When the Doctor Has to Lie: The Strong Delusion

I had no intention of lying, but it seemed I had no choice.

I could not believe I was saying these words. This scenario was contrary to everything I had learned in kindergarten, grade school, high school, college, and medical school. I had chosen my wife based upon these very sound principles. We named our children following traditions and understanding that preceded human history. Now I was called upon to ignore, relearn and explain to myself and the young woman/man and her/his mother something I did not believe. So, I started slowly, being careful to try to not upset his mother (could be father) who sat at the bedside. I had to appear to accept this delusion.

‘Yes sir, you can still have a menstrual cycle until the hormone replacement and surgery are complete.’

That seemed to calm them a bit. He/she was still experiencing menstrual cramps and break through bleeding. He/she had persuaded the doctors that a trial of hormone therapy was preferable to immediate hysterectomy. The breasts had already been removed, but he/she wanted to wait. He/she might change his/her mind.

‘Thank you so much doctor. We just wanted some straight answers from you. You have answered our questions and made things very clear; he/she and she said.’

I felt stupid just trying to make sense of this clinical situation. I did not believe the very things I was sharing. I was lying. I was pretending that the scenario in front of me made sense. In a world where we have chosen which science we want to believe; this seems the pinnacle of science being subverted.

The world mocks creationists, global and climate change deniers. But it is so willing and ready to embrace the belief that XY is the same as XX. The world decries the conspiracy theories about pandemics, but accepts without questioning whether men are men and women are women. Girls and boys can choose what they want to be and their parents are dissuaded and even ridiculed for not allowing their children to accept their natural selves. As if a child who wants to smoke a cigarette or drive a car cannot make the appropriate choice, but choosing their own gender, now that is only natural.

So, I lied. I ignored the obvious in this setting, so as not to upset the two people in front of me and pretended that anatomy and physiology didn’t matter. If I can lie to them about this, what lies can I tell the man who wants to be a woman? Can he still get prostate cancer? Will I measure his hemoglobin and hematocrit based upon his choice of gender or upon the persistent physiology and endocrinology that will rage in his body once the exogenous hormone levels drop? If I remove this body part and reconstruct it to look like this body part will this be more natural?

I don’t even try this on my car. Steering wheels are not the same as rolling wheels.

Will we continue to lie to our patients? I pray that these scenarios are rare and that we can find a way to avoid subverting science. I fear we are most likely to keep on lying.

2 Thessalonians 2:11 for this reason God will send them strong delusion, that they should believe the lie