Understanding Gender Dysphoria, page 3
Also, I know many people who are navigating gender identity concerns who love Jesus and are desperately seeking to honor him. I think it would be a mistake to see these individuals as rebellious (as a group) or as projects. Some do identify as transgender or use other labels or ways of naming their reality, and I would like the church to provide a supportive environment for them as they navigate this difficult terrain.
Rather than reject the person facing such conflicts, the Christian community would do well to recognize the conflict and try to work with the person to find the least invasive ways to manage the gender identity concerns. I will return to this principle throughout the book, but the idea is that there are many ways in which a person who experiences gender identity concerns along a continuum might manage experiences of gender dysphoria. Just as the experiences reside along a continuum, so too do the possibilities for exploration of identity and management of what contributes to gender dysphoria.
Concluding Thoughts
Gender identity concerns remain one of the most complex and difficult to fully understand. We know so little about the etiology and best course of care, though there are strong proponents for different theories and approaches, and there is division among mental health professionals on some important points and between some mental health professionals and some members of the transgender community. We will discuss each of these issues in greater detail in subsequent chapters.
When the topic of treating gender dysphoric children is brought up, some professionals focus on resolving gender dysphoria to reach congruence with the child’s birth sex. This has been increasingly viewed with skepticism; vocal critics from the transgender community have expressed how this is not unlike conversion therapy for homosexuality. Also, once a child reaches late adolescence or adulthood, there are few large-scale studies of psychosocial interventions toward this end, and even less optimism for such a resolution once a person has reached adulthood. Perhaps as a result, the field has moved in the direction of support for those who wish to pursue cross-gender identification, with several models that either “wait and see” or facilitate such cross-gender identification through puberty suppression. Once a person reaches adulthood, consideration is then given to medical interventions to facilitate cross-gender identification, and these may include hormonal treatment and sex-reassignment surgery.
As we close this chapter, I want to point out that there has been one study published of male-to-female transgender Christians.15 It noted conflicts with gender identity and religious identity in terms of personal faith, God and the local church.16 Interestingly, some transgender Christians shared that their gender dysphoria led to a strengthening of their personal faith; others reported a past struggle with their faith, and still others left the organized religion with which they grew up. For some, the challenges they faced brought them closer to God, but others reported a strained relationship with God because of their gender dysphoria. Particularly common was past conflict with the local church community or the persons and leaders who represent these organizations. I will return to this study throughout this book, as some of the information shared in that context may inform our broader discussion.
It is unclear to me at this time whether there is any one outcome that is ultimately satisfying to everyone who has a stake in these discussions. It is such a rare condition that we have little good research from which to draw strong conclusions, and I have known people who felt gender dysphoria so strongly that they felt nothing less than their sanity and their life was at stake. They desperately sought a resolution to the dysphoria that caused them significant distress and impairment. This is not an argument that they should pursue the most invasive procedures, but we also acknowledge that we understand and empathize with that decision, as painful as it often is. Rather than reject the person facing such conflicts, the Christian community would do well to recognize the conflict and try to work with the person to find the least invasive ways to manage the dysphoria. Perhaps future programs of research will provide greater insight and clarity into an area that seems particularly difficult to navigate at this time. These include but are not limited to research on the types of resolutions sought by people with an eye for the developmental considerations associated with gender dysphoria in childhood, adolescence and adhulthood, how strength of gender dysphoria is related to various attempted resolutions, the role of personal values and religious faith commitments in seeking resolutions, and so on. There is an opportunity here to learn much more than we know at present, and we would do well to enter into the discussion with patience and humility as we balance multiple perspectives on how best to resolve what people often report to be an impossible situation.
2
A Christian Perspective on Gender Dysphoria
Introduction
A few years ago I was presenting on gender dysphoria to a large group of Christian leaders when a hand shot up in the back of the room. I asked the gentleman if he had a question. He did. Opening his Bible, he stood up and cleared his throat, creating a pause that heighted the expectations the audience had for what he might say. He then paraphrased 1 Corinthians 6:9-10, and asked, “What do you do with the Word of God, which clearly says ‘neither the effeminate . . . shall inherit the kingdom of God’?” This was a rhetorical question. He closed his Bible and sat down as if to say, “That covers it. We are done. The matter is closed.”
It is one of those difficult moments in public speaking. As the person conducting a workshop, it is tempting to use the platform to take on a person who takes a position intended to close down the discussion. However, I have never wanted to interact with an audience in that way. When I have made the mistake of using the stage toward that end, I have always regretted it. Also, in this case, he and I have in common a high regard for Scripture. I thanked him for his commitment to the Word of God. I appreciated that his reference point was Scripture as an important resource in any discussion about matters of life and faith and ministry. I fully intend for it to be a reference point for me too.
