The Transgender Conversation: An Introduction

FOREWORD Thank you for picking up this little booklet. You honor me by reading it. As you begin reading, I need to give you a couple of “heads ups.”

First, I’m writing this to offer my personal perspective on a hot topic. I am not writing this as a prelude to a long, in-depth, church-wide conversation. I’m not preparing FBC Huntsville to issue a statement of any kind. This is simply my perspective as a pastor, much like Acknowlamentaction was my perspective on race. Anyone outside FBC who honors me by reading this should know I speak for myself; not for FBC. And I will say here, as I said about my work regarding race, I still have a lot to learn.

Second, I realize some of the content here may seem pretty graphic. I certainly don’t intend to be offensive or inappropriate.

It’s just hard to have the transgender discussion without covering delicate subjects. I intend for this to be read by adults and mature teenagers.

If you prefer to know my basic positions on the transgender conversation, you may jump straight to page 51 where the section, “Now, to what I believe,” begins. However, my preference and plea would be that you read through the booklet from the beginning and prayerfully consider the subject on your own before you see what I believe. Truth is, once we get past “Why This? Why Now?” and “Necessary Vocabulary” you will find my perspectives on various topics throughout the booklet, so skipping ahead is possibly unnecessary.

Thanks again for considering my viewpoint on transgender people, and the questions surrounding their struggles. Together, perhaps we can learn more about an important and complex conversation.

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The Transgender Conversation: An Introduction She asked to see the pastor, and I happened to be the pastor. It was several years and several states ago.

Her husband had just told her he was born with the anatomy of a man, but the mind and heart of a woman. Within a few weeks the husband would travel to another state to have what the lady described as a “sex change” operation. The couple would soon divorce, she said, and her husband would begin life as a woman.

The lady was bewildered. So was I. I had never heard of such a thing.

That was my introduction to the transgender conversation.

I’m old enough to have lived through lots of complex, confusing, and divisive cultural matters—from the Vietnam War to Same-Sex Marriage. Never have I come across a tougher conversation than this.

In the public arena we debate which restrooms transgender persons should use, whether those born male who now identify as female should participate in female athletic events, and whether the government should pay for sex-reassignment surgery for military personnel. The Christian Medical and Dental Association is predicting a potential flood of firings and lawsuits when physicians refuse—out of religious conviction—to honor requests for sexreassignment surgery and/or prescriptions for hormones and puberty-blockers.1 We wonder about the meaning of terms we are hearing for the first time, and we struggle with what we should do if our daughter says, “I’m a male trapped in a female body.” We marvel at how much our culture has

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changed in our lifetimes, and we ponder where this cultural shift is headed.

It would be easy for us to pitch a fit, throw up our hands, and declare, “The world’s gone mad!” I admit I have shaken my head in near disbelief a few times as I have studied the transgender movement. But transgender-identifying people deserve better from us than shock and scorn. They deserve more than condescension and mere pity. They deserve to have us, as followers of Jesus, try and understand, and feel as best we can, their distress. And they certainly deserve our genuine compassion. People identifying as transgender are often marginalized, bullied and rejected, sometimes even by their families. The rate of attempted suicide among transgender-identifying persons is alarmingly higher than the attempted suicide rate among the general population. That is a painful statistic and a public health issue.

We don’t have to approve of sex-reassignment-surgeries, drag queens, and hormone treatments in order to be informed and loving. We are talking about precious humans who bear the imprint of the Almighty. They deserve our love, not our disdain.

As one mother of a transgender female told me, “This isn’t an ‘issue’ to be debated. This is my child.” Transgender people and those who love them deserve our thoughtful and compassionate response.

There is much I still do not know about transgender people. I do know that, as a follower of Jesus, I am to love my neighbor. And I know that the transgender person is my neighbor.

And, by the way, I am weighing into this conversation with a plea that you study for yourself. My theological education informs my understanding of the transgender question, but I am neither a physician nor a professional counselor. I’ve done my homework and have considered various perspectives on the topic. I have worked hard to understand people who identify as transgender as best I can, and I stand firmly (though humbly) on the positions I 3

will take here. But this is a complex question, so please consider my statements to be one source in your own research.

