Gender Dysphoria: Tentative Theological Reflections on the Transgender Question

A few weeks ago I was the theological consultant on a panel looking at gender dysphoria at a conference in Canberra. It was a helpful gathering and I think we all learnt a lot. I am presently working on an article on the topic and will post on it in more detail at a later stage but thought I would make a tentative start in this post. Your comments and pushback will help me to clarify some of my own thinking.

What theological tools can we draw upon to guide us when we consider the issue of gender dysphoria?

First we need to be sure what we are talking about.

Gender is usually defined as the condition of being male or female, typically referring to social and cultural differences rather than biological ones, and dysphoria refers to a state of unease or distress – the opposite of euphoria. Gender dysphoria is then usually seen as the distress caused by the discrepancy between a person’s gender identity (their self-experience of their gender) and the person’s sex assigned at birth on the basis of their visible sexual anatomy. The level of distress can vary significantly, and in some people leads to a request for hormonal and surgical sex reassignment. While strictly gender dysphoria is a wide ranging term and should not be limited to transgender questions, in practice it usually is, and given the brevity of this post, I will restrict myself to transgender questions.

It is also important not to confuse the gay debate with the transgender debate. The questions of causation and the ethical issues involved are different. While it is true that most transgender people are sexually attracted to people of their anatomical sex, as they do not experience themselves as being members of that sex, it does not feel like a same sex attraction. This is not at all the same for gay people, who in the vast majority of cases do not experience themselves as belonging to the opposite sex, and have no desire to be so.

Given this, what broad theological principles can guide us in our response to gender dysphoria?

Biblically, there is little material that directly addresses this question. It is true that some quote passages like Deut 22:5 “A woman must not wear men’s clothing, nor a man wear woman’s clothing” and Deut 23:1 “No one who has been emasculated by crushing or cutting may enter the assembly of the Lord”. These might be followed up with 1Cor 6:9-10 which in older translations reads “neither the effeminate… shall inherit the kingdom of God.”

However careful examination shows that none of these passages are particularly relevant to the transgender debate.

The question of men wearing women’s clothing and the reverse has been rendered incomprehensible in an age of uni-sex clothing and increased awareness of different cultural norms. Are Scottish men guilty of wearing women’s clothing when they don the kilt? There was a time when some churches refused to allow women to wear “trousers” to church, but such churches are now hard to find. The intent of the command seems to centre around gender integrity, and this does have relevance to the transgender question, but more of the integrity approach later.

As regards passages concerning being made a eunuch, it is important to recognise that the ancient world did not link this to transgender issues. Secondly, the exclusion of eunuchs from the assembly is implicitly overturned by Jesus in Matt 19:12 “For some are eunuch’s because they were born that way; others were made that way by men; and others have renounced marriage because of the kingdom of heaven.” This is even more emphatically underlined by the conversion of the Ethiopian eunuch recorded in Acts 8:26-40. The Spirit goes to extraordinary lengths to ensure the conversion of this man, so it is clear that he is a most welcome addition to the family of God.

The reference to the “effeminate” in 1Cor 6:9 refers to those who adopt the passive position in male to male anal sex, as was usual for male temple prostitutes, and indeed most later translations have dropped the term the “effeminate” and validly replaced it with “male prostitutes” – so this is also of little significance to the transgender debate.

If the biblical text provides no direct guidance, are there broader theological concerns which should guide us? In his excellent book on the topic, Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture, Mark Yarhouse notes three common types of responses amongst Christians to transgender questions. He distinguishes between the integrity framework, the disability framework and the diversity framework. It is worth unpacking each view a little.

The integrity framework places its emphasis on the essential sacredness of maleness and femaleness at creation. The woman was made from the rib (or side) of the man and together they formed a whole. God’s creational intent was for these two different genders to complement each other to make a whole – and out of that creative coupling the possibility of new life emerges. Anything that is seen to tamper with this ideal creation mandate is seen as a violation of the original intent and integrity of creation. Those who operate from an integrity framework constantly point back to God’s intention and believe that an acceptance of anything less than this constitutes an unacceptable compromise. For the transgender community, the message received is essentially that they must learn to accept and to be the gender assigned as a result of their physical anatomy. Transitioning via hormonal therapy or surgical intervention would not be considered an option.

