Understanding Gender Dysphoria, page 19
There are two sides to every story. I do not know all of the details about Mike’s experience and how it was or should have been handled, but it raises questions we all have to grapple with in terms of how to respond to gender identity concerns in the context of a faith community.
I shared in chapter five that an estimated 50 percent of people who meet criteria for and receive services for Gender Dysphoria drop out, likely due to frustration with the process or possibly other reasons. The paths that are before them include (1) resolving their Gender Dysphoria in accordance with their biological sex; (2) engaging in cross-dressing behavior intermittently to manage dysphoria; or (3) adopt the cross-gender role, which may or may not include hormonal treatment and sex-reassignment surgery.10
In each case, as a person navigates gender incongruence in adulthood, whether they resolve their dysphoria in accordance with their birth sex, engage in cross-dressing behavior intermittently, or adopt a cross-gender role, they will have common concerns and areas of need moving forward. Each will need social support, assistance with and from family members, help in exploring their personal faith, aid in finding a corporate faith community, assistance in learning and applying helpful coping activities, and so much more.
Table 7.1. Pathways in Adulthood and Issues with Support
Path 1
Path 2
Path 3
Path 4
Unresolved outcome. Resolve in accordance with their birth sex. Engage in cross-dressing behavior and role intermittently (often privately or in distant venues/locales). Adopt cross-gender role and identity, which may include hormonal treatment and sex-reassignment surgery.
Social support, family relationships, personal faith, corporate faith community, healthy coping activities, address any co-occurring mental health issues, and so on.
I imagine some readers will be thinking to themselves, I just want the person to choose the right path. I can understand that thought. However, paths are chosen with reference to a number of factors, not in isolation. People choose paths in the context of the community they have been able to form around themselves. If you want a person to choose a path that seems more redemptive, you will want to be part of a redemptive community that facilitates that kind of decision making for every person who is a member. Recall, though, that redemption frequently takes the form of making meaning out of suffering. With gender dysphoria, there is meaning to be found in one’s gender identity and in the state of tension experienced in gender dysphoria.
A Redemptive Community
I opened the section on “Care and Compassion in the Body of Christ” with a story about a young person who left a youth group despite the youth pastor’s attempts to demonstrate hospitality. I want to acknowledge that the story about the youth pastor raises additional questions about what it means to be a redemptive community, particularly the corporate/communal aspect of attempts at inclusion. When teens in a youth group can drive a young person away from a church that is intentional about reaching out to those on the margins, it has to at least raise the question of whether youth are able to understand the nuanced messages of inclusivity and tolerance while also holding biblical perspectives on complex matters.
I see two common impulses that the church may need to re-evaluate. One impulse is to convey the integrity framework to the exclusion of the potential benefits seen in the disability or diversity frameworks. Such a church would be of little relevance to people within their own community who are navigating gender identity concerns, nor would they have much of a way of communicating and understanding concerns about identity and community that are increasingly relevant to the broader culture. I imagine the thinking would be something along these lines: “The best witness to the culture is orthodoxy around a biblical understanding of sex and gender.” However, as I have suggested, too often Christians can fall into more rigid stereotypes about gender that reflect more cultural concerns than biblical concerns, and people can overcorrect toward stereotypes out of concern for the deconstruction of sex/gender norms. In my view, such a church may struggle with compassion and empathy and provide little by way of a sense of identity and care to those within their own community who may be navigating gender identity concerns, let alone be able to understand the experiences and interests of those who are in their local community. Beyond that, we are going to see increasing numbers of people within the culture who are not likely to understand the foundations to the integrity framework and who may experience the church as having no regard for fundamental interests (identity/community) that are best met through the diversity framework.
The other impulse is to convey tolerance and inclusivity—to draw exclusively on the diversity framework to the neglect of the integrity and disability frameworks. We can imagine a church that is so focused on cultural relevance it loses sight of the ways in which some are pushing hard to deconstruct sex and gender norms. Churches with this emphasis face the challenge of becoming a welcoming place at the risk of conveying to youth who are on their own developmental journey that there is little by way of relevance to a Christian view of sex and gender and what it means to be a part of a Christian community.
Some readers will likely be thinking: But that’s exactly what we want to teach—all are welcome! My point is that the nuance we are discussing requires a fairly sophisticated understanding of complex issues, and the trade-off may lead many young Christians to lose any sense of biblical absolutes when little can be said about things like sex differences and gender. We need good examples of what a church looks like that models and lives out a balance of welcoming and ministry with clear biblical testimony.
