There is no paucity of academic studies, medical literature, or media attention given to concerns about gender ideology and being transgender. When reporting their findings, however, some researchers and practitioners working from a purely secular perspective overstep medical observations to make metaphysical pronouncements. This causes considerable confusion and stifles dialogue that could occur if the line between medicine and philosophy were clearly delineated. Properly understood, transgender describes an observable distress due to incongruence between one’s birth sex and gender identity. Conversely, gender ideology is a metaphysical conclusion, which argues that a person’s gender is fluid and open to personal choice. Clearly distinguishing between these can help families, clinicians, and society provide medically appropriate and culturally competent care to those with gender dysphoria, especially children.

Academic medical ethics must be a bulwark against a disturbing trend toward post-truth cultures. Activism of course has its place in massive cultural debates like abortion. The fact that so many people care so deeply about these debates is part of what makes them so important. But especially when coming from clinicians, academics, and others to whom we entrust the care of our public discourse, interventions into the debates must be disciplined by a thoroughgoing commitment to engage with the available data to back up the central claims even when those claims seem like common sense—perhaps especially when they seem like common sense.

Physically enhancing brain–machine interfaces communicate elec­tronically with the patient’s mind in both directions. They present significant opportunities to improve a patient’s health and to restore his or her physical function, but they also present problems for the patient’s sense of agency and self. This is exacerbated by notions of extension and enhancement that are not grounded in an authentic human anthropology that describes the inherently dignified person as an integral union of body and soul.

An exchange between Christopher Tollefsen and Steven Jensen highlights the contrast between a theory of natural law that relies purely first-person account of intention and one that relies more on elements from the physical world. Tollefsen, a proponent of New Natural Law theory, argues that the fetus’s death in the Phoenix case was an unintended side effect of saving the mother’s life. Jensen criticizes NNL generally and particularly for this conclusion. He argues that facts outside the agent make this procedure immoral. This essay provides a more neutral perspective on the debate by laying out each argument clearly and identifying the fundamental issues present in the discussion. A fundamental and probably irreconcilable difference involves whether certain intentions should be included in the species of an action or characterized as fairly or unfairly accepted side effects. Nevertheless, the differences between these two accounts are not as great as they initially appear.

Female genital mutilation/cutting is a multifaceted, culturally entrenched issue. In response to the United States Conference of Catholic Bishops’ resources dealing with the issue of FGM/C, this paper explores what resources sexual ethics can provide Catholic hospitals facing this issue, specifically with regards to the request for reinfibulation (the restoration of infibulation, also called FGM Type III). FGM/C ought not to be treated as a univocal medical practice; rather, in natural law evaluations of the act, the practice of reinfibulation ought to be separately acknowledged. Reinfibulation cannot be properly considered a mutilation in the same way that other types of FGM/C are. Thus reinfibulation should be performed in Catholic hospitals for those women who request it, as part of delivering culturally competent care, justifiable through the principle of material cooperation.

Body identity integrity disorder (BIID) is experienced by a small percentage of the population, whose idea of how they should look does not match their actual physical form. The most common manifestation of BIID is the desire to have a specific limb amputated. In a small number of cases, the desire is not for the removal of a limb, but to be blind or paralyzed. There has been a lot of discussion regarding the possible physiological, neurological, or psychological etiologies of BIID. This paper examines the ethical implications of the different approaches to help those with BIID. These approaches and the dilemma that doctors face in cases of BIID are the subject of the final section, which offers some tentative ethical conclusions regarding this disturbing disorder.

Contemporary mental health professionals exhibit interest in integrating spirituality into the services they provide to clients. This clinical integration raises questions about both the goals of mental health services and the professional relevance of mental health providers’ spiritual competency. Drawing on the Christian anthropology of St. Thomas Aquinas, Benedict Ashley’s approach to psychotherapy differentiates psychopharmacological, psychotherapeutic, and spiritual approaches on the basis of the different domains of a client’s personality. These domains are the focus of different professions, and Ashley’s account suggests that mental health providers who lack additional spiritual-moral training should adopt a clinical model that recognizes their work is spiritually oriented but not spiritually directive.