GENDER DYSPHORIA

Perhaps one of the most ‘hot’ topics today in society and in the Church is gender identity. From ‘Caitlyn’ Jenner to ‘bathroom laws,’ for some Christians it feels as though the very foundation of humanity, the distinction between male and female, is being ripped away. It is relatively easy to type an opinionated comment on the Internet or look away from someone on the street who is not obviously either a man or a woman. But when a father or friend or husband named Daniel asks to be called Danielle, the situation becomes more personal.

As Christians seek to enter the gender identity conversation at an individual and institutional level, we must be willing to learn with an open mind, listen to those with experience, and examine our own prejudices. In his book Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture, professor and psychologist Mark Yarhouse presents three lenses through which gender dysphoria may be viewed, and how we might take the best of each framework as we respond to individual situations.

SO, WHAT IS GENDER DYSPHORIA?

Gender studies is a complex topic, but the first step is distinguishing between sex and gender. Sex refers to the physical, biological and anatomical aspects of being male or female. Gender, on the other hand, refers to the psychological, social and cultural aspects of being male or female. “Gender role,” then, is the ways in which people adopt the cultural expectations for their gender. For example, long hair, make-up, a maternal instinct and domestic pursuits are traditionally associated with femininity, while facial hair, athleticism and leadership positions are traditionally associated with masculinity.

These standards are certainly changing, as more women work outside of the home and more fathers stay to raise children. But there are still some rigid stereotypes, particularly in the Church, about how men and women should act. As unique individuals, each one of us will express our gender differently. Most people’s physical bodies match up with the gender that they experience, but this is not always the case.

When the incongruence, or divide, between a person’s biological sex and experienced gender identity causes significant distress, they may be diagnosed with Gender Dysphoria. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) replaces “gender identity disorder” with “gender dysphoria,” and describes it this way:

“For a person to be diagnosed with gender dysphoria, there must be a marked difference between the individual’s expressed/experienced gender and the gender others would assign him or her, and it must continue for at least six months. In children, the desire to be of the other gender must be present and verbalized. This condition causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.”

Often, but not always, gender dysphoria begins during childhood. Symptoms include desiring to be the other gender and a preference for clothing, toys and activities associated with the opposite gender, as well as a dislike of one’s own gender. The ‘Brain-Sex’ theory of gender dysphoria in part argues that children compare themselves to peers around them, and if they don’t fit into one category, they conclude that they must belong in the other. Some of us might say, ‘I played sports and I’m a woman!’ or ‘I played with Barbies and I’m a man!’ but for those with gender dysphoria, the simple preferences add up to a disconnect that is significant and persistent, though they may not have words to describe it.

“I can’t pinpoint a time where I was like, ‘I have gender dysphoria,’” says Kayla, 19, a biological female who prefers they/them pronouns. “I remember always wanting short hair, but I was too afraid to ask my parents for a short haircut because I was afraid it would be too ‘boyish.’” In middle school, Kayla tried to fit in by wearing feminine clothing and makeup, but always felt extremely uncomfortable. “It’s not me. I’m not girly.”
In 11th grade, Kayla began wearing masculine clothing and shaved their head to raise money for cancer research. After that, people began referring to them as a boy, and they would be stared at or confronted when they went in the women’s bathroom. “Now I have this fear of public bathrooms, and I try to avoid them at all costs. I don’t like being looked at. I don’t like attention drawn to me.”

Kayla’s gender dysphoria lessened at college. Fellow students were accepting of their new identity, and addressed them with whichever pronoun felt most comfortable. Coming home on breaks was also a return to the confusion and discomfort they felt before.

“For a lot of people, college is a symbol of moving forward, moving on,” says Kayla. “For me, exploring my gender dysphoria is a huge step forward in who I am. Coming back here, I want to change how I’m known, but everyone knows me as ‘she.’ It caused me a lot of stress. When I’m at work and someone says, ‘Yes, ma’am,’ it’s like someone punched me in the gut.”

HOW IS GENDER DYSPHORIA TREATED?

Gender Dysphoria is rare, with approximately 1 in 11,000 men (0.009%) and 1 in 30,000 women (0.003%) seeking treatment at specialized clinics. The number of gender dysphoric people is probably much higher, though, because the vast majority never admit they are questioning their gender identity.

Once the condition has been diagnosed, the individual and mental health professional must decide what course of action to take. Some seek to manage dysphoria in order to identify with birth sex, while others choose to cross-dress, take hormones, or undergo surgery in order to present as their preferred gender.

