On Friday, May 17, the (Jesuit) University of San Francisco will hold the 2013 commencement exercises for their School of Nursing and Health Professions. The commencement speaker and recipient of an honorary degree will be Barbara Garcia, director of health at the San Francisco Department of Public Health. Ms. Garcia was appointed by then-Mayor Gavin Newsom in 2010. She is an open lesbian.

Garcia is probably best known to the wider public following national news coverage of a decision of the San Francisco board of supervisors that the city’s Healthy San Francisco  program—that is, the taxpayers—will, in addition to coverage for abortion and contraception, provide free “gender reassignment surgery.” As director, Garcia will be in charge of implementing this program. On November 10, 2012 Gay Star News reported “San Francisco will now offer mastectomies (removal of the breasts), genital reconstructions and other surgeries recommended for some transgender people under the city’s 5-year-old universal health care plan.” Garcia justified the procedures: “The community felt the exclusion on Healthy San Francisco was discriminatory and we wanted to change that as the first step.”

As the San Francisco program shows, there are many people who take gender reassignment surgery seriously, rather than seeing it as a mutilation born of mental illness. To put “gender reassignment surgery” into a proper perspective, let’s examine an identical syndrome called Body Integrity Identity Disorder.

The noted bioethicist Wesley Smith, writing at the Human Exceptionalism blog at National Review, describes it: “BIID, also known as ‘amputee wannabe,’ is a terrible mental illness in which sufferers obsesses and truly anguish about becoming an amputee–which they perceive as their true identities.” He went on to explain his experience at something called the “transhumanist” conference:

“At the (‘transhumanist’) conference, the transhumanist speaker argued that [disorder] sufferers should be able to have healthy limbs amputated. On one hand, I couldn’t believe my ears. On the other, I wasn’t surprised. These days, we often don’t treat mental illnesses, but instead, tend toward acceding to and normalizing them. The speaker also argued, that since we have long permitted sex change surgeries, why not amputations? Truth to be told, there is logic there.”

There is indeed.  Smith continues:

“A year or so before Patrick’s (a person suffering from [the amputation disorder]) operation, a psychologist asked him if he would take a pill to make his disorder go away, should such a treatment exist. It took a moment for him to reflect and answer: maybe when he had been a lot younger, but not anymore….”

Smith reflects: “Radical individualism is now the avatar with powerful forces urging that self identity become the be all and end all–no judgment allowed–perhaps even to the point that one day it will mean permission to chop off healthy limbs and other body parts.”