That’s a really good point — I think we can unpack at least some of the options available.

Let’s first circumscribe the reality of our true natures into three categories: mental, genotypic, and phenotypic. What you think, what your genetic code thinks, and what your body developed as.

Case 1: Mental and Physical dysphoria with Genetics

Now, there is one kind of transgender that I fully get — Androgen Insensitivity Syndrome. In this case, even though the genetic code is for a male, androgen isn’t processed by the body (in fact, it’s turned into estrogen), and your body develops as female. Let’s assert for sake of argument these people are mentally women, and physically women, even though they are genetically men.

In this case, I’d consider them women, even though they do not have uteruses, cannot bear children, and do not menstruate. I certainly would not suggest any surgery to make their physical body “match” their genetic code, nor would I suggest any counseling to make their mental image “match” their genetic code.

Case 2: Physical and Genetic dysphoria with Mental

In this case, we have male genetics, a male body, but a mental state that believes it should be female. We could be as simple as “two out of three wins”, and assert that the problem is with the mind simply by majority rule, but I think that’s a bit too superficial of an analysis.

However, I think we come to the same conclusion if we think about it more thoroughly. At most, we might hope to modify the physical to match the mental (which would bring us back to case 1), since we don’t have any capability for genetically rewriting XY -> XX. This is complicated by the fact that we’ll be fighting a body that does process androgen, and so we’ll be disrupting its natural state continuously with hormone treatments. Even the best surgery and hormone treatment might not allow a person to “pass” as a woman, the way people with AIS do naturally.

So given the dangers of physical intervention (with the caveat that if we ever do develop treatments that effectively mock the AIS condition it changes the calculus), it seems the proper point of intervention here is mental, especially if the person is suffering from mental distress with the way they are naturally.

Case 3: Mental and Genetic dysphoria with Physical

This is the sad case of “sex reassignment” after botched circumcisions. Mentally, the person feels male. Genetically, the person is male. Physically, the person has been mutilated.

Again, the superficial “two out of three wins” can apply here, but let’s dive down a little deeper.

In this case, although the physical doesn’t match the mental, we do have the advantage of the hormonal being aligned with the mental — even if we do reconstructive surgery to simulate male genitalia, any hormonal treatment will align with the natural body, rather than fight it. The person might never have the full capacity of a man who wasn’t mutilated, but it still behooves us to consider this person male.

FtM

Now, the above examples were focused on male genetics, but I think for at least case 2, they are also applicable in the other direction.

For case 1, I don’t know of any analog to AIS where a genetic female develops male genitalia and a male mind, but it could exist.

For case 3, I don’t know of any sex reassignment at birth that would take a genetic and mental female and declare them a male…I’m not even sure if that’s theoretically possible, since they’re really no way to mutilate a vulva by accident to create a penis and scrotum.

Other cases?

Now, I’ve laid out the options as I imagine them, and would be more than happy to hear alternatives or critiques. I think the problem is that most of the left-wing doesn’t actually want to have any sort of analytical or logical discussion on this — it’s all just subjective feeling, and anyone who has a different opinion or disagrees is evil.

But hey, maybe I’m wrong, and we’ll hear from someone who has a liberal analysis of my cases that come to different conclusions :)