The question that arises is: In what ways does the Bible speak to this issue of gender dysphoria? I am not asking whether it has any relevance. I am an evangelical Christian who affirms that Scripture is a reliable guide for the believer. The Bible is “fully truthful in all its teachings.”1 It is, then, a “sure source of guidance”2 in matters of faith and life. I affirm that view of Scripture and hold it in high regard. It is precisely because Christians hold a high view of Scripture that we want to come to it with respect for what it addresses and how it informs our present concerns. That is certainly the case as we turn to the topic of gender dysphoria.
There is a need to balance between two hazards when we turn to the Bible to inform our discussion about gender dysphoria. The one hazard is to look to Scripture for answers it is not prepared to provide.3 The other hazard is to fail to critically reflect on the sociocultural context in which we live and make decisions about gender identity and dysphoria.
Let’s look at the first hazard. As I think about gender dysphoria as a condition diagnosed by mental health care professionals in the twenty-first century in the West, it is hard to know how to apply some of the biblical references to sex and gender.
In part because of the connections often made between the transgender community and the gay community (or lesbian, gay, bisexual and transgender [LGBT] community), people often ask, Is gender dysphoria like homosexuality? If the traditional Christian sexual ethic views same-sex behavior as a moral prohibition, does this prohibition extend to transgender issues and, if so, how? Put differently, should gender dysphoria be approached like a predisposition to behavior that falls in a category of moral evaluation in the way that Christians might discuss same-sex behavior? Is it like homosexuality in some important ways?4 The moral equivalent, then, would be a concern for cross-dressing activities and the potential desire for and use of hormonal treatment and sex-reassignment surgery, let alone questions of sexual intimacy and relationships.5
The second hazard is to fail to appreciate and therefore critically engage the sociocultural context in which we live and make decisions about gender identity and dysphoria. I have already discussed gender dysphoria as a mental health issue that is a diagnosable condition (Gender Dysphoria). For some Christians, that will place the topic squarely in a frame away from sexual morality per se and into the realm of how mental health professionals think about these concerns. However, we can also recognize that Christians might not view mental health issues and moral issues in the same way the broader culture views these issues.6 It might not be enough to just point to a diagnostic manual for confirmation that an issue is strictly a mental health concern and that it has nothing to do with moral and ethical considerations.
Where does that leave us? There is a tremendous opportunity—as we keep these two hazards in view—to offer a thoughtful, informed reflection on the ways in which Scripture enters into our discussion. What I want to do first is look at some of the common biblical passages that are cited with reference to this topic. Then I will move the discussion toward the broader themes where we can have more confidence in what God is saying to us about gender dysphoria. For this we will look at creation, the fall, redemption and glorification.
Frequently Cited Biblical Passages
Let me go back to the gentleman who stood up and paraphrased 1 Corinthians 6:9-10. Remember that he said, “neither the effeminate . . . shall inherit the kingdom of God.” As I shared with him and others present, I read that passage as being about the man who is passive in a same-sex sexual encounter and not specifically speaking to the topic of gender dysphoria or transgender issues.7 The primary moral concern is with same-sex behavior, and while cross-dressing may have played a role in that context, it is less clear to me that specific dress and appearance was the primary concern or the moral prohibition having to do with sexual activity.
It is possible that both are a concern, and my overall thought is that this gentleman brings up a good point. What does Scripture say? How do we read Scripture and avoid the two hazards I described above?
More so referenced than the 1 Corinthians passage is a passage from Deuteronomy. It is not uncommon in discussions about gender dysphoria and transgender issues for interested parties to point to Deuteronomy 23:1, which says, “No one who has been emasculated by crushing or cutting may enter the assembly of the LORD.” Likewise, Deuteronomy 22:5 reads, “A woman must not wear men’s clothing, nor a man wear women’s clothing, for the LORD your God detests anyone who does this.”