Furthermore, let’s make sure we don’t spend all our time in our comfort zones and echo chambers. I get frustrated when people fail to seriously consider both sides of hot topics. It seems intellectually lazy to me, and even irresponsible, for anyone to listen only to voices that confirm our presuppositions.

Confirmation bias—looking for data that support our predispositions and ignoring evidence that counters our predispositions—has no place in a conversation about complex subjects. People who voice strong opinions without evidence of having considered contrasting perspectives lose my attention pretty quickly.

When we study, let’s study widely, and let’s be widely informed.

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Why this? Why now?

Why in the world would I jump into such a controversial conversation as this? A good friend from outside our congregation, when I told him I was going to weigh-in on the transgender conversation, responded, “You know, you don’t have to tackle every controversial topic out there.”

So, why this? Why now?

Well, while our church (FBC, Huntsville) was having a familywide discussion in 2016 about same-sex relationships, our world was shifting its attention quickly from homosexuality to transgender people.

I believe we can’t not talk about this now. Our church should be part of our culture’s big conversations. And this is a big conversation!

Some might even contend that the Church is already too late to the conversation.2 Why might some believe that? Well, let me offer, without comments of either affirmation or disapproval, a brief history.

There have been people who did not fit the male/female norm as far back as historians have written. But the topic was not mainstream until fairly recently.

The first sex-change operations were in Europe in the early 1900s.3 A few similar surgeries followed, but seem not to have gotten wide attention.

In 1952 a front-page headline in New York City’s Daily News read, “Ex-GI Becomes Blonde Beauty.” The story told of what was then called a “sex-change” surgery in which George Jorgensen became Christine Jorgensen.

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Christine Jorgenson is often referred to as the first American to undergo such a surgery, though she probably was simply the first American to gain widespread notoriety for such. The surgery was performed in Denmark.

In 1965 Johns Hopkins became the first major clinic in the U.S. to offer sex-reassignment surgery (SRS). Within ten years, over twenty centers for SRS opened in the U.S., and a thousand Americans had chosen the surgery.

The transgender movement began to pick up steam about the turn of this century. By that time, public awareness of persons who identify as transgender had grown until the “T” for Transgender was added to the acronym “LGB” (lesbian, gay, bisexual).

In 2011 Chastity Bono—daughter of the famous singing couple, Sonny and Cher—transitioned to Chaz Bono. A popular documentary, Becoming Chaz, told the story of the change.

In 2014 a Time magazine cover story declared our Western culture had reached a “tipping point,” and in 2015 CNN said we have reached a “transgender moment.” The notion of someone living as a sex different from his or her biological (birth) sex was now widely acknowledged and affirmed.

One of the most celebrated male athletes of my time is the 1976 Olympic decathlon winner, Bruce Jenner. In 2015, Bruce Jenner came out as transgender and asked to be known as Caitlyn. Caitlyn was awarded ESPY’s Arthur Ashe Courage Award later that year.6 In 2015 several bills were introduced in state legislatures intended to limit public restrooms to the birth listed on one’s birth certificate. In 2016 North Carolina’s “bathroom bill” got a lot of publicity when 6

several corporations and movie studios responded by threatening to boycott the state. The National Basketball Association moved its All-Star Game, and the NCAA moved its March Madness championship rounds, away from North Carolina in protest of the “bathroom bill.” The U.S. Justice Department equated one’s gender identity with one’s sex (more on “gender” and “sex” below) and found North Carolina’s restroom law in violation of the Federal Civil Rights Act. In 2016 the Federal Government declared that transgender students must be allowed to use the restrooms that match the gender with which they identify. My understanding is that the Federal Government’s mandate, when it has been challenged, has been upheld in federal courts, including the 11th circuit, under which Alabama falls.4 Merriam-Webster’s 2019 “word of the year” was they, the pronoun often preferred by those who identify as transgender.

As I write this (2022), Admiral Rachel Levine is our U.S. Government’s Assistant Secretary for Health & Human Services. Admiral Levine was born Richard Levine and transitioned to female in 2011.

