Understanding Gender Dysphoria, page 5
What does the assertion of an essential female and male mind/spirit even mean? We may make a lot of differences between the sexes, but as I noted earlier, the group differences among males and among females are much more noteworthy than the differences between the two groups (between males and females). I am not saying that there are no differences in gender identity, but the underlying assumption of a fundamentally dichotomous gender identity difference may not be as helpful and may lead to a kind of rigid stereotyping that could actually exacerbate questions about gender identity.
The tendency to move toward rigid stereotyping of dichotomous gender identity differences has to be held in tension with our current sociocultural context in which sex and gender as fixed categories are being deconstructed. That is, the idea that they are norms or standards is being challenged in favor of a genderless society, which I will discuss further below. Christians can note that there is a difference between recognizing exceptions to binaries (and offering a thoughtful, compassionate pastoral response to those for whom this reality is quite salient) and arguing that the sex binary is arbitrary, socially constructed or oppressive. Quite the contrary, the Christian argues that the sex differences are instructive.39
While I am on the topic of deconstructing sex and gender, I should note that most transgender people I have known are not in favor of a genderless society. Quite the opposite: they favor a gendered society, but they long for a sense of congruence in which their body and their mind align. This is especially true for those who identify as transsexual. Most are not meaning to participate in a culture war; most are casualties of the culture war. Younger people in the transgender community may be landing more in the area of genderqueer or genderfluid in ways that may challenge assumptions about a sex binary extending toward a gender binary in any fixed or rigid way.
So members of the church who do not experience gender dysphoria should not assume that all transgender persons want to deconstruct sex and gender per se. There are voices in our culture that do want that, to be sure. But the average person who identifies as transsexual is unlikely to be that person.
However, most people sorting out gender identity concerns do so in a cultural context in which a culture war has been taking place. On the one side are those who view sex and gender as more or less arbitrary and a reflection of authority structures (including religious authority) that needs to be challenged and ultimately defeated. The goal there is to deconstruct sex and gender. On the other side are those who oppose such a direction. They view sex and gender as meaningful categories that, at least in the case of sex, are tied to essential aspects of what it means to be human.
Where are Christians in this mix? Some Christians have entered into the culture wars, while others have focused on what they see as other ways to witness to the culture. While this is not a book about the culture wars, what I would say is this: Christians often react to the deconstruction of sex and gender, and they should offer a reasoned response to it (i.e., retain convictions) in a spirit of mutual respect (i.e., with civility)40 and a pastoral heart of compassion. They would do well to offer a thoughtful response rather than a knee-jerk reaction, particularly when there are people within our own communities who are navigating these gender identity concerns in their own lives. If the church only responds in the larger context of a culture war, we are going to have real casualties—people who see the church as interested in defending their turf rather than coming alongside those who are on the margins.
Moreover, Christians can do more than just avoid being culturally reactive. We can be proactive. We can listen to the person who experiences gender dysphoria. We can come alongside them and remain in a sustained relationship even when things are unclear for us or when we do not know what to say. Some churches will feel called to be more missional to a changing culture. They will approach unchurched and dechurched persons—including those who experience gender dysphoria—from a much more open and welcoming position in which any person entering their community will be made to feel welcome and connected to others. I will discuss this further in chapters six and seven.
Redemption. As we move in our discussion of the fall toward the theme of redemption, we recognize that God does not leave humanity in its fallen condition. A proper understanding of redemption and glorification is essential to understanding a Christian approach to the world around us, to ourselves, to the question of gender identity and dysphoria. Scripture reminds us that God does not abandon us in our fallen state. Rather, God steps into our fallen world through the incarnation, through the person of Jesus, and he fully intends to redeem believers, to sanctify or make them holy, to set them apart for his purposes.
To think in these terms, we want to then consider our telos and our place and purpose in creation. As O’Donovan puts it, “Abstraction from teleology creates a dangerous misunderstanding of the place of man in the universe. For it supposes that the observing mind encounters an inert creation—not, that is, a creation without movement, but a creation without a point to its movement.”41
A Christian perspective on gender identity and gender dysphoria sees these topics in the context of God’s redemptive plan—with an eye for the direction and purpose of our very existence. When a person’s symptoms rise to the level of a diagnosis of Gender Dysphoria, they contend with a specific cluster of symptoms that are identified in the contemporary nomenclature of mental health concerns, in ways that are not unlike how other people contend with issues that make mental health and well-being difficult for them. Some struggle with anger. Others struggle with lust that takes the form of sexual addiction. Still others struggle to delight in their relationship with their spouse, their children, or their neighbors or coworkers. Each of these is an expression of how our mental health and experience of well-being is not what God intends for us. They are expressions of our state. In response to this state or condition and in support of a direction and purpose, Christians ought to restore one another. Christians hold out hope that God is at work redeeming these experiences and believe we glimpse something of a future glory with him when we see gains made in our experiences of mental health and well-being.
