going through Church teaching with regard to human nature and the liceity of various forms of medical intervention. After having established these basic principles, the doctrinal note then applies them to the issue of transgenderism. This is an entirely reasonable approach to the topic and one befitting a doctrinal note issued by the USCCB.

Horan too offers a rather senseless objection on this count. He scolds the doctrinal note because it does not:

[A]cknowledge the breadth of treatments and practices in gender-affirming care, which can include surgical interventions (admittedly the most serious and invasive)… as well as non-surgical social adaptations such as adjusting how one dresses, presents themselves, names themselves or selects pronouns.

Perhaps the reason the doctrinal note does not speak about dress, names, pronouns etc. is that the doctrinal note is about–as the title indicates–technological manipulation of the body. Thus the Bishops do discuss “interventions involv[ing] the use of surgical or chemical techniques that aim to exchange the sex characteristics of a patient’s body for those of the opposite sex or for simulations thereof.”

Proof Texting?

One critique both authors shared was that the doctrinal note contained many cases of proof texting in their appeal to Papal, Biblical, and ecclesial authority. Horan writes “References to the Catechism of the Catholic Church and proof-texting from encyclicals by Popes Benedict XVI and Francis to give a false air of universal conclusiveness does not make a sound theological argument” and again, ” Recourse in this document to proof-texted passages from Genesis, for example, are… irresponsible”. For her part, Lysaught says that the document contains “a prooftexted quote from Laudato Si’“, “prooftexts from the Catechism and select papal documents”, and that Scripture “is reduced to two prooftexts”. Indeed, in light of such accusations one might think all the Bishops did was deceptively compile quotes from various sources to support their agenda.

Prooftexting is generally understood as using quotations from authorities in a deceptive way so as to make it seem like the position of the authority is the same as the position of the one making the prooftext while in fact that is not the case. By contrast, I’m sure Lysaught and Horan would agree that it is legitimate to cite Church teaching when one does so accurately. So the question then is did the Bishops in fact use prooftexting or were their quotes legitimately used for supporting their argument?

Despite the claims of prooftexting by Horan and Lysaught, neither of them actually bothers to reproduce a quote from the doctrinal note and explain how it is a “prooftext”. The closest either gets is when Fr. Horan absurdly claims that quoting Genesis 1 in support of a traditional understanding of mankind as constituted of a binary of male and female is “as irresponsible in identifying historical, social and scientific realities today as claiming that the Earth was created in six 24-hour days “. I wonder what meaning Genesis 1 does have if “God created them male and female” doesn’t even mean that! As for the numerous papal citations and citations from other magisterial documents, neither Horan nor Lysaught ever bother to explain one instance in which the quote proffered by the Bishops is a prooftext rather than a sensible citation of Church authority to explain or exposit their point.

Lysaught for her part does complain that “[h]alf of the 34 papal citations come from Pius XI and XII” which indicates that, “[a]part from one citation, the document reads as if Vatican II never happened”. Evidently quoting both from Vatican II, as well as from Pope Benedict XVI (who was at Vatican II), Pope John Paul II, Pope Francis, and recent statements from the CDF “read as if Vatican II never happened”.

What is obvious from reading the doctrinal note and from the responses of Horan and Lysaught is that Church teaching is very clear on the issue at hand, namely of whether it is morally licit to perform gender reassignment medical procedures on those suffering from gender dysphoria. Throughout their articles, Horan and Lysaught fail to cite even one statement from the magisterium which supports their position on that issue. Citations are made to various dissident theologians such Lysaught’s appeal to the notorious dissenter Charles Curran, or to individual private theologians such as Horan makes to himself, Becket Gremmels and others. Obviously, people who disagree with Lysaught and Horan can also appeal to private theologians who hold their preferred position. Fortunately for Catholics, we don’t need to resort to discerning which opinions among a swarm of private theologians is the right one. Rather, we have a magisterium which can authoritatively and definitively teach on these topics. The magisterium has in fact spoken about sex, maleness and femaleness, and the liceity of medical procedures which remove bodily organs and so forth. The fact that the Bishops can produce dozens of quotations within their short document and Lysaught and Horan can produce zero tells any fair minded reader which side of the dispute the magisterium is on regarding transgender reassignment procedures.

