The person I’m writing about, who is very close to me, has read this and given permission to publish it.

I’ll call him Guy. Guy has the body of a 20-year-old woman. He knows himself to be a 20-year-old man.

We talk weekly. It’s a great privilege. Guy and I are amazingly open with each other. I don’t doubt his claim of being male. It’s easier for me to believe that Guy is male than it is for him to believe my claim that my Self has no gender, it being pure consciousness.

I support Guy in every way. He knows how much I love him, care about him, and want what is best for him.

Guy is contemplating surgical modification to align his bodily form with his gender. Presently he seems more committed to breast removal than to the other possibilities. When I asked why, he mentioned the false message about his gender that his breasts convey to others. There is also the discomfort that wearing a binder produces when he conceals his breasts.

I think he also indicated that they just don’t feel right. Shouldn’t be there. But I may have added that myself.

Now, here is my problem. My problem, not his. Even though I support Guy 100% and don’t want to make his path more difficult, when I think of the surgical transformations that may lie ahead for him, especially the genital surgeries where so much can go wrong, I silently shriek inside.

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I’ve told him this. He’s very understanding. When I told a close friend about this inner shriek, she said she responded in the same way. A desire to support but an inner scream.

Easy for me. I’m not living with the dysphoria and the social situations that Guy deals with.

But I’ve found myself trying to dig deeper to find an alternative path. I asked myself what is the actual situation confronting Guy. Guy is a man in a woman’s body. He thinks his breasts are a lie. But it seems to me that removing them can also be construed as a lie. It hides the truth that he is a man in a woman’s body.

Will surgery give him a man’s body? I think it won’t. It will give him a surgically modified woman’s body. We aren’t made with interchangeable parts. Humans don’t come packaged that way. Maybe people like me will have to die off and those who see us with interchangeable parts will be the new storytellers.

Why, I wonder, can’t the truth, the actuality, the way things are, be OK? A man in a woman’s body. A male mind in a woman’s body. This is the reality of the situation. Why can’t what is actually the case be how we appreciate things? I lean toward believing that surgery in this case falls under the doctrine, “Just because you can do something doesn’t mean you should do it.”

Next, I wondered about love for a man in a woman’s body who decides to be who he is and not what he surgically might be. It seems to me any combination of minds and bodies can be right for two people. Attraction will be much more complicated than the male and female variables allow for. You love who you love.

I also wondered why brainwashing a mind to conform to a body is so powerfully condemned and considered morally wrong but hacking a body to conform to a mind gets a pass.

I’m aware that some people reject the male-female dichotomy. Others, nonbinary folks, assert that for mind and/or body, the dichotomy does not apply to them. But these options don’t seem to apply in Guy’s case. He has a male mind, and wants his female body transformed into a male body.

He wants his body image and gender identity to conform, the messages his body and mind send to others to be consistently singular.

I resist his desire because I fear for his safety and dream of him being able to be what he is without need of correction.

Is my resistance justifiable? Might not Guy turn the tables and ask, “Why can’t you go with what is? I am who I am, I want what I want. That’s what is real here. Your inner shriek is your problem. Not mine.”

Integrity requires my response be “Indeed.”

Richard S. Bogartz is professor emeritus of psychology at the University of Massachusetts Amherst.