On the 18th of June, 2024, the Section for Public Sphere Dialogue of the Missionary Department of the Archdiocese of Belgrade and Karlovci organised a panel discussion entitled Sex and Gender – One or Two Realities, Consensus or the Possible Conflict with Oneself at the Belgrade Youth Centre. The event attracted great public interest and was very well attended. Unfortunately, due to the enormity and complexity of the topic, as well as the limited time available for discussion, many important questions were either not addressed or were left insufficiently clarified. To provide answers to such questions and further clarify the issues concerning this important and complex topic, we have asked the Coordinator of the Section for Public Dialogue of the Archbishopric’s Missionary Department, Deacon Dr. Aleksandar Milojkov, who has been dealing with this subject for a long time, to further clarify the key issues related to gender ideology, which he will do through a series of texts in our blog section.
This is the first article on this topic by Dr. Milojkov:
Gender Ideology and the Instrumentalisation of Science
Doubt is the foundation of science. It propels science forward in its theoretical examination of reality, making scientific theories more precise and accurate. Today, many thoughtful people rightly highlight this creative scientific doubt as something worthy of praise, pride, and as a benefit to all of mankind. However, alongside this creative scientific doubt, when it comes to science itself, we also need to cultivate doubt with regards to the ideological instrumentalisation of science – a critical scepticism that would protect science from ideological interference and dictation within the scientific narrative itself.
Specifically, we have reason to suspect that the so-called gender ideology and ideological queer and feminist theories have greatly infiltrated science, imposing their own ideological, non-scientific concepts and dictating their own narrative, often perfidiously cloaked in scientific garb. One fundamental non-scientific concept that gender ideology has introduced into the realm of science is the so-called idea of “gender”. In fact, this new term that has entered the medical narrative, cannot even be adequately translated into the Serbian language, as it stems from a particular ideological and social construct. When we use the word “rod” (kin) in Serbian, it primarily refers to a group of genetically related people. Hence, the undeniable connection between the noun “rod” (kin) and the phrase “to give birth”, as well as the related terms such as “relative” or “kin”. In a broader context, “rod” refers to a group of people who share a common origin, language and culture. This group of people is called a nation (in Serbian, the root “rod” is also found in the word “narod”, meaning nation). As a folk song goes: “Whoever is a Serb, and of Serbian descent, and does not come to the Battle of Kosovo…” In this context, it is clear that “rod” (gender) is not necessarily related to “sex”.
In grammar, we speak of three genders: masculine, feminine and neuter. Nouns, pronouns, and adjectives can be masculine, feminine, or neuter in gender. Nouns of all three genders can denote living beings, inanimate objects, and abstract concepts. When it comes to living beings, grammatical gender can be related to biological sex, but not necessarily. For instance, the noun “person” or “individual” takes the feminine gender, but it refers equally to individuals of both male and female sexes – for example, “My friend Oliver is an exceptional person”, but also “My late teacher Divna was a very interesting person.” These minor examples also illustrate the inconsistency and absurdity of the so-called gender-sensitive language, which the creators of our Law on Gender Equality have insisted upon. It has, fortunately, recently been revoked by the Constitutional Court.
Moreover, in the Serbian language, the term “rod” is also used in biology. In biology, “rod” denotes a taxonomic category in the classification of living organisms, encompassing one or more phylogenic species. In this context, “rod” is derived from the Latin word genus. The English word “genus” has the same Latin origin, which in biology means the same as the Serbian word “rod.”
I mentioned the English word genus in order to make the following point clearer. None of the three meanings behind the Serbian word “rod” bear any relation to the noun “gender” and its adjective, used in the context of ideological theories of so-called gender identity. In these theories, the English noun gender is used, and its translation into Serbian as “rod” completely misses the concept that gender represents, as the Serbian term “rod” has no connection to it. Therefore, in this ideological context, it is better to use the anglicism “gender” rather than “rod”.