The disability framework acknowledges that God’s original intent was for two different genders and for members of each gender to embrace their identity with delight. The fall however distorts all of creation and gender dysphoria is simply one of the many sad results of the fall. While gender remains unproblematic for most people, it is deeply problematic for some. In this view gender dysphoria is a consequence of the fall in much the same way as blindness or deafness is. The individual impacted is not personally responsible for their condition, but is simply part of a fallen human race in whom the impacts of the fall manifest themselves differently. While we should always make our best effort to reverse the impact of the fall (in whatever ways it impacts us) this is often impossible. When this is the case, we should accept the best attainable outcome without attaching moral blame to the person impacted for not being able to replicate the ideal envisioned at creation.

While we routinely think this way when it comes to most medical conditions (such as blindness or deafness), the disability framework nudges us to view transgender issues in the same light, affirming that we are dealing with a medical issue rather than a moral issue.

Whereas the first view (the integrity framework) essentially keeps repeating what is supposed to be, the disability framework is more philosophical in accepting that the impact of the fall will only be overcome on the day when all things are made new. Without pretending that transgender behaviour is ideal, it is more willing to accept that for some it might be the only liveable solution (and given the very high suicide rate amongst the transgender community, the term liveable is a suitable choice).

Those who adopt this framework usually accept that transgender people have three essential options to choose from. First, they can resolve to live in accordance with their birth sex (the only option those who adopt the integrity framework consider valid). This is often only possible if the level of dysphoria is mild. A second option is to periodically adopt the role of the gender experienced and to engage in cross-dressing behaviour to support this experience. Transgender people sometimes do this to provide intermittent relief, often doing so at distant venues where they are less likely to be identified. A third option is to permanently adopt a cross-gender role. This may or may not be supported by hormonal treatment and sex reassignment surgery.

Those who accept that being transgender is essentially a medical condition are usually supportive of the transgender person finding which option will work best for them, albeit that they will always feel a sense of sadness that this person has this load to carry.

The diversity framework is the third identified by Yarhouse. While the strong form of this view is likely to have little appeal to Christians, in a more modest version it simply reprimands society for constantly excluding minorities, and argues that while same sex attraction (the gay question) and gender dysphoria (the transgender question) impact a relatively small percentage of the population, we should take special care of such groups simply because they are minorities. Advocates remind us that we should not condemn a minority preference as an abnormal preference – and lament that we have confused the two.

The diversity framework also exists in a far more militant form, and in this form it is difficult (impossible) to defend from a biblical perspective. Viewing gender diversity as something to be celebrated and honoured and wanting to move the discussion of gender beyond a male-female binary, it argues that we need to free ourselves from the restrictions imposed by binary thinking. Advocates suggest that we can discover within our self a potential for as many different bodies, sexualities and identities as we might wish to have. The deconstruction of gender is viewed as a necessary step on the journey towards liberation and freedom. It does not take too much reflection to realise that if this view were to gain wide traction, the ideal of marriage as a lifelong covenantal relationship would be abandoned. However, this is the more extreme view of the diversity framework, and as noted earlier more modest versions also exist.

Yarhouse argues that it is possible to work towards an integrative model which works with the best of each of these frameworks. He helpfully writes: “Another question for reflection is this: What is volitional here? A person can choose to engage in cross-gender behaviour (or, to a lesser extent and to remind us of the continuum, gender bending behaviours of one kind or another). The experience of true gender dysphoria, however, is not chosen, nor is it a sign of wilful disobedience, personal sin or the sin of the parents as such.” (81)

I think that is a helpful note on which to close. This is not an easy topic (and I do intend to do more work on it). As always, let me add a plea that we remember that we are not primarily talking about a condition but about real flesh and blood people. You might well know some of them – it might be your child… it could even be you. If so I hope that what I have written does not offend you, but rather that in some small way it might be a sign of hope that we are all starting to think more deeply about something that has been ignored for far too long.

And let us also remember that if church history has taught us anything, it is that it is better to err on the side of being too compassionate, than it is to err on the side of being too judgemental. In fact I doubt that compassion can ever be an error…

Nice chatting…