Glorification. The fourth act of the biblical drama is tied to redemption insofar as it asks the teleological and eschatological question, What is creation moving toward? We are not offered much by way of a look into the eschaton. Jesus is recorded as saying we will not marry in heaven (Mt 22:30), but that is not to say we will have a “genderless existence”: “He does not say there will be no gender in heaven, but only that there will be no marriage as we have in this life on earth.”42 I like the way O’Donovan notes that “humanity in the presence of God will know a community in which the fidelity of love which marriage makes possible will be extended beyond the limits of marriage.”43
Also, we are given an image in the New Testament for the church, and that is of a bride. In this intimate relationship, Jesus is the groom (Eph 5:31-32). This same image is offered again in the presentation of the New Jerusalem (Rev 21:2, 9). Although we do not want to read too much into this, it raises the question of whether these images “form a timeless analog, underscoring the lasting value of and perhaps a divine purpose behind human gender” insofar as
maleness and femaleness forever defines an important aspect of the relationship Christ has to all of us, his church. How our individual gender identities will play out in the eschaton is not revealed, but God wants us to forever think of our relationship with Jesus through a monogamous, male/female relational analogy.44
When we look at church history, we see little initial focus on sexual differentiation in the early Christian tradition. According to Roberts, what may have been rather unclear comes into greater focus with Augustine, who believed that “sexual difference is an ontologically significant feature of humanity in every era of theological history, from creation to eschaton.”45 Indeed, Augustine suggested that “sexual difference will be adapted to some new use in heaven, in the eschatological era when marriage is obsolete.”46 Both Luther and Calvin would extend this discussion of the importance of sexual difference, placing a greater emphasis on marriage than celibacy, but asserting that “sexual difference is a fundamental aspect of being human, regardless of whether one is married or not.”47
To return to the present, Christians ought to thoughtfully discern God’s will because—from the perspective of the eschaton and of glorification—we are moving toward a time when all we will know is conformity to God’s will:
When we speak of Christian morality in relation to the kingdom of God . . . we assert the same dependence of the present upon the future. The conviction of a final triumph of God’s will, in which every other created will is conformed to it, makes sense of our present relative and imperfect commitment to doing God’s will. . . . We do not even pretend to describe what the life of perfect participation in the restored order of creation will be like; for the only model for such a description was concealed from our sight by a cloud at the point of his glorification, so that the apostle must say that although we are no children of God, it has not yet been shown us what we shall be (1 Jn. 3:2).48
From this brief sketch of a Christian understanding of the biblical drama we see that an understanding of sin brings with it a corresponding affirmation of the inherent goodness of creation. A Christian perspective also affirms that the inherent goodness is tainted and incomplete in some ways. So there is a need to balance key doctrines about personhood with each of the four acts of creation, fall, redemption and glorification. Again, each of us is created in the image and likeness of God and therefore of infinite worth. Further, sexual difference is from creation and has been a part of Christian thought as ontologically significant and in some ways a living parable about the relationship between God and his people. At the same time, Christians recognize that we are marred by the fall—we are broken, incomplete and disordered persons. However, the reality of redemption and the hope of resurrection tells us never to give up and that God’s grace is sufficient to cover all of what we may encounter (including our own wrongs) if we are in a right relationship with God.
Different Frameworks for Conceptualizing Gender Identity Concerns
As we look at the available evidence from Scripture—specific passages and the various themes that arise from reflecting on the four acts of the biblical drama—we are left with the question of how the Christian is to engage the work being done in the area of gender incongruence or gender dysphoria. I have found it helpful to distinguish three different frameworks for understanding gender identity concerns; these function as three lenses through which people view the topic.
The integrity framework. The first lens is what I refer to as the integrity framework. This lens views sex and gender and, therefore, gender identity conflicts in terms of “the sacred integrity of maleness or femaleness stamped on one’s body.”49 Cross-gender identification is a concern in large part because it threatens the integrity of male-female distinctions. Proponents of this view would cite many of the biblical passages I mentioned above (e.g., Deut 22:5; 23:1). Even if there was some concession that some of the Old Testament biblical prohibitions were related to avoiding pagan practices of their neighbors, the overall themes from Scripture support the importance of complementary male-female differences from creation (e.g., Gen 2:21-24).
