Metron and Gender Surgery
An Anderson-ic Dialogue
I had come early to the place of judgment, for I was told that the officers of the university wished to speak with me concerning the charge laid against me. The charge, as you have heard, was that I questioned the gods whom the Sun Devils recognize, and that I corrupted the youth by asking them whether the things called sacred by the Sun Devils were truly sacred, or only sacred because the Sun Devils had named them so.
While I waited, I saw a physician named Metron standing near the columns. Ze was dressed in the manner of those who possess great confidence before they possess great wisdom, and ze seemed neither troubled nor ashamed, though I was told that ze too was awaiting trial.
Seeing that ze was in good spirits, I approached
.
Anderson: Good morning, doctor. You appear cheerful for one who waits upon the judgment of the university.
Metron: And why should I not be cheerful, Anderson? I have done good, and I am eager to explain it before the court.
Anderson: That is excellent news. For I am also awaiting trial, though I am accused of doing evil by asking what the good is. Perhaps you, having done good and knowing it, can help me.
Metron: I will, if I can.
Anderson: Tell me first: what is the charge against you?
Metron: They accuse me of removing healthy parts from the body of a teenager.
Anderson: Healthy parts?
Metron: Yes.
Anderson: Not diseased parts?
Metron: No.
Anderson: Not gangrenous, cancerous, or otherwise dangerous to the life of the patient?
Metron: No, nothing of that kind.
Anderson: And the teenager was not one of those rare cases in which the body itself is ambiguous concerning male and female?
Metron: No. The body was clear enough.
Anderson: Then the body was healthy and whole according to its own nature?
Metron: According to the crude judgment of the body, perhaps.
Anderson: The body now has judgments?
Metron: Do not mock me, Anderson. I mean that, biologically speaking, the parts were healthy.
Anderson: I am glad we agree on this much. The parts were healthy biologically. And yet you removed them?
Metron: I did.
Anderson: Because you judged that removing healthy parts would be good for the teenager?
Metron: Not merely I. The teenager judged it. That is the important point.
Anderson: Ah, then perhaps we have found something worth examining. You say the surgery was good because the teenager judged it to be good?
Metron: Yes. The teenager believed it would bring relief, authenticity, and happiness.
Anderson: Then, according to you, what is good for a person is whatever that person believes to be good?
Metron: In matters of identity, yes.
Anderson: Only in matters of identity?
Metron: Chiefly in such matters.
Anderson: Let us not hurry. For I am slow in understanding, and the court may be less patient than I am. You say the surgery was good because the teenager believed it was good. But I wonder: does believing a thing good make it good, or does one rightly believe a thing good because it already is good?
Metron: That is too abstract. In medicine we deal with suffering persons, not airy definitions.
Anderson: I admire your compassion. But perhaps definitions are not so airy when knives are involved.
Metron: The patient was suffering. The patient desired the procedure. The patient believed the procedure would help. Therefore I helped.
Anderson: You say the patient believed the procedure would help. Tell me, do patients ever believe falsely about what will help them?
Metron: Of course they do.
Anderson: For example, might a fevered patient believe that drinking poison would cool the blood?
Metron: Perhaps.
Anderson: And would the belief make the poison helpful?
Metron: No.
Anderson: Or might a starving patient believe that painted bread on a wall would nourish him?
Metron: No one would believe that.
Anderson: But if he did, would the painted bread nourish him?
Metron: No.
Anderson: Then in some cases, what is good for the body is not determined by belief?
Metron: Obviously not.
Anderson: And the physician must know the difference between what seems good to the patient and what is good for the patient?
Metron: Yes, in ordinary cases.
Anderson: Then the physician is not merely the servant of desire?
Metron: No, not merely.
Anderson: Nor merely the priest who blesses whatever the patient already believes?
Metron: No.
Anderson: Then help me understand. In ordinary medicine, the physician asks what is truly good for the patient, even when the patient is mistaken. But in this case, you say the patient’s belief that the surgery was good made it good. Why is this case different?
Metron: Because this concerns the self.
Anderson: The self?
Metron: Yes. The teenager believed ze was not the gender assigned by the body at birth.
Anderson: Assigned by the body? You speak as though the body were a clerk in the university office, stamping papers.
Metron: You know what I mean.
Anderson: I rarely know what people mean until they tell me. Do you mean that the teenager’s body was one sex, but the teenager believed zerself to be another?
Metron: Yes. And that the birthing doctor assigned a gender without asking my patient.
Anderson: Your patient while a baby?
Metron: Yes.
Anderson: Is a doctor able to look at the body and figure out what gender it is, even just after birth?
Metron: The doctor can tell the sex but not the gender.
Anderson: And your patient wants to align their mental gender with the physical sex of the body?
Metron: Yes.
Anderson: So your patient concedes that gender has physical markers and wants to cut up the body to look something like the desired sex look?
Metron: You are understanding.
Anderson: I’m not sure there is understanding, is this just a contradiction? And the surgery was intended to make the body become what the teenager believed zerself to be?
Metron: To align the body with the self, yes.
Anderson: Did the surgery make the teenager into the other sex?
Metron: Not in the biological sense. Just in some appearances.
Anderson: In any biological sense?
Metron: It created the appearance.
Anderson: The appearance of the other sex?
Metron: A resemblance, yes.
Anderson: So the surgery did not make the teenager become the other sex, but made the teenager slightly resemble the other sex?