It is worth addressing the fact that while Lysaught and Horan do quote Pope Francis, neither of them quote him on the issue of transgenderism. The Bishops on the other hand do and his points directly support theirs. The only quotes of Francis provided by Lysaught and Horan are general remarks about how to approach moral issues with compassion and love. They completely ignore Francis’ actual opinion on the issue at stake which is directly contrary to theirs. Once again, the nature of the quotations provided by both sides show where the pope stands on these issues.

Who’s making arguments?

Both Horan and Lysaught criticize the bishops for failing to make arguments for their position and for failing to present a respectable intellectual document. Lysaught is relentless on this account: “This means that episcopal communications must meet basic standards for a careful, professional, well-reasoned argument. The doctrinal note does not.” Or again:

[A]n essential second step in any adequate, professional analysis or argument is to carefully and charitably summarize the arguments and positions of one’s interlocutors before turning to refute them. The committee makes no attempt to do this.

and finally:

[T]he committee offers no argument to justify categorizing the WPATH standards as technological manipulation; they simply assert this as the frame of the entire issue.

Is Lysaught correct? No. Between Horan, the Bishops and Lysaught, the Bishops are in fact the only ones who present anything resembling an argument relevant to the issue of transgenderism. The Bishops’ argument is actually quite clear. With regard to the liceity of gender reassignment medical procedures they reason as follows:

  1. For a medical procedure which removes organs or tissue to be licit, that procedure must be done for the sake of the health of the entire person and the organs in question must be diseased.
  2. But in sex reassignment surgeries, the organs in question are not diseased nor is the procedure necessary for the health of the whole person.
  3. Therefore such procedures are illicit.

This is a very simple syllogism which is clearly stated in their note. They state the first premise in paragraph 11 when they state:

Pope Pius XI also stressed…that, as a rule, one is not allowed to ‘destroy or mutilate’ members of one’s body. At the same time however, he affirmed that there can be exceptions when the welfare of the body as a whole is at stake.”

After further explication of this and from some specific criteria Pius XII added to Pius XI’s teaching, they then state premise two a little later on in paragraph 15:

These [i.e. sex reassignment] technological interventions are not morally justified either as attempts to repair a defect in the body or as attempts to sacrifice a part of the body for the sake of the whole. First, they do not repairt a defect in the body: there is no disorder in the body that needs to be addressed; the bodily organs are normal and healthy. Second, the interventions do not sacrifice one part of the body for the good of the whole.

From these two points the conclusion I stated above follows. Lysaught and Horan disagree with the Bishops conclusions but attack neither premise of the argument. Ironically, for all the time Lysaught criticizes the Bishops for failing to provide an adequate “professional analysis or argument” she fails to even restate let alone refute a single premise of the Bishops’ case.

Theological Flaws?

Another critique offered by both Horan and Lysaught is that the Bishops’ doctrinal note suffers from theological problems. Lysaught claims that the note’s view of natural law goes beyond “the fundamental theological conviction — widely agreed upon… that God created all of creation and all human persons and created them as good” and insists upon various “often contested” claims such as: “That God created an order” (emphasis Lysaught’s), that such order is “inscribed in human bodies” (emphasis Lysaught’s), that sex is binary, that men and women differ not merely physically but psychologically and spiritually, that our bodies have a spousal meaning, and that the above things are foundational to society.

Lysaught notes that instead of arguing for each and every one of these propositions, the Bishops merely assert them via “prooftexts”. As we have already seen, such claims are basic Catholic teaching. Hence one simple reason the Bishops need not argue for such claims is that it is manifestly clear that the Church teaches them. If Lysaught wants to contest this, then she should present an actual argument with actual citations of magisterial texts and not merely the opinions of dissident theologians.

The only support Lysaught gives for her claim that these teachings are questionable is her claim that these positions are rooted in

[T]he voluntarist God of Neo-Scholasticism, so ably described and critiqued by moral theologian Dominican Fr. Servais-Théodore Pinckaers — a god who wills, a god who established the moral law by designing, planning and ordering nature

This last claim is confused on multiple counts. For one, to describe the “God of Neo-Scholasticism” as “voluntarist” is to betray her ignorance of either voluntarism or Neo-Sholasticism. Neo-Scholasticism is a theological movement spawned in the late 19th century after Leo XIII’s encyclical Aeterni Patris which gave special prominence to St. Thomas Aquinas’ teaching and theological methodology. The fact that such thought focused around Aquinas is important. Aquinas, as well as his followers, were decidedly not voluntarist. Consider the 1917 Catholic Encyclopedia’s description of Neo Scholasticism:

