So that One’s Soul be Tranquil: A Jewish Definition of Health and Gender-Affirming Care

Abstract: Some arguments against gender-affirming care (which often stem from religious ideologies) are based on a narrow definition of health where medical care is seen as only restoring an individual to typical physical functioning, and gender-affirming interventions are an unnecessary harm to the body. Some defenders of gender-affirming care argue that the interventions are necessary due to the intensely negative mental health consequences of gender dysphoria including depression and suicidality. In this presentation I argue for a different religious definition of health, one that provides a positive grounding for gender-affirming care outside of mental illness. Jewish medieval thinker Moses Maimonides, in his Laws of Character Traits, argues that the purpose of health is to be the best possible servant of God, which necessitates proper sleep, nutrition, and that one’s “soul be tranquil.” This definition of health requires more than proper functioning, and presents an argument that an individual must be able to live with integrity regarding their identity so they can be “tranquil,” flourish, and serve God properly. I will also note that in Judaism, being a servant of God can require physiologically unnecessary bodily interventions, namely male circumcision. Thus, as a category these kinds of interventions cannot simply be seen as damaging God’s already “perfect” creation, like in other definitions of the body and health. Although this argument does not solve all the Jewish legal issues regarding trans healthcare, and is not meant as a universal ethic, it provides an alternative religious understanding of health that positively grounds gender-affirming care.