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2. Is [the threat of ] a suicide attempt considered a situation
of piku’ach nefesh, allowing a physician to violate trans-
gressions in order to save the suicidal patient’s life?

3. Is a person who wants to injure himself, change his gender
from male to female and destroy his ability to reproduce,
which is a Divine gift, considered a shoteh [an imbecile]
and mentally ill?

With Heaven’s assistance we shall explain these matters:
The first topic: It’s important to realize that changing a male so
that he appears to be a female involves six Torah prohibitions: 1.
Castration; 2. “A man shall not wear women’s clothing”; 3. Inflicting
injury on oneself; 4. Nullification of the mitzvah of procreation; 5.
“You shall not approach any forbidden union”; 6. Emitting semen for
naught.

1. The Shulchan Aruch (Even Ha’ezer 5:1) writes, “It is for-
bidden to mutilate the reproductive organs, whether of a
human, or of a domesticated or wild animal, or of a bird,
whether these be kosher or non-kosher. Whoever carries
out castration is flogged for violating a Torah prohibition…
and even [further] castrating after castration receives lash-
es.”
This is learned from the passuk,“And [an animal whose
testicles have been] crushed or pounded or detached or
severed you shall not offer to Hashem, nor shall you do
this in your land.” (Vayikra 22: 24). This is a very serious
prohibition; the Torah penalizes a person who has himself
sterilized, forbidding him from entering G-d’s community
by marrying a Jewish daughter.
Thus writes the Sefer Hachinuch (Mitzvah 559):
“Among the reasons for this mitzvah – to distance a per-
son from damaging the reproductive organs under any
circumstances, as is known to be the practice of kings, who
sterilize males in order to appoint them as guards over

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