And, of course, there is Facebook. At one time Facebook offered you 56 gender options for your personal profile. But that was seen as too restrictive. Now they offer fewer options to choose from, but leave a space for you to fill in your custom gender choice however you deem appropriate. By the way, these are the pre-set options: Agender, Androgyne, Androgynous, Cis, Cis Woman, Cis Man, Non-binary, Gender Fluid, Gender Questioning, Gender Nonconforming, Genderqueer, Gender Variant, Transgender, Trans, Trans Female, Trans Male, Trans Person, Trans Man, Trans Woman, Trans*, and Two Spirit (a Native American term). Beyond those options, as I mentioned, is the unlimited ability to fill in your preference in your own words.

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A GLAAD (Gay and Lesbian Alliance Against Defamation) report released in November 2021, said, “43% of non-LGBTQ people think gender is not exclusively male and female, up from 38% in 2020. And 81% of non-LGBTQ people anticipate nonbinary and transgender people will become as familiar in everyday life as gay and lesbian people have.”

In September 2021, the Evangelical Lutheran Church in America (ELCA) installed its first openly transgender bishop, Megan Rohrer.

Rev. Rohrer will oversee ELCA churches in Northern California and Northern Nevada.

In a move that shocked many, the December 2021 issue of DC Comics revealed that the new Superman is bi-sexual, so kids are reading of that in their comic books.

Pushing back against this trend, in April 2021, Arkansas passed the Save Adolescents from Experimentation (SAFE) Act, described as an attempt “to prohibit gender transition procedures for minors, including the use of puberty blockers, cross-sex hormones and surgeries.” However, in July, a Federal judge blocked the law from taking effect, and the Arkansas law is now with the U.S. Court of Appeals for the Eighth Circuit. The Alabama Attorney General has joined Attorneys General from 17 other states to support Arkansas’ SAFE Act. 5 In May, 2021, Tennessee passed a law prohibiting hormone treatment for transgender-identifying, prepubescent children.

As this booklet is being printed, a bill known as the “Alabama Vulnerable Child Compassion and Protection Act” is headed to the Alabama Senate. The bill “would make it a felony for a doctor to prescribe puberty blockers or hormones or perform surgery to aid in the gender transition of people 18-years-old or younger.”6 The 8

bill also would require school officials to report a student’s expressions of gender dysphoria to the student’s guardians.

Sadly, violence against people identifying as transgender is increasing. On November 18, 2021, a PBS headline read, 2021 is Now the Deadliest Year on Record for Transgender People. Other recent news stories have reflected this alarming trend of cruelty.

The number of children and adults coming out as transgender, and the frequency of transgender-identifying persons in the news, are surging. A New York Times article on January 14, 2022, spoke of an “upsurge in teenagers requesting hormones or surgeries to better align their bodies with their gender identities.”7 On the registration desk of a medical facility, in late January 2022, I saw the following: “If your gender identity is different from the sex you were assigned at birth, please let the registrar know.” I would not have seen that notice a couple of years ago.

Why the upswing in transgender identification? Is it because we are simply more sensitive to the topic? Are family dynamics changing and thus fueling this increase? Is it because we have “mainstreamed” and “normalized” transgender identity so that more are willing to identify as transgender? Is it because of what some call “social contagion?”

Whatever the reason or reasons, the trend is unmistakable and undeniable. We may very well be on the cusp of a movement, a cultural epidemic, a transgender revolution.

All this gets us back to why I believe I should tackle this subject, and tackle it now.

For one thing, our children have been hearing phrases like “bi” and “trans” since long before they could have known what those words mean. I believe they need to learn about these matters from their informed parents and Christian family; not just on the school bus. Our students and children are, undoubtedly, 9

going to talk about the transgender topics. If, as a church, we have this conversation, more mature voices will be able to help our young people consider the transgender conversation from a biblical perspective.

Moreover, we adult followers of Jesus need to be informed participants in our culture—a culture that is changing rapidly. If we are going to be salt and light in our world…if we are going to be in-but-not-of the world…we have to understand our world. We must neither reject, nor accept, what we hear or read without informed reflection. (That’s part of what we mean when we talk about the “priesthood of believers.”)

Furthermore, humans are not souls that just happen to inhabit bodies. We cannot separate the spiritual and the physical so easily.