What exactly is gender (so-called “rod”) and where does this concept come from? Gender is a sociological and psychological construct, a narrative about the existence of so-called “gender roles”, through which men and women express their masculinity or femininity. The concept emerged as part of sociological and psychological theorising. The term “gender roles” was coined by psychologist John Money in 1955, who claimed that gender is “everything a person says or does in order to present themselves as someone having the status of a boy or man, or a girl or woman.” This view can be considered to be the origin of the confusion that would later turn into the modern gender ideology. It marks the beginning of the unacceptable blending and equating of what belongs to ontology (the study of being) with a sociological and cultural construct, and the related subjective psychological experience.
In other words, it is impossible to equate what someone is (a man or a woman) with what a particular society considers to be appropriate behavior and the appropriate social roles for men and women (these are the so-called “gender roles” in gender ideology, or as they claim, the manifestations of masculinity or femininity). The social roles of men and women are variable across different cultures and time periods. For instance, not too long ago, one manifestation of masculinity, which was considered an exclusively male social role in our social and cultural context, was military service and the pursuit of a professional military career. Even in recruitment for military education, the main criterion was that the candidate be male. Today, it is well-known that females are equal candidates for military service, with many women serving professionally in the armed forces. This new social role has certainly not changed the fact that women are still women. The so-called manifestation of masculinity and femininity is a variable cultural and social construct, and as such, it has no place in determining the reality of being male or female. The latter is an immutable, essential reality – or, simply put, belongs exclusively to biology. It is possible to play around with human biology, with the help of modern scientific advances, to try to obscure it, and even mutilate it, but not fundamentally change it in the process of the so-called “gender transition.” I will elaborate on this more in the next text.
I will now return to the pioneer of the “gender role” and “gender identity” theory, psychologist John Money, to demonstrate how dangerous it is to ontologise the so-called gender identity and believe that some cultural manifestations of masculinity or femininity can make someone truly a man or a woman. John Money firmly believed that the so-called social roles could indeed become and indeed are ontological categories, capable of making someone a man or a woman. To support his theory, he conducted experiments, one of which ended tragically in the case of a Canadian boy, called David Reimer. David was born as a boy named Bruce in 1965. During a circumcision procedure, his penis was severely damaged when he was just eight months old. Following John Money’s advice, a “gender identity change” procedure was carried out on Bruce, which is now referred to in medicine as a gender transition. Bruce was given the name Brenda, an artificial “vagina” was surgically created, and he was subjected to hormone therapy in order to suppress his masculine traits and promote feminine ones, while being raised as a girl. Unfortunately, the poor boy, who later became a young man, endured a living nightmare because Money’s constructed female gender identity could not suppress Bruce’s natural, male identity.
Even before learning about the events of his early childhood, and despite living as a “girl”, “Brenda” felt like a boy. At around ten years old, “Brenda” discovered the truth about “her” identity and the experiments performed on “her’. At the age of 15, he abandoned hormone therapy, reclaimed his true identity as a male, and adopted the name David. Tragically, the psychological consequences of the “gender transition” experiments that had been performed on him were profound , and David took his own life in 2004 at the age of 38. His twin brother Brian, also committed suicide in 2002, after suffering severe distress, related to the family situation and the experiments performed on his brother.
Now, let us look at the facts that demonstrate how an ideological construct, based on the theory of so-called “gender roles” and “gender identity”, entered the realm of medical science (and today there are even attempts to biologise this construct), where it should never been allowed to appear. Gender ideology has infiltrated medicine, both in terms of the narrative and in terms of reifying (ontologising) something that is a non-medical, ideological construct. We will compare two documents from the World Health Organisation (WHO) and two documents from the American Psychiatric Association (APA). These are the International Classification of Diseases (ICD) by the WHO and the Diagnostic and Statistical Manual of Mental Disorders (DSM) by the APA. Let us look at how the biological concept of “sex” and “sexual” has been replaced by the ideological term “gender”. Both of these documents have undergone revisions – the ICD now has eleven versions, and the DSM has five. The latest two versions of these two documents are of particular interest to us, as they demonstrate the evident infiltration of ideological terms into medicine. Specifically, we are referring to the DSM-4, adopted by the APA in 1994, and the DSM-5, adopted by the same association in 2013. On the other hand, we have the ICD-10, published by the WHO in 1990 (implemented in 1992), and the ICD-11, published by the WHO in 2019 (implemented in 2022).