The theological approach that is at the foundation of the integrity framework raises similar concerns about cross-gender identification as are raised about homosexuality. In other words, from this perspective same-sex sexual behavior is sin in part because it does not “merge or join two persons into an integrated sexual whole”; the “essential maleness” and “essential femaleness” is not brought together as intended from creation. When extended to the discussion of transsexuality and cross-gender identification, the theological concerns rest in the “denial of the integrity of one’s own sex and an overt attempt at marring the sacred image of maleness or femaleness formed by God.”50
Language that refers to maleness and femaleness as “sacred” may be unfamiliar to some readers. In the integrity framework, this language is appropriate and comes in part from Genesis 2:21-24, which
refers to woman being formed from a part of the “earth creature” (‘adam, related to ‘adamah, “earth, ground”), the Hebrew term used, though commonly translated “rib” in this passage, refers nearly everywhere else in the Old Testament to “side” of sacred architecture: the ark, tabernacle, incense altar, temple rooms. The implication is that to tamper with one’s creation as male or female (here by seeking to mask or even put under the knife one’s embodied masculinity or femininity) is sacrilege.51
Theologically conservative Christians will resonate with this framework. To them, the integrity framework most clearly reflects the biblical witness about sex and gender and becomes the primary lens through which they view gender dysphoria and transsexuality. While it may be challenging to identify a “line” in thought, behavior and manner that reflects cross-gender identification, there becomes a point at which the integrity framework is concerned that cross-gender identification moves against the integrity of one’s biological sex, an immutable and essential aspect of one’s personhood.
As I mentioned above, other issues arise when we discuss the idea of maleness and femaleness and how we respond in the context of a fallen world. Recall Looy and Bouma’s reminder that while gender is both “good” and “vital” it is also only a part of human nature and that the variability seen here is further complicated by ways in which the fall distorts “both physical experiences and cultural expressions of gender.”52 But the integrity framework is an important contribution to this discussion, as it reminds us of God’s creational intent and is the primary (or even exclusive) lens for most evangelical Christians.
A caution to those who adhere to the integrity framework is the risk of overstating the case—that is, to promote the view that “gender and sexuality were designed in a particular manner for particular purposes implies a universality and stability that discounts the constantly shifting diversity that we observe and experience.”53
It should be noted that many people, some Christians included, do not view gender dysphoria or transsexuality or every experience of cross-gender identification as an extension of homosexuality in precisely this same way. They may be uncomfortable with cross-gender identification or have reservations about the more invasive procedures (e.g., sex-reassignment surgery), and they may not have another way to conceptualize the phenomenon. However, from a theological perspective and in terms of a traditional Christian sexual ethic, they do not reach the conclusion that the experience of gender dysphoria or attempts to mitigate the dysphoria belongs to the same class of behaviors that are deemed immoral.
The disability framework. A second way to think about gender dysphoria is with reference to the mental health dimensions of the phenomenon. I refer to this as the disability framework. For Christians who are drawn more to this framework, gender dysphoria is viewed as a result of living in a fallen world in which the condition—like so many mental health concerns—is a nonmoral reality. Whether we consider brain-sex theory or any other explanatory framework for the origins of the phenomenon, the causal pathways and existing structures are viewed by proponents of the disability framework as not functioning as originally intended. If the various aspects of sex and gender are not aligning, then that nonmoral reality reflects one more dimension of human experience that is “not the way it’s supposed to be.”54
There are different ways to think about various mental health conditions as nonmoral realities. For example, is the diagnosis of Gender Dysphoria more like what we see with an eating disorder, like anorexia, a condition that has multiple contributing factors in terms of causation and maintenance but is thought to be significantly influenced by the sociocultural context in which we reside today? Or is the diagnosis of Gender Dysphoria more like a depression associated with differences in levels of serotonin, so that biology makes a significant contribution but so do other factors that could contribute to and certainly maintain the concern? Or could it be like schizophrenia that is thought to be largely based on biological contributions and not as clearly tied to culture as such?
Yet a preference for seeing the diagnosis of Gender Dysphoria as a disability of some kind still raises many questions about etiology, prevention, maintenance, and treatment and care. There are many kinds of “disabilities,” if you will. There are many paths to disability as well.
My point at present is that, in each of the above cases, we do not think of personal morality as the reference point when we think of the mental health condition. Also, we do not tend to reference morality when we focus on treatment (whether curative or palliative) in terms of whether a person eats or views themselves as too fat when they are below their weight for their body size and type. Nor do we view a person’s depression as sin or a person’s struggle with schizophrenia as sin. Rather, they contend with a condition made possible in light of the fall. The person may have choices to make that are associated with their response to symptoms or overall treatment approach (again, whether curative or palliative), and those choices may have moral and ethical dimensions, but their condition is not one they chose; that is, they are not morally culpable for having it.
Those who are drawn more to this framework seek to learn as much as can be learned from two key sources. The first source is special revelation, and I am thinking here of meaningful themes regarding sex and gender from Scripture. The second key source is general revelation. Here I am thinking of research on etiology, prevention and intervention, as well as the lived reality of persons navigating gender dysphoria. The care provided would be through a lens of compassion and empathy. The question then arises, How should we respond to a condition with reference to the created order, the reality of the fall and the hope of restoration?
