Puberty blockers, cross-sex hormones, and gender reassignment surgery are all used to relieve suffering—not physical suffering, but the psychological and emotional suffering caused by gender dysphoria. Most feel alleviating that suffering is a moral imperative; therefore, so is allowing these interventions. Few realize, however, that the psychological and emotional burden often remains even after transition.

Think about it,” my friend said, his voice tinged with aggression. “Why did you become a man? Because you didn’t have any other option socially. Wouldn’t it be better if kids didn’t have such constraints on who they could be?”

My friend (let’s call him Jim) had a preteen with no history of gender dysphoria who had recently come out as nonbinary. Jim was supportive, even enthusiastic. He shared his story with local news and invited questions and dialogue from our small church. So I asked him over to my home to hear more and, when the moment seemed right, express my fears for his family.

Which is undoubtedly why Jim preempted me by asking why I chose and continued to choose the male gender. To reply that, lacking power to swap my male gametes and DNA for female, I had no such choice would have cut too quickly to the heart of the matter. So I deflected the question.

Biding my time did nothing to assuage Jim’s anger. For him, expressing or even implying concern with his parenting choices or his child’s decisions was out of bounds. By voicing that concern, which I eventually did more explicitly, I made him and his child “unsafe.” He seems, in fact, to have experienced my fear for his child as tantamount to assault. Our friendship was over.

I have no doubt that Jim’s motivation was to protect his family. But he had been seduced by a culture-wide mass movement bent on “the quest for freedom from natural limits,” as the English theologian Oliver O’Donovan described it in a series of indispensable lectures when Jim and I were still in diapers. That movement wishes to dispense with human nature especially with regard to sexual difference and sexuality. Nature, after all, implies limitation. “To hate one’s own flesh is the limit of self-contradiction to which our freedom tends,” O’Donovan said. “It is the point at which our assertion of ourselves against nature becomes an attack upon ourselves.”

Happily, these forty-year-old lectures have been reissued in a slim volume that includes a new introduction by Matthew Lee Anderson and a retrospective by O’Donovan. Begotten or Made? remains relevant for its clarifying theological analyses of abortion, in vitro fertilization (and the concomitant disposal of embryos), surrogacy, contraception, marriage, and more. O’Donovan begins, however, by addressing what in 1983 was called “transsexual surgery,” a topic his original audience might have thought a waste of time but will strike no one that way today.

“The great intellectual challenge that faces our age in view of these innovations is not to understand that this or that may or may not be done,” writes O’Donovan, “but to understand what it is that would be done, if it were to be done.” A careful look at what was considered best practice for treating gender dysphoria stood to clarify for O’Donovan’s Thatcher-era audience where our culture’s quest to shed our natural limits was taking us. Likewise, O’Donovan’s little enchiridion will help today’s reader begin to grasp just what it is we do when we begin IVF treatments, use contraception, undertake surrogacy, or undergo so-called “gender affirming care.”

First, it reveals “our cultural conception of freedom as the freedom not to suffer,” a conception that implies a moral imperative to continually push back humanity’s natural limits in order to overcome suffering. Second, it brings to the fore the accompanying “exclusive importance of compassion among the virtues.” Compassion moves to relieve suffering, he writes, and so “circumvents thought, since it prompts us immediately to action.” All of which means that we have little idea what we are doing in continually pushing back the boundaries of human nature.

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