Understanding Gender Dysphoria, page 16
A person can also record times when they find themselves influencing gender dysphoria. They could write, “I feel better about my gender identity when I spend time with God. When I pray, it helps.” Another person might say, “It has helped to serve other people—to do short-term missions and other things like that. I think I get a glimpse of a bigger picture.”
An illustration may help with mapping. A person who experiences gender dysphoria can be invited to imagine his or her computer screen or cell phone screen and the small icons that are present on the screen. These icons are small when they are minimized at the bottom or side of the screen, but they are always there. They can be double-clicked and an icon’s application, file or folder will occupy the entire screen. The size of the icon, or how it reacts on the screen, is up to the person. The person can then be invited to think of their experiences of gender dysphoria as an “icon on the computer screen.”4 What they can begin to track are the times and experiences in which the icon of their gender dysphoria is essentially “double-clicked”—the experiences that make their gender dysphoria larger, so that it occupies the entire screen. It may also be helpful to journal events, experiences, thoughts and so on that seem to keep the icon of gender dysphoria smaller on the screen. This essentially means that the person’s experience of gender dysphoria is more manageable.
Figure 6.2. Monitoring gender incongruence
Taken further, if there are other icons on the screen—that is, other icons that represent parts of the person—these can also be explored in a journal or in discussions with a counselor. If the person has some success minimizing the icon called “gender dysphoria” (that is, not focusing on it exclusively), could they then see other icons that represent parts of themselves, which might allow them to maximize the other icons of interest?
Write about when you might maximize/blow up the “gender dysphoria icon.”
What is it like for you when your gender dysphoria is “double-clicked” and takes up the entire “screen” of your life?
Write about when you might minimize/reduce the “gender dysphoria icon.”
What is it like for you when your gender dysphoria is “minimized” and you are able to see the other “icons” on the “screen” of your life?5
This kind of exercise may be helpful to some people who experience gender identity conflicts, particularly those for whom their dysphoria ebbs and flows. Those who may not find it as helpful are those for whom the experiences of gender dysphoria do not respond to any kind of discernible pattern, in which case the minimizing and maximizing can be more confusing and frustrating.
Another exercise some people find helpful is to interview their concern. This involves identifying and externalizing the conflict they experience in their gender identity and talking to it as though it were a person who could share its thoughts and experiences. A person could ask the following questions in an interview of his or her gender identity concerns: In what areas of my life have you been causing me difficulties? In what ways have you affected my relationship with God? In what areas do I seem to get the best of you?
It may also be helpful to ask the person to draw their gender identity concerns, particularly how they see these concerns during an interview. Are they having a quiet discussion in a coffee shop? Or is this more like an interrogation at police headquarters? Those two images alone would communicate volumes about how the person experiences his or her gender identity conflicts.
Attributional Search Regarding Gender Identity
In addition to mapping gender identity concerns, it can be helpful to reflect with a person on gender identity and meaning making. This is referred to as “attributional search” or joining a person on an attributional search regarding gender identity. The central question associated with attributional search is: How does the person make sense of his or her gender incongruence? This is more a question of meaning making. I often illustrate this as a person asking the question about what all of this means. For example, in chapter two I introduced three different explanatory frameworks: integrity, disability and diversity frameworks. In terms of meaning making, an integrity framework might be reflected in a person who experiences gender incongruence as a concern because he or she is a Christian who views the incongruence as a reflection of a fallen world.
A disability framework might share this perspective—that the disability is what one may find from time to time in a fallen world. It is essentially a nonmoral reality in a world that is touched in so many different ways by sin. It is not the person who has sinned—anymore than we would think of the person who has any other medical or psychiatric condition as having sinned in terms of being personally responsible for the phenomenon.
Finally, when we look at the diversity framework, we can make a distinction between the strong and weak forms of the framework. Recall that the strong form may be voiced by some transgender advocates who wish to deconstruct sex and gender. The weak form is primarily interested in how to address questions of identity and community among those who experience gender dysphoria. In my view, one of the overlooked benefits to the weak form of the diversity framework is that it provides an affirmation of identity and community, two important considerations for anyone who is navigating gender identity concerns.
Competing Messages
The transgender community is rather unique. In some regards it is part of the gay community. The popular string of identity labels is lesbian, gay, bisexual and transgender (LGBT). However, persons who identify as transgender often report some point of tension with the gay community, too, as reactions to actual transgender persons vary widely.
