Gender Dysphoria-Pikuach Nefesh Or Not

Thanks for your time. I am wondering if pikuach nefesh can be applied in this scenario below: A child grows up with severe gender dysphoria from age 4 as long as they can remember. Throughout preteen & puberty it gets to the point of attempted suicide. Severe depression, unable to be functional socially, unable to live normally. Thus begins years of investigation at hospital, get transexual medical diagnosis & begins treatment (surgery, hormones). After that, all anxiety is gone, no more suicidal thoughts or attempts, depression diagnosis is gone. It did save a life.

If that soul now matches the outside, and every discomfort is cured why is it not allowed, by which Torah verse? Science, shows it is biological and not a choice, thus this does happen despite growing up in frum families. Rambam's commentary to why men are not allowed to dress in women's clothing & vice versa is due to an idolatry connection of worshiping sun & moon. That doesn't have anything to do with trans medical dysphoria diagnosis cases. It is more like intersex medical condition. In risk of breaking the commandment of Leviticus of homosexuality, could they not live celibate? Is it not better to live celibate trans compared to dead?

Can it according to halacha thus, be allowed and seen as a case of pikuach nefesh? Why not? Michal was allowed to wear tefillin because our sages say she had a male soul, if she lived today and suffered the same, would she not have been permitted to transition for example? How come she was permitted to do the male mitzvot and there is reference to reincarnation in different gender body if it's not allowed today? Would not trans people’s mitzvot in orthodox way according to their gender they are living as complete with their soul bring Tikkun Olam faster, compared to them living atheist? Deeply thankful for your time, Rabbi. Best regards, Chaim.

Thank you for your question.

This website focuses on providing practical halachic guidance for real life situations for people seeking help. It is not intended to address hypothetical questions.

That being said, in the case you described, for it to be considered pikuach nefesh, it could only be decided on an individual basis by a Rav, together with a medical expert.

I would also like to bring to your attention Rashi on the pasuk you mentioned regarding not wearing clothing of the opposite gender. Rashi explains that this prohibition is in order to keep the two genders separate and to prevent immorality.

This is the quote of Rashi;

(ה) לא יהיה כלי גבר על אשה - שתהא דומה לאיש כדי שתלך בין האנשים, שאין זו אלא לשם ניאוף: 

 A man’s garment shall not be on a woman, explains Rashi, that a women should not make herself resemble herself like a man in order to mix with men, for this is done only for the purpose of immorality. 

Wishing you all the best.

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