Metron: You put it correctly.
Anderson: I am only trying to put it clearly. If it is false, correct me. The teenager was not intersex. The teenager’s body was healthy. The surgery removed healthy parts. The result did not make the teenager become the other sex, but made the body resemble the other sex in certain respects so as to possibly trick some people. Is this accurate?
Metron: It is succinct, but not inaccurate.
Anderson: Good. Then let us ask: what is it to be what one is?
Metron: Now you are taking us into metaphysics.
Anderson: I was hoping we might arrive there before the trial. Courts are often less dangerous than metaphysics, but only because they are less honest.
Metron: Very well. Ask.
Anderson: Is there such a thing as human nature?
Metron: Yes, in a broad sense.
Anderson: And is a human being the kind of being whose good depends upon that nature?
Metron: I suppose so.
Anderson: For example, if a horse eats grass, grass is good for it according to the nature of a horse. But if a man eats only grass, he will not flourish, because man is not a horse.
Metron: Yes.
Anderson: And if a fish is placed in water, it lives according to its nature. But if a man is held under water, he dies, because man is not a fish.
Metron: Obviously.
Anderson: Then the good of a being is not determined by desire alone, but by the nature of the being that desires.
Metron: That seems right.
Anderson: So to know what is good for a human being, we must know what a human being is.
Metron: Exactly.
Anderson: And to know whether a surgery is good for a human being, we must know whether the surgery perfects, heals, restores, or otherwise serves the nature of that human being.
Metron: Yes.
Anderson: Then if a surgery damages a healthy human body, we cannot call it good merely because the patient desired it.
Metron: Unless the damage to the body heals the self.
Anderson: Ah, now we have returned to the self. Tell me: is the self a human self?
Metron: Of course.
Anderson: And is the body a human body?
Metron: Yes.
Anderson: Then are there two human beings here, one called the self and one called the body?
Metron: No.
Anderson: Is the human being the self alone, while the body is merely an instrument?
Metron: Not merely.
Anderson: Is the body part of the human being?
Metron: Yes.
Anderson: Then to harm the body is to harm the human being, unless the harm is ordered to some healing of the whole.
Metron: That is generally true.
Anderson: And if the body is already healthy, the question becomes whether the mind’s belief that the body is wrong is true or false.
Metron: The question is whether the person can live authentically.
Anderson: Perhaps. But if authenticity means living according to what one believes, then we have not escaped our earlier problem. For a man may authentically believe he is a horse, but oats and a stable will not perfect his nature.
Metron: This is different.
Anderson: It may be. But we must say how. Is the teenager actually the other sex, or becoming the other sex, or merely desiring to imperfectly appear as the other sex?
Metron: The teenager is becoming who ze truly is.
Anderson: Becoming? Then ze is not yet what ze will be?
Metron: In one sense, yes.
Anderson: But can a thing become anything whatsoever?
Metron: No.
Anderson: Can an acorn become an oak?
Metron: Yes.
Anderson: Can an acorn become a dolphin?
Metron: No.
Anderson: Why not?
Metron: Because that is not within its nature.
Anderson: So becoming is governed by being?
Metron: Explain.
Anderson: A thing can become only according to what it already is. The acorn can become an oak because it is by nature ordered toward oakhood. It cannot become a dolphin, not because it lacks sufficient affirmation or therapy, but because becoming is limited by being.
Metron: That is true of acorns.
Anderson: Is it false of human beings?
Metron: Human beings are more complex.
Anderson: More complex, certainly. But does complexity abolish nature?
Metron: No.
Anderson: Then we must ask whether a male human being can become a female human being, or whether he can only come to resemble one in certain outward ways. Likewise, whether a female human being can become a male human being, or only resemble one in certain outward ways.
Metron: You are reducing the person to biology.
Anderson: Not at all. I am refusing to reduce the person to false belief and mistaken desire. You have said that the body is part of the person, that the body was healthy, that the surgery did not make the person into the other sex, and that becoming is limited by nature. I am only asking whether medicine should serve the human being as he is, or the image he desires to become.
Metron: But the teenager suffered because the body did not match the inner self.
Anderson: Then there was a conflict between belief and body.
Metron: Yes.
Anderson: And when belief and body conflict, which one should the physician treat as authoritative?
Metron: The self.
Anderson: Even when the body is healthy?
Metron: Yes, if the distress is great enough.
Anderson: If a self incorrectly believes himself to be the Emperor Napoleon, would you encourage this and provide surgery to alter his height or would you treat him with therapy to get his beliefs to match reality?
Metron: He’s not the Emperor Napoleon, I would not cut up a healthy body to change his height.
Anderson: Then medicine no longer asks, “What is the body?” but “What does the patient believe the body ought to be?”
Metron: Only in gender cases, yes.
Anderson: And the scalpel becomes the servant of metaphysics.
Metron: Perhaps it always has been.
Anderson: I agree. That is why we must ask whether the metaphysics is true before we cut.
At this, Metron grew quiet, though ze did not appear persuaded. Ze was beyond reasoned argument and into the realm of dogmatic assertion. The officers of the court passed near us, and I could hear the murmur of the university beyond the doors. The people had gathered to decide whether questioning their gods was impious. Yet I wondered whether the greater impiety was not questioning them, but obeying what might be demons without knowing what is good and what is not.
Metron: Anderson, you make everything confused.
Anderson: No, my friend. I only notice when someone’s ideology is already confused.