Generally speaking, however, the transgender community sends a very affirming message to another person who is navigating gender identity issues. I refer to these messages as cultural scripts. A script is a cultural expectation for behavior and meaning making. In most settings, there is a cultural expectation to behave a certain way, for example, as with a congregation listening to a pastor deliver a sermon. There is a cultural expectation for an audience listening to a speaker at a TED Talk. These cultural expectations are scripts. From a narrative perspective, a script is essentially a storyline that can shape behavior but also provides messages imbued with meaning and purpose. I suggested in an earlier work that there is something like a gay script for people who experience same-sex attractions. A gay script contains expectations for both behavior and meaning making. Something akin to that can be identified in discussions about gender identity too.
Storylines from the transgender community. There is a kind of script from the transgender community (what I will refer to as a “TG script”) that helps people make sense of themselves and locate themselves in a broader transgender community. How does that script read?
Gender dysphoria reflects a naturally occurring difference among types of people (transgender rather than cisgender).
Your gender dysphoria as gender incongruence suggests who you are (“who I am”) rather than how you are (“how I am”).
Gender dysphoria points to a community of others who experience a similar phenomenon (“I am part of the transgender community”).
Your gender incongruence points to something at the core of who you are, something that is central to your identity.
The general message picked up as a TG script is that the gender incongruence is important data that tells the person something about identity. The dysphoria may signal who the person “is”—that is, “who I am.” A person can take that in a number of directions, but the idea is that “I was born in the wrong body; the person I am is inside of me, and I need to express that.” The person has a sense of identity (who I am; I am transgender) and a sense of community: “I am part of the transgender community,” which could mean different things to different people.
If we were to visually illustrate this script, we would see that the diversity framework is given considerable weight relative to the integrity framework and the disability framework.
Figure 6.3. The TG script
A person often receives the message that they are born this way. As I discussed in chapter three, scientists do not know what causes gender incongruence. It is a rare phenomenon and one in which we have little by way of research to inform the discussion. A popular theory is the brain-sex theory, but there are gaps in our understanding of that theory too. There is likely no one causal path that accounts for the many and varied experiences that fall under the transgender umbrella as well as what we see as a continuum of gender incongruence, even among those for whom incongruence is the more salient experience.
Another part of the TG script is that the gender incongruence forms the core of that person’s identity. It is central to that person’s sense of self. Again, that could take the form of “being transgender” as the identity in and of itself, or it could signal who they are if they were to express themselves as the other sex. This view lends itself to expression of one’s true self in behavior, attire and role.
If we try to illustrate the TG script in a Venn diagram, we see that the script relies primarily (and, in many cases, almost exclusively) on the diversity framework. It answers important questions about identity and community. The integrity framework is also in play for those who see an essential maleness and femaleness as part of the discussion but believe that the brain-sex theory explains how what is essential is in a cross-gender-identified brain that is in contrast with anatomy. The disability framework may also be a part of the discussion insofar as the person who experiences gender dysphoria finds the diagnosis of Gender Dysphoria helpful to them by providing them with the language and conceptualization to explain what has been inexplicable to them.
Storylines from the local Christian community. In contrast to the transgender script, the local Christian community also extends a script to those who experience gender incongruence. The backdrop to the messages frequently sent from the Christian community is fairly rigid stereotypes about what it means to be male or female. These inform gender roles that are difficult for some people to live in, particularly if a person does not have stereotypical presentation or interests.
That cultural backdrop informs a message with expectations for those who experience gender incongruence. The messages vary somewhat from person to person, but the general message has included things like:
This is a spiritual matter; this is sinful.
Fulfillment comes from adopting a traditional gender role that corresponds with your biological sex.
The failure to find worth and purpose and meaning in traditional gender roles and expressions is a mark of willful disobedience.
Cross-gender behaviors and roles are unacceptable as they undermine the truth about who you have been made to be.
There are two primary messages from the local church regarding gender dysphoria. One has to do with gender dysphoria as sin, and in many cases this has been conveyed as though the gender dysphoria itself were a sign of willful disobedience. The second message from the evangelical Christian community is often to find worth and purpose and meaning in traditional gender roles, and that failure to do so is sin. As a person seeks ways to navigate their gender incongruence and perhaps manage their dysphoria in the least invasive ways possible, they see few options as acceptable to fellow Christians, as those “least invasive” approaches may be viewed as going against the created order and deemed sinful.
