The person coming to see the doctor is body, mind, and spirit: a body with particular structures and functions; a mind with thoughts, feelings and perceptions; and a spirit that relates to God, others and self, that must choose between right and wrong and seeks meaning in life. When body, mind and spirit are in disharmony, it is important to identify the problem. There are many ways in which patients want to believe something about their bodies not based on reality. The physician should compassionately bring that person back to a firm grounding based on physical reality, not feed the delusion.
If a person presents to me with a distortion of perception of his or her normal body, I am obliged to stand fast on physical reality. I recently had a patient tell me her skull was shrinking. In reality she was depressed and losing weight which prompted this distorted perception. Her skull had not shrunk. The aberration of the normal physiology of brain function resulted in a distortion of perception and mood needing treatment, not her skull.
If a person comes to me suffering with anorexia nervosa convinced she is overweight when in fact she is not, I need to rely on the scale and my powers of observation of the body. The distortion of perception does not change the physical reality that she is starving herself. I should be sympathetic and empathetic to her convictions, compassionate and understanding of what may be causing her to believe thus. Nevertheless I would do a disservice to her by agreeing with her identification of being overweight.
If a person perceives himself to be 6 feet 6 inches tall when in fact he is 5 foot 5 inches, I must trust the measuring device.
If a man with normal anatomy presents to me convinced he is a woman, I must rely on my powers of observation and recognize the person is composed of a trillion cells with the genetic composition of XY and not XX, with the anatomic parts of a man. Indeed if there are findings of brain function that can be measured in the man's brain by sophisticated imaging which are different than those of persons without such a perception, those findings would simply corroborate a departure from normal functioning.
Anatomy and physiology make the complementary nature of man and woman self evident. The necessary functions of the male and female bodies that result in the propagation of human beings set the necessary standard for sexual behavior between men and women. Indeed it is a law of life that for humans to continue to exist, this relationship must persist. There are aberrations from this relationship, but to be sure, they are aberrations, a departure from normal anatomy and physiology. For humans to exist, man is made for woman and woman is made for man.