It is important to note that the DSM is a diagnostic and statistical manual published by a professional association of psychiatrists in the United States. As such, the position of the American Psychiatric Association (APA) does not have universal validity, unlike the position of the World Health Organisation, which is a UN agency, with both having 194 states as members. However, the position of the APA is highly relevant and influential in medical and scientific circles, when it comes to psychiatry and mental health. Not only that, but when comparing the DSM with the International Classification of Diseases (ICD) of the World Health Organisation, it is evident that the DSM has had a significant influence on the ICD. Specifically, the infiltration of gender ideology into the WHO’s International Classification of Diseases, was obviously done under the influence of the Diagnostic and Statistical Manual for Mental Disorders of the American Psychiatric Association. Here are the comparisons which demonstrate it.
In DSM-4 (published in 1994), we find the term “gender” and “gender identity”. This version of the Diagnostic and Statistical Manual of Mental Disorders by the APA includes a list of diagnoses belonging to Gender Identity Disorders, under the code 302. These include: Gender Identity Disorder in Children (302.6), Gender Identity Disorder in Adolescents or Adults (302.85), and Gender Identity Disorder (Unspecified) NOS (302.6). The DSM-4 also contains a list of sexual disorders (sexual dysfunctions and paraphilias), but it does not include the concept of “sexual identity”, only of “gender identity”. Now, let us compare this with the terminology in the ICD-10, published by the World Health Organisation in 1990 (four years before DSM-4). In the tenth version of the International Classification of Diseases by the WHO, there is no mention of “gender” or “gender identity”; only “sex” and “sexual identity”. Thus, what DSM-4 refers to as Gender Identity Disorders, the ICD-10 refers to (in Latin) as Disordines identitas sexualis (Disorders of Sexual Identity). Clearly, we are dealing here with the concept of sexual , as opposed to gender identity. In ICD-10 this disorder is classified under mental disorders (psych code F).
The category of Sexual Identity Disorders (F64) includes the following diagnoses: Transsexualism (F64.0), which is defined as “the desire to live and be accepted as a person of the opposite sex (to one’s own), usually accompanied by discomfort with or an inadequacy of one’s own sex. The person wishes to undergo a change of sex through surgery or hormone treatment”; Dual-role Transvestism (F64.1), defined as “the wearing of clothes of the opposite sex to enjoy the temporary experience of membership in the opposite sex, without any desire for permanent sex change or surgery”; Sexual Identity Disorder in Childhood (F64.2); Other Sexual Identity Disorders (64.8); and Sexual Identity Disorder, Unspecified (F64.9).
It is clear that the concept of gender identity entered medicine through the DSM-4 of the American Psychiatric Association. Prior to that, the ICD-10 spoke exclusively of sexual identity. What is common to both documents is that the disorder of sexual identity (in ICD-10) or gender identity disorder (in DSM-4) is treated as a disorder. Now let us see what has changed in the most recent versions of these documents.