These two inclinations I have described may represent two different ways in which churches are missional. The first one we do not tend to think about as missional, but I believe a case can be made that such a church is attempting to be inwardly missional with its focus on clear teachings for those who are within the community. This kind of church places greater emphasis on the integrity framework. It is a church that sees as its mission the communication of a faithful, biblical witness about sexuality and gender to those who reside within. Such a church may risk not being as hospitable to those on the outside (not being outwardly directed, which is a more common understanding of a missional church) because the emphasis is on conveying biblical truths to those on the inside.
The other way of being missional is what I think of as outwardly missional, by which I mean the focus is on being missional to the local, broader community in the area surrounding the church itself. The emphasis is on reaching out, inviting in and creating a sense of belonging, as I indicated above. People are frequently drawn to this model because so many apparent obstacles to being a part of a church are removed. The risk here is that in making every effort to be inclusive, people in the church may actually experience some confusion about identifying biblical standards and being a biblical witness. This is especially challenging in the example I cited above in which we are counting on young Christians who are on their own journey to grapple with a rather complex and nuanced understanding of sex and gender that may be hard to fully understand.
Also, as we move forward in creating redemptive communities for all Christians, including those who are navigating gender identity concerns, we have to acknowledge the sociocultural context in which we live and in which the person is making these decisions. The prevailing view within the mental health field is to address the dysphoria through cross-gender identification and expression, supported in the context of therapy, and with the possibility of additional steps to facilitate a transition. That decision is being made in a sociocultural context in which the cultural trajectory is toward the absence of (or deconstruction of) gender norms and distinctives. The Christian community can uphold differences in biological sex and gender norms but will want to do so while also resisting rigid gender stereotyping that frequently functions as a knee-jerk response to this cultural momentum.
Based on my consultations with many churches throughout the United States, I do not think there is one blueprint that every church can follow to be that kind of redemptive community. I encourage churches that are either inwardly or outwardly missional to at least recognize the strengths and also the potential shortcomings to one or the other approach, as they may benefit from offsetting some of the weaknesses in their approach with more intentional steps in light of our overarching discussion. Toward that end, there are some concepts that may be helpful to the Christian community that wants to create redemptive space. These are clarity, relational ethic, humility, climate, sanctification and social support.
Clarity. The issue of clarity has to do with thoughtful reflection on a biblical perspective of concepts like sex and gender. What do we teach and affirm about sex and gender? As the church wrestles with how to provide appropriate care to those in our communities who are navigating gender identity concerns, we would be wise to remember that good theology and sensitive pastoral care must be reflected in the doctrine, policies, and pastoral applications of the local church. As we sort out good scholarship in this area and how to communicate it and apply it in ministry and pastoral care, we do well to keep in view that the very nature of sex and gender is being deconstructed by some people in these discussions in ways that even many transgender persons would be uncomfortable with.
Relational ethic. As I noted earlier, there is reason to believe that the next generation of Christians—even in cases in which they retain a traditional Christian sexual ethic—places greater emphasis on sustained relationships with those with whom they disagree. Because churches are comprised of Christians from multiple generations, there may at times be tensions between those who value a relational ethic and those who do not. In my view, thoughtful teaching on sexuality and gender will have to take that into consideration as we consider how to value others, form relationships in a diverse and pluralistic culture, and sustain those relationships while living faithfully before God.
Humility. The church could demonstrate greater humility about what we know and do not know about the topic of gender dysphoria. Even as the Christian community offers clarity in articulating a biblical witness about important constructs in this area, we can still be humble stewards of what we know and what we do not know. It would be helpful if scientists and others who are stakeholders in these discussions were also demonstrating humility, but we can do what we can within our own communities to consider the current limitations to our understanding in this area at this time.
Pastors or other Christian leaders can also demonstrate humility by being a resource to a multidisciplinary treatment team. I would not want a pastor to reach the conclusion that reading this book now qualifies them to treat someone who is gender dysphoric. As I have shared, if a person’s gender dysphoria reaches a level at which that person receives the diagnosis of Gender Dysphoria, he or she may receive input from various mental health professionals, some with expertise in gender identity issues, as well as medical personnel, such as endocrinologists. Humility can be seen in being a part of a larger team with different perspectives but with a common goal of serving the best interest of the person who is requesting help.
Climate. I return to the question of rigid gender stereotypes. Many men’s ministries focus on themes of biblical manhood but end up looking too much like cultural associations with masculinity that are likely to be very difficult for the person struggling with gender identity concerns. Similarly, women’s ministries can focus on a kind of cultural femininity that is portrayed as the biblical expression of being a woman. In other words, too often, in response to assertions that appear to seek to deconstruct sex and gender, Christians respond not with a dispassionate reflection on the view but with a knee-jerk reaction that swings the pole in the other direction.