Among Catholics, neo-Scholasticism gains ground day by day. It is doing away with OntologismTraditionalism, the Dualism of Gunther, and the exaggerated Spiritualism of Descartes. It is free from the weaknesses of Pragmatism and Voluntarism, systems in which some thinkers have vainly sought the reconciliation of their philosophy and their faith. (emphasis mine)

Voluntarism is a view regarding the relationship between the intellect and the will and posits either a primacy or at least an independence of the will from the intellect. Voluntarism takes various forms and can be applied both to creatures and to God. It seems it is this latter form that Lysaught is referencing.

The fact that Lysaught claims that Neo-Scholastics (i.e Neo-Thomists) were voluntarist is inaccurate. Worse is her claim that the quotations adduced by the Bishops are in any way voluntarist merely because the mention “order” and God’s “will”. In fact, the only part of her own characterization that could be voluntarist is her phrase “a god who established the moral law”. If she means that the moral law comes entirely from God’s will rather than intellect than that would indeed be voluntarism. But do the Bishops say this? Not at all.

There isn’t the slightest hint of voluntarism in the doctrinal note. There is rather, a defense of the natural law, and of the order that God created. But both of these are things the very Servais Pinckaers she mentions defended in his writings on moral theology. What makes one a voluntarist is a belief in the primacy of the will over the intellect not using the word “order” 42 times.

Consider what Pinckaers says in his chapter “Freedom and Happiness” from his book Morality: The Catholic View. He describes the “freedom for excellence” as something which

Unites one’s actions in an ordered whole through a finality that ties them together interiorly.

Morality: The Catholic View pg. 74

This closes mirrors the bishops’ statement when they note:

The human person, body and soul, man or woman, has a fundamental order and finality whose integrity must be respected

Section 7

These are both simple statements of the natural law tradition not “voluntarist” ones. If the Bishops’ use of “order” and “finality” make them voluntarist, does that make Pinckaers a voluntarist too? Obviously not.

Overall, if Lysaught wants to argue that the note is voluntarist, she needs to present an argument to that effect. Here again we have the irony that Lysaught, who repeatedly lambasts the Bishops for failing to live up to professional standards of argument, herself doesn’t properly articulate what voluntarism is and thus does not represent the position of her interlocutors accurately.

Moral Fault?

Horan makes perhaps the strongest claim against the Bishops themselves and argues that:

Documents like this one are a form of formal cooperation with evil because there are people who will read this and use it to justify excluding real people, harming real people or denying medically necessary treatment to real people, and this last point is the clearly stated intention of the authors

It is unclear how harming people by denying treatment is the “clearly stated” intention of the authors when in fact they clearly state the opposite. “They [hospitals] must employ all appropriate resources to mitigate the suffering of those who struggle with gender incongruence.” This is a serious charge brought against the bishops by Fr. Horan. To formally cooperate with evil, a person must intend the evil with which they are cooperating. Thus, Fr. Horan must read the entire document by the Bishops as something which is disingenuous. Rather than an attempt to lay out what they believe to be Catholic teaching, the Bishops are instead simply using their opportunity to tell Catholic Hospitals to do things that will harm transgender people.

The irony of Lysaught’s and Horan’s responses come to their height in this accusation. Both writers quote Francis on the need to be charitable when engaging others on moral issues. Horan says for example, “Pope Francis has called for the church to embrace a ‘culture of encounter,’” and Lysaught made a call to “carefully and charitably summarize the arguments and positions of one’s interlocutors before turning to refute them” (emphasis mine). Despite these exhortations to charity Fr. Horan feels empowered to simply state that the doctrinal note:

reminded me of abusers who claim to be “acting out of love and concern” but do nothing but cause greater harm and violence. The tone of this document reads like something written by abusive parents invoking “tough love” as they send their queer children to “conversion therapy.”

What an uncharitable reading of the official teachers of the Church! Bishops can certainly do harm and they are not immune from attack. But if the Bishops are wrong then Horan and Lysaught need to prove it. Cite from the actual magisterium of the Church and show how the Bishops “prooftexted”. Present actual arguments against their position regarding these medical procedures. In the end, Do anything, anything, beyond the broad generalizations, mischaracterizations, and accusations which made up the bulk of both of their responses.

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