In DSM-5 (published in 2013), the concept of gender identity remains, but it has been depathologised. In DSM-5 of the American Psychiatric Association, Gender Identity Disorder has been replaced with Gender Dysphoria, while retaining the same code, 302., which now covers what was previously referred to as Gender Identity Disorder. What does this mean? It means that the mere incongruence between the biological sex and how a person perceives themselves (or their “gender”, as gender ideologues would say) is no longer considered a disorder or a diagnosis. The diagnosis now refers to the distress or discomfort the person feels due to the incongruence between their biological sex and their “gender identity”. Dysphoria is a Greek word meaning something that is difficult to bear, that is intolerable. Here we have the paradox that the problem is not in the root cause of the distress and suffering, but the suffering itself. To put it simply: the problem no longer seems to be that the tooth is rotten, but that you feel pain because of it!? Isn’t this nonsensical? Of course it is! In human psychosomatic nature, the feeling of suffering and pain always signals that something in the psyche (soul) or soma (body) is not right, that there is some disorder. In the newly coined term, “gender dysphoria”, this principle no longer applies, and things have been turned on their head. The psychiatric philosophy of treating the so-called gender dysphoria, focuses exclusively on affirming “gender”, not sex. So, in treating gender dysphoria, the new approach is to adjust the sex to fit the “gender”, not the other way round. Whether the philosophy behind this treatment results from psychiatry’s current inability to bring “gender” into harmony with the biological sex, or whether it stems from the influence of gender and queer ideologies, is as yet unknown.
Finally, the latest version of the International Classification of Diseases (ICD-11) by the World Health Organisation (published in 2019) has incorporated everything found in the DSM-4 and DSM-5 of the American Psychiatric Association. The concept of sexual identity has been replaced with gender, and the depathologisation of what was once known as a disorder of sexual identity has been carried out. In ICD-11, within the group of mental disorders (Psych code F), there is no longer a diagnosis for Sexual Identity Disorders (F64). What was previously included under this diagnosis has been moved to a newly formed category in ICD-11, called Conditions Related to Sexual Health. Within this category of conditions (no longer disorders) is also the condition called Gender Incongruence, with new codes: NA60 (for adolescents and adults), NA61 (for children), and NA6Z (for unspecified gender incongruence). It is also stated that this “condition” corresponds to the now outdated term gender dysphoria. Thus, ICD-11 of the World Health Organisation follows the same philosophy of treatment as DSM-5 – the problem is the dysphoria or distress, and not that which causes the distress. The cause is no longer viewed as a pathology, but a “condition” that can be altered, in order to eliminate distress, exclusively by affirming “gender” (through hormone therapy and surgical “sex alteration”).
The depathologisation of what was once known as a disorder of sexual identity was one of the key demands of activists, promoters, and organisations advocating for gender ideology and the proponents of queer theories. If you seek justification for this depathologisation from the medical profession itself, the response you get is that the goal was to reduce the societal stigma against the so-called transgender individuals. The fight against the stigma of any kind should indeed be welcomed and supported. However, can societal (de)stigmatisation be an argument in medicine for determining whether something is a disorder or not? Many people with various illnesses, particularly neurological (such as epilepsy, for example) and psychiatric disorders, often face stigma because of their health issues. Many of them experience serious difficulties in finding work and everyday functioning in society. Should epilepsy or numerous psychiatric illnesses be removed from the list of disorders and reclassified as “conditions” to reduce the evident social stigma? Of course not. Stigma is fought in other ways, and not through the ideological reclassification as a “condition” of what has always been and remains to be a disorder – merely because of the fact that it causes distress, pain, suffering, depression… On one occasion, I asked a respected psychiatrist privately to explain the difference between the terms “condition” and “disorder” in medicine, in the context of this issue. She replied, “The difference is…political.” Thus, the difference lies in dressing up reality, for the purpose of establishing and supporting an ideology, which, we have every reason to suspect, has infiltrated medicine and, to a great extent, instrumentalised it for its own ends. Such suspicion is not only justified, but also necessary today – at least as much as the initial doubt that long ago gave birth to science itself. That initial doubt was the foundation of science and continues to be its cornerstone today. The suspicion which we have discussed in this article, serves to protect science from ideology.
Deacon Dr. Aleksandar Milojkov