There are other practical steps that could improve climate. One female-to-male transgender Christian shared, “One thing I have learned is that no matter how compassionate the people and pastor are, if there isn’t a family bathroom, things get complicated fast and you don’t go back.” These may seem like small things, but they are practical steps that can have a big impact.
Sanctification. Christians walk out their faith in a relationship with Christ and as a result of the Holy Spirit in a way that is meant to move them toward greater Christlikeness. This is sanctification, or being set apart for God’s purposes. It refers to being made holy. The way I tend to think about sanctification is growing in spiritual maturity. Spiritual maturity informs decision making. In an atmosphere of grace, can the Christian community invite one another to greater spiritual maturity to inform important decisions that are often down the road? This is a long process that requires from all of us a lot of space, grace and patience. It is important to provide a kind of sustained presence (out of our own developing spiritual maturity, which will certainly be challenged in this complex arena) while someone is navigating gender identity concerns, meeting with experts in gender identity issues and making key decisions about how best to manage their experiences of gender dysphoria.
Social support. With the other things in place—clarity, humility, improved climate and an emphasis on personal sanctification—we are now in a position to offer the kind of social support that is so needed today. In an atmosphere of grace, can we come alongside people who are navigating this difficult terrain? What I envision here is a small community of fellow believers who are willing to pray for and with the person navigating this terrain, as well as to identify and follow through on practical needs that can be met in the life of the person who is gender dysphoric.
Concluding Thoughts
I opened this chapter with several examples at Christian institutions that represent the conflicts the Christian community is heading toward. On matters of sex and gender, and in our increasingly diverse and pluralistic culture, a traditional Christian perspective on these matters will continue to be challenged in many settings and for a range of reasons. We will be witness to legal challenges to the way in which Christians have historically related to these topics, and that may put many Christians in greater conflict with the broader culture. Based on the consultations I have provided over the years, these will be issues at Christian campgrounds, faith-based institutions of higher education, churches, not-for-profit entities that provide humanitarian relief worldwide, and many other institutions. This will be in the area of employee hiring, health care provisions, lodging and facilities, and much more.
The Christian community has several ongoing responsibilities moving forward. These have to do with thoughtful scholarship in this area, which includes:
critical analysis and engagement with the work being done in the area of sex and gender
thoughtful engagement with best practices in clinical service provision to those who have been diagnosed with Gender Dysphoria
listening to the experiences of faithful believers who are navigating gender identity conflicts in their own lives
identifying the best way to be a faithful witness to a broader culture in which norms regarding sex and gender are eroding
engaging with “convicted civility” those who are actively deconstructing norms related to both sex and gender
identifying and implementing best practices as the body of Christ and, in particular, the local church in relation to unchurched and dechurched transgender persons
providing sensitive pastoral care to those in the Body of Christ who are navigating this terrain
This book is one modest step in this direction. I do not think Christians will speak with one voice on the topics of gender dysphoria and gender variant presentations. As I shared previously, the topic of gender dysphoria is not the same as homosexuality. The question of applying a Christian sexual ethic to same-sex behavior appears clearer to many Christians—although this is also being disputed in many settings, particularly mainline denominations and among younger Christians.
I have made the case that evangelical Christians may benefit from an integrated framework that can provide a way to respond to the different challenges the Christian community is facing. That integrated framework is based on the three existing lenses through which people often approach the topic of gender identity and gender dysphoria: the integrity framework, the disability framework and the diversity framework. Evangelical Christians are understandably drawn first and foremost to the integrity framework with its emphasis on the sacredness and essential elements of maleness and femaleness. As I have pointed out, evangelicals will be cautious about the disability framework and likely quite critical of the diversity framework. However, in my view, each of the three frameworks may provide important considerations that, taken together, inform a thoughtful, reasoned Christian response to gender identity and gender dysphoria. As we look at the broader cultural discussions and the challenges facing Christian institutions, it is important to realize how speaking solely with reference to the integrity framework will increasingly isolate evangelicals from a cultural context in which the diversity framework is emerging as most salient and is frequently a source of guidance within the mental health professions, which draw principally on the diversity framework and, to a lesser extent, the disability framework.
The way forward is to clearly identify which framework is the point of reference to those with whom you are in dialogue. Among those who advance the diversity framework, keep in mind the differences between strong forms of that framework (with the goal of deconstructing both sex and gender norms) and weak forms (that are primarily concerned with identity and community). As the church learns from each of the three frameworks, we begin to have an integrated framework that informs both ministry settings and Christian engagement with the broader culture. Christians can benefit from valuing and speaking into the sacredness found in the integrity framework, the compassion we witness in the disability framework, and the identity and community considerations we see in the diversity framework. No one framework in isolation will provide a sufficient response or a comprehensive Christian model of pastoral care or cultural engagement.