As I shared earlier, an argument can be made that there is an integrity associated with our maleness and femaleness, something essential and sacred that is ultimately bumped up against in the experience of transsexuality. At the same time, thoughtful Christians have reflected on these same passages and the scope of Scripture and encouraged us to be cautious about making too strong a declaration. For example, in their discussion of these and other biblical passages, the Evangelical Alliance Policy Commission notes that Deuteronomy 23:1 and Deuteronomy 22:5 are commonly referenced by Christians who are looking for a biblical perspective on transgender concerns. However, they are concerned that such an appeal often reflects “simplistic moral readings of the Bible that treat it as a sort of ethical cookbook.”8
The EAPC notes “a clear progression in Scripture which culminates in the implied acceptance of the genitally-mutilated by Jesus in Matt 19:12, and the conversion, baptism and acceptance into the Kingdom of God of the Ethiopian eunuch in Acts 8:26-39.”9 In the context we have (answering a question put to him about divorce), the Matthew 19 passage, insofar as it references those who “choose to live like eunuchs,” almost certainly refers to those who choose not to marry (rather than suggesting they were castrating themselves).10
These passages appear to reflect a concern that the ancient Israelites not participate in rituals that were practiced by the Canaanites:
It is likely that, in keeping with God’s covenantal concern to preserve the holiness of his character reflected within the covenant community of Israel, and to avoid anything which threatened Israel’s existence and harmony, the cross-dressing prohibition was introduced to prevent involvement on the part of the Israelites in contemporary Canaanite religious rituals of the day, which involved swapping of sex roles and cross-dressing.11
The EAPC offers a further sobering reflection tied to the meaning of the words in Deuteronomy 23:1: “Nevertheless, the strength of the Hebrew word translated as ‘abomination’ or ‘detests’ indicates that in the sight of God such practices were fundamentally incompatible with the identity of God’s people.”12 Other passages, such as Deuteronomy 22:5, were likely “intended to signify a reaffirmation of divine intent, in that the sanctity of the distinctiveness between the two created sexes is to be maintained.”13
The passages from Deuteronomy are certainly important, and we can see different ways in which we might understand them. We can also see that even where we might demonstrate some restraint and caution, we see a reaffirmation of gendered distinctiveness that Christians would want to understand and support.
In addition to these passages from Deuteronomy, the other passages that we need to discuss have to do with eunuchs. The EAPC mentions them in conjunction with the passages from Deuteronomy, so let me come back to how we might best understand eunuchs. In Acts 8:26-40, we read about Phillip and the Ethiopian Eunuch:
Now an angel of the Lord said to Philip, “Go south to the road—the desert road—that goes down from Jerusalem to Gaza.” So he started out, and on his way he met an Ethiopian eunuch, an important official in charge of all the treasury of the Kandake (which means “queen of the Ethiopians”). This man had gone to Jerusalem to worship, and on his way home was sitting in his chariot reading the Book of Isaiah the prophet. The Spirit told Philip, “Go to that chariot and stay near it.”
Then Philip ran up to the chariot and heard the man reading Isaiah the prophet. “Do you understand what you are reading?” Philip asked.
“How can I,” he said, “unless someone explains it to me?” So he invited Philip to come up and sit with him.
This is the passage of Scripture the eunuch was reading:
“He was led like a sheep to the slaughter,
and as a lamb before its shearer is silent,
so he did not open his mouth.
In his humiliation he was deprived of justice.
Who can speak of his descendants?
For his life was taken from the earth.”
The eunuch asked Philip, “Tell me, please, who is the prophet talking about, himself or someone else?” Then Philip began with that very passage of Scripture and told him the good news about Jesus.
As they traveled along the road, they came to some water and the eunuch said, “Look, here is water. What can stand in the way of my being baptized?” And he gave orders to stop the chariot. Then both Philip and the eunuch went down into the water and Philip baptized him. When they came up out of the water, the Spirit of the Lord suddenly took Philip away, and the eunuch did not see him again, but went on his way rejoicing. Philip, however, appeared at Azotus and traveled about, preaching the gospel in all the towns until he reached Caesarea.
A eunuch is a man whose testicles have been removed. In the biblical context, Jesus makes a rather interesting comment that I alluded to earlier about eunuchs. His comments are recorded in Matthew 19:12:
For there are eunuchs who were born that way, and there are eunuchs who have been made eunuchs by others—and there are those who choose to live like eunuchs for the sake of the kingdom of heaven. The one who can accept this should accept it.
The mention of eunuchs in this context has been thought by some authors to be speaking of a “third sex” or perhaps relevant to gender dysphoria. I can understand the desire to see in this passage something that would help us understand these issues better; however, we have no evidence that eunuchs were either a different gender or gender dysphoric. Adrian Thatcher asserts that the eunuchs who were “born that way” refers to “people who are born with ambiguous genitalia.”14 That seems plausible; others have suggested that it could also reference some condition comparable to a diminished sexual capacity, although it may be hard to speculate beyond that. The eunuchs in these contexts were most frequently either court officials or slaves.15
Thatcher also discusses those who castrate themselves for the kingdom of God. He argues for three ways to approach the text: (1) literally, though he is rightly skeptical of the claim that these would be people who actually as a group castrated themselves; (2) metaphorically, by which it would mean “have renounced marriage,”16 but Thatcher is unconvinced; and (3) hyperbolically, as an exaggeration that ultimately points to a “training of the will” or “a life of sexual self-restraint.”17 There may be something to this last consideration, although I think the more common interpretation of renouncing marriage is a reasonable interpretation and has historically been compelling to many Christians.