Ultimately, these messages communicate shame to the person navigating gender identity concerns. Shame is the psychological and emotional experience of believing yourself to be inadequate in ways that lead you to reject yourself. It hides itself from others on the assumption that if others knew this about the person, they too would reject them.
If we illustrate the conservative religious script in a Venn diagram, we see that the integrity framework is the prominent lens through which gender dysphoria is seen. The disability framework may be a consideration insofar as conservative religious people can conceptualize gender dysphoria as a mental health concern that may reflect a unique way in which the fall has touched the person, but this script does not draw on the diversity framework, and may even be suspicious that the disability framework ultimately relies on assumptions from the diversity framework.
Figure 6.4. The conservative religious script
A study conducted of transgender Christians asked about pain they experienced from their faith community as they navigated gender identity issues in their lives. One participant wrote: “The negative messages from the Church did irreparable harm to my self-esteem that took most of my life to recover from.”6 Speaking to the isolation that often accompanies shame, another participant simply wrote: “It kept me hidden for years.”7
Other possible storylines. As Christians consider a response to the person who is navigating gender identity concerns, it may be helpful to introduce other possible storylines. I am thinking here of storylines that contrast with the TG script and the script from the local conservative community of faith.
Experiences of gender dysphoria are part of my reality (that is, “how I am”).
I did not choose to experience gender dysphoria or gender incongruence, and I honestly do not know the cause.
Perhaps being transgender is part of my identity; however, I am a complex person and am more than gender dysphoric.
I do not know how I came to experience gender dysphoria, but I can consider what it means to me today and where I go from here.
There are probably a dozen different directions for any experience of gender dysphoria, and I plan to consider many of them, and may select some of them, considering the least invasive steps when possible.
Again, this list of possible other storylines is not exhaustive. What it does is “thicken the plot” of the existing TG narrative as well as the storyline from the local community of faith.
Figure 6.5. Other possible storylines
How do these other possible storylines look with reference to the integrative framework that seeks the best from the integrity, disability and diversity frameworks? It’s unclear whether there is one way to best illustrate this. I imagine this could vary from setting to setting and individual to individual as it is tailored to what motivates each person’s cross-gender identification as well as what it means to manage the dysphoria. These are the lenses through which we look, and we can be thoughtful about these ratios—what we need to consider—and how these considerations will be applied.
The Venn diagram changes when we consider other possible storylines. I am not suggesting that the integrity framework is exactly equal in weight and application to the diversity framework or the disability framework, but they will overlap much more here. Perhaps different people with different presentations will draw from us different ratios of consideration in ministry. The disability framework can help the church foster greater compassion and empathy for the person navigating gender dysphoria. The integrity framework is still an important consideration for the Christian, and it may even inform meaning-making structures that have not been fully identified but may be related to the diversity framework and are absent in the disability framework.
A Multi-Tier Distinction
One exercise that some people find helpful is to discuss a multi-tier distinction in language and meaning. In the multi-tier model, one way to describe a person’s experience is to simply say, “I am a person who experiences gender incongruence.” This is perhaps the most descriptive way to communicate part of a person’s experience.
A second way to describe one’s experience is to say, “I am someone who is transgender” or “I am a transgender person.” This is the use of transgender as an adjective. It describes how a person is (in contrast to identity as such).
A third approach to language and meaning is to say, “I am transgender.” This use of language communicates identity; it is the use of the word transgender as identity, that is, who a person is.
The last approach to language and meaning in this multi-tier approach is to say, “I am transgender, which I define as. . . .” This is the use of transgender with an added personal definition to communicate more accurately who you are and how you understand that identity and what weight or significance it is given at the same time.
Table 6.1. A Multi-Tier Distinction in Language and Meaning
Language Meaning
Tier 1 “I am a person who experiences gender dysphoria.” The most descriptive way to convey part of your experience.
Tier 2 “I am someone who is transgender” or “I am a transgender person.” Use of transgender as an adjective; describing how you are.
Tier 3 “I am transgender.” Use of transgender as identity. This is who you are.
Tier 4 “I am transgender, which I define as . . .” Use of transgender and a personal definition to more accurately define who and how you are at the same time.
It is also possible that identity labels are used based on situation. Some transgender persons will identify as such in front of a class to teach them what the term means, how they experience their gender identity and how other expressions might fit under the transgender umbrella. However, that same person might not identify as transgender in any other setting.