Kayla began meeting with a gender counselor, who helped them to sort out their feelings about gender and their place in a binary world. In fact, many people experiencing gender dysphoria do not feel that they fit in either gender category. For example, a person who is “genderfluid” embraces and exhibits both male and female genders, while an “agender” person does not consider themself either male or female.

Kayla currently identifies as agender, and while they might consider transition or hormones in the future, they are managing their dysphoria now through clothing, hairstyle and neutral pronouns. “[Transition is] a big decision that I want to make sure I’m positive with,” they say.

“As someone who’s agender or non-binary, it’s very hard to live,” adds Kayla. “I feel like I have to pick a side. Sometimes it would be a lot easier if I would just make up my mind and figure it out.”

WHAT DOES THE BIBLE SAY ABOUT GENDER DYSPHORIA?

Although there are no verses in the Bible directly addressing gender dysphoria, like there are for homosexuality, there are some passages that may be cited against cross-gender behaviors. 1 Corinthians 6:9-10, in a list of other sins, says that “neither the effeminate…shall inherit the kingdom of God,” The Greek word translated here as “effeminate” literally refers to the active and passive participants in a homosexual act. In addition, the full list includes “idolaters,” “thieves,” “drunkards,” and “slanderers,” with the sexual sins not separated as worse than the others.

The book of Deuteronomy in the Old Testament contains rules given by God and recorded by Moses to govern the behavior of the Israelites. For example, “No one who has been emasculated by crushing or cutting may enter the assembly of the Lord,” (23:1) and “A woman must not wear man’s clothing, nor a man wear woman’s clothing, for the Lord your God detests anyone who does this” (22:5). God called the Israelites to be different from the people groups around them, who often practiced idol worship and human sacrifice. As best as they could, the Israelites were supposed to uphold God’s creation of maleness and femaleness, and be physically perfect during worship.

We can also look to passages like Acts 8:26-40 that discuss eunuchs, or men whose testicles have been removed. Since they could not have offspring or establish their own dynasties, eunuchs were considered to be more trustworthy and loyal to the king. Despite their low class, eunuchs often served as royal guards in ancient societies. In this story, Paul is prompted by the Holy Spirit to approach a eunuch reading the Scriptures, and goes on to teach him about Jesus and baptize him. The eunuch was most likely castrated as a boy without his consent, but his physical deformity and class status did not exclude him from following Jesus or becoming a Christian.

Jesus also mentions eunuchs 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. The one who can accept this should accept it.” Here, Jesus is speaking to his disciples about marriage, and in this context “eunuch” may also mean someone who chooses not to get married or have sex. Though living outside of society’s norms, the eunuch is not sinning, nor is he asked to change before becoming a Christian.

Christians will continue to disagree about how to interpret these passages in the context of our modern culture. For example, since Jesus came to give us a direct relationship with God, physical deformities do not affect our ability to worship him. Also, clothing standards have changed dramatically over thousands of years, and the distinction between men’s and women’s clothing is small. Rather than only looking at single verses, Mark Yarhouse looks to frame gender dysphoria within the four acts of the ‘Biblical drama’:

“Sexual difference is from creation and has been 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 encounter (including our own wrongs) if we are in a right relationship with God.”

HOW SHOULD CHRISTIANS RESPOND TO GENDER DYSPHORIA?

Yarhouse offers three frameworks through which gender dysphoria may be viewed, and Christians may draw from one or all of them when addressing any given situation.

The Integrity framework focuses on the sacredness, or importance, of the distinction between males and females. We are created uniquely by God, and gender is an integral part of who we are. Though feeling gender dysphoria may not be a sin, choosing to cross-dress or transition to the opposite gender is seen as willful violation of the way we were created. This frame holds true to traditional biblical teachings, but often misses the compassion and community that those experiencing gender dysphoria need.

The Disability framework focuses on gender incongruence as the result of our fallen world. Like anorexia or schizophrenia, Gender Dysphoria is treated as a medical condition that is non-moral, (neither good nor bad), and not caused by sin. This lens inspires compassion, as others recognize that gender dysphoria is not a choice, and feel empathy towards the person. On the other hand, it may treat the condition as something solely to be fixed, rather than an identity to be celebrated.

The Diversity framework Yarhouse divides into two types. The “weak” version focuses on identity and community, celebrating being transgender as an expression of diversity in our society. The “strong” version of the diversity framework seeks to push back against traditional definitions of sex and gender, in order to deconstruct them. This lens is what many Christians are afraid of and outright reject.

