What it costs people

The Brain in the Wrong Body

A thought experiment, the Church’s own doctrine of gendered spirits, and what the evidence does and does not show, with adults and children kept apart.

The thought experiment

Imagine that twenty years from now brain transplants are possible. Your brain is placed in a body of the other sex. You wake up, and it feels wrong. Most people, asked what should be done, say the same thing: put the brain back in a body that matches it, or failing that, make this body match the brain as closely as possible.

That is the logic of transition, stated by people who would never call themselves supporters of it. This page does not settle every question it raises. It asks what the thought experiment shows, what it does not, and how the Church’s own teaching fits.

The strongest objection comes first

The thought experiment assumes the very thing in dispute: that a person has a stable inner sex that can fail to match the body. In the transplant case, that is true by construction, because the brain really did come from another body. For a real person, whether the feeling of mismatch is fixed, and what will relieve it, is exactly the question. That matters most for children, whose sense of themselves is still forming, and the evidence on medical treatment for minors is genuinely thin.

• The evidence on minors is weak. The systematic reviews behind England’s Cass Review found 50 studies of puberty blockers (York review) and 53 of hormones, only one of them high quality, concluding “there is a lack of high-quality research” (York review). The same reviews found blockers do suppress puberty, with some loss of bone density, and that hormone studies suggested mental health may improve during treatment, though the evidence is weak. A third York review, of psychosocial support, found only ten studies, most of low quality, so it could not show those approaches work either (York review).
• The law has followed that caution. In June 2025 the Supreme Court upheld Tennessee’s ban on gender transition treatments for minors, holding that the law “is not subject to heightened scrutiny” and passes rational basis review. It was a ruling about the Constitution, not about medicine, and it left the policy question to voters and legislators (United States v. Skrmetti).

What the evidence shows for adults

For adults the picture is different, though still not perfect. A large meta-analysis of 27 studies of people who had gender-affirming surgery put regret at around 1 percent (Bustos and colleagues, 2021). Those studies are observational, often follow people from specialized clinics, and measure regret in different ways, so they should be read as low, not as settled. A Swedish study of 324 people found that after surgery they had “considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population,” and its authors concluded surgery “may not suffice as treatment,” while noting the design cannot show surgery caused those outcomes. The American Psychiatric Association states that “the term ‘transgender’ is not a psychiatric diagnosis”; the diagnosis is gender dysphoria, the distress some people feel, not the identity itself.

What the Church teaches

The Church’s own topic page says it “does not take a position on the causes” of transgender feelings. Its policy, in the General Handbook, is that “worthy individuals who do not pursue surgical, medical, or social transition away from their biological sex at birth may be baptized and confirmed,” that a male member “who does not pursue surgical, medical, or social transition” may hold the priesthood, and that temple ordinances are “received according to a person’s biological sex at birth” (General Handbook, chapter 38). It asks bishops and stake presidents to address individual circumstances “with sensitivity and Christlike love.”

Where the doctrine meets the thought experiment

Here is the part worth sitting with. The Church teaches the first half of the premise: that gender existed before the body. Elder Dallin H. Oaks said in 2018 that “we all lived as male or female spirits.” It teaches that every person existed before birth as a spirit with a gender, and that this premortal identity is eternal. That is very close to saying a person has an inner gender that came before the body.

Church policy then treats one more step as settled: that the spirit’s gender matches the body’s sex at birth. The Proclamation does not say this in so many words, though Church policy treats sex at birth as controlling for baptism, priesthood and temple ordinances, and Church leaders read the doctrine as supporting that. Nothing in the doctrine of premortal spirits, taken alone, requires it. A member who believes in gendered spirits has, in principle, already accepted that a person’s identity began before the body did. The question the thought experiment asks is why that identity could never end up in a body that does not match it, when bodies are born with every other kind of variation.

What is true on the other side

• The research on children is weak, and caution about irreversible treatment for minors is reasonable. England’s health service restricted puberty blockers after the Cass Review.
• Not everyone who feels distress about their body will feel it forever, especially in childhood.
• The Church does allow transgender members to attend and be baptized if they do not transition, and asks leaders to respond with love.

The common rebuttals

“Your body is your sex. Feelings do not change that.”

As biology, sex is real and this page does not deny it. But a church that teaches each person had a gendered spirit before birth has already said the body is not where identity begins. The disagreement is about which one should give way when they do not match, and for adults, the evidence on regret is low.

“What about the suicide statistics?”

Be careful with them. The most-cited figure, that 46% of transgender and nonbinary youth seriously considered attempting suicide in a year, comes from the Trevor Project’s 2024 survey, which recruited through targeted social media ads. Its rates were close to those in a national CDC survey, which suggests real distress, but it is not a population estimate, and it measures thoughts, not deaths.

What this means

The Church already believes each person is a spirit with a gender that came before the body. The thought experiment only asks what follows if the two ever do not match.