Unconditionally Love

Priscilla, 21, has had several friends come out as transgender. As she watched them experiment with drugs and alcohol, as well as makeup and hair extensions, Priscilla began to learn what it means to unconditionally love, even when it’s difficult.

“Care for them not out of duty, but out of sincerity,” she says. “There’s a struggle going on that we have no control over, and we need to give that up to God. All we can do is love. All we can do is accept. All we can do is not throw them out so they have no place to go but somewhere dark. In order for God to be most glorified, sometimes we have to go into the darkest of places so that the redemption story is even greater.”

“It’s not wrong to feel a difference in emotions or feel attracted to people. But what you do about those emotions and where you let them lead you… that’s where it gets kind of blurry,” she adds.

Don’t Assume

Noah, 19, works with Agape, a ministry “to establish common ground between the LGBTA (Lesbian Gay Bisexual and Transgender Association) and InterVarsity Christian Fellowship” at the University at Buffalo. When someone close to him was struggling with homosexual feelings, “that started in me a sense of compassion.” Now he wants to challenge the conservative assumption that being transgender is a sin.

“The very reality that ‘I don’t feel like my body and my mind match,’ is just a statement of our brokenness,” he says. “I acknowledge that it’s not God’s design…but I don’t think it’s quite that simple to make this assertion that your body is fine, so there’s something wrong with your mind. Who’s to say, [maybe] your body is broken and your mind is fine. Why do we put precedence on the external?”

Be Like Jesus

Eric, 43, is a pastor at a Southern Baptist church in New York. As he has matured in life and in ministry, he tries to listen to and learn from the people rather than the issues. “Just like any prejudice, it’s easy to just throw a label on someone and not even think it through or take time to understand.” As a reflection of Christ, we should aim to respond to any social issue the way he did.

“[Jesus] always approached people in such stressful situations with amazing grace and a peaceable demeanor,” says Eric. “Yet he was always meekly, gently, corrective. Sin was never left un-dealt with nor was sin sought out where it was not already evident. Transgender issues are not always laced with sin as a backdrop or a presupposition.”

Listen

Kayla, who grew up in a religious home but considers themself an atheist, has experienced varying, often strong, reactions to their gender identity. “It’s a whole set of terminology that no one wants to take the time to learn,” they say. “Some people just don’t want to understand and they just immediately dismiss it, and because they don’t understand it, they get upset.” They often see Christians using “religion or their upbringing as an excuse to not open their mind up.”

“Listen to, understand where this person is coming from,” Kayla continues. “Not just Christians, but anyone. If someone asks to be addressed with certain pronouns, just do it. It’s not that hard, especially if you don’t know them.”

Kayla wishes that there were more opportunities for conversation and discourse within churches, such as discussion groups or guest speakers. “Create a safe space for people,” they say. “Don’t exclude us as someone who needs help.”

Kayla is not alone in coming from a religious household and being open to continuing a connection. According to “Us Versus Us,” a study on religion and the LGBT community by Andrew Marin, 86% of LGBTs were raised in a faith community from ages 0-18. 54% of LGBTs leave their faith after the age of 18, yet 76% are open to returning to faith and it’s practices.

Gender dysphoria, therefore, is not something outside church doors that Christians must barricade themselves from. Increasingly, young people of all religious backgrounds are questioning and exploring their gender identities, and the solution is not to enforce gender roles even more strictly.

“We like to put things in little boxes so we can understand them,” says Priscilla. “Don’t isolate, either way. A lot of people are fighting [society], but they’re hurting, because we don’t give people enough choices.”

As cultural attitudes towards gender identity and dysphoria continue to shift, Christians can choose to either hide in fear or anger, or engage in conversation. Genesis tells the story of gender from the beginning, where “maleness” and “femaleness” together represent the image and character of God (1:27). Adam and Eve’s perfect relationship with each other and with God looks very different from our world today. Throughout history, societies have assigned strict and often-arbitrary gender roles to men and women. Those who do not fit these molds can be bullied or made to feel less-than or broken.

As Christians, that’s where we believe Jesus comes in. We are all broken, spiritually and often physically or mentally as well. No matter how someone with Gender Dysphoria chooses to manage the disconnect between their mind and body, we can offer compassion, support and community, as well as a non-judgmental and listening ear. Jesus came to mend our broken relationship with God now and eventually make us physically, mentally and emotionally whole in heaven. Now that is good news.