God created us body and soul, so how we see and treat our bodies, and how we engage with others sexually, are deeply spiritual matters. God created us so that our sexuality (our physical attractions and the choices we make based on those attractions) has roots running deep into our hearts. What people do with our/their bodies is a topic into which Christ-followers need to speak.

We’re having this conversation also because Jesus modeled the 1 to 99 principle. You know the parable of the shepherd who left the 99 to care for the one. So, must we be concerned about individuals, even if they make up a small (but rising) percentage of our population. One reason I was cautioned about having this conversation is that there are so few transgender persons. I understand that argument, but it seems to me we reflect the nature of Jesus when we choose not to overlook even those whose numbers are few.

Finally, and perhaps most importantly, this is about both speaking truth and loving people (Ephesians 4:15). Some people speak what they believe to be truth, but they speak in such harsh and legalistic tones that the only people listening are their supporters. Some Christians mock trans people, or dismiss them, or bully them, often in the name of “taking a stand.”

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I recently heard a prominent Baptist pastor speak of Rachel Levine, the transgender Assistant Secretary for Health & Human Services, whom I mentioned earlier. In his nationally broadcast sermon, the pastor spoke mockingly of Levine as “a man, prancing around in a skirt, pretending to be a woman.” “It’s sick!” he declared. The pastor’s lines about Admiral Levine got a round of applause from his congregation.

I understand the importance of being plainspoken and of speaking our convictions. But, I wonder how many people are going to look to that pastor, or that congregation, for answers about their genuine questions and confusions. My guess is, not many. Perhaps it sounds trite, but I honestly wonder, “What would Jesus do?”

Would Jesus deride people? Did he? Is derision Christ-like? The answer to all those questions is, “No.” On the other hand, some people are kind and loving, but their undiscerning affirmation of everything LGBTQ seems unhealthy both for individuals and for our society. I want to speak the truth, as I understand it, about the sanctity of our bodies, about the dangers of a cult-like subculture that is luring children and teens, and about biblical sexuality. It seems irresponsible not to give voice to God’s plan for men and women.

In short, we have to try and speak truth and exhibit love.

Whether or not I’m successful, it is my sincere intention to do both in this booklet.

That’s why we’re talking about this. And, as I said regarding our church’s same-sex discussion, the time to have the conversation is now, before an individual’s name is connected with the questions.

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Necessary Vocabulary It is important that we understand the key terms associated with the transgender conversation. If you’re like I was when I started studying this, the vocabulary is really confusing. Some words are used differently in the transgender conversation than in general usage, so it’s helpful to see how they are used in this unique context.

In this section, I am not offering opinions of approval or disapproval; I’m simply sharing information. I offer the description of these terms as they are used in the transgender conversation.

Key Terms: “Sex,” “Gender” and “Transgender” Sex and Gender Many use “gender” only when speaking of language, such as the masculine and feminine nouns and pronouns in Spanish and French. Also, many of us use the words “gender” and “sex” synonymously and interchangeably. One might say, for example, “Both genders, male and female, are represented in the leadership plan.” Although “sexes” would be more appropriate than “genders” in that sentence, we all would understand the intent.

Beginning in the 1960’s, though, “sex” and “gender” have come to be used differently by many. This new use of “gender” is traced to John Money of Johns Hopkins University.8 In today’s transgender conversation, these two words “sex” and “gender,” are not synonymous and not interchangeable.

Austin Hartke put it crassly, but simply: “Gender is what’s between your ears, and sex is what’s between your legs.”9 That’s a memorable description, for sure, but it’s overly simplistic. Let’s dig a little deeper than that.

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Sex refers to the biological/physical/anatomical characteristics that identify us as male or female. When we speak of “sex” in this conversation, then, we are speaking of hormones (estrogen dominant in females or testosterone dominant in males), chromosomes (those molecules that carry our DNA—XY for males and XX for females), gonads (internal hormone producing and reproductive organs), genitalia (external sexual organs), and secondary sex characteristics (hair, breasts, musculature, etc.).

Sex is defined primarily by how the body is structured to reproduce. That does not mean people are male or female only if they reproduce, of course. It simply means that a person’s sex is determined by his or her potential role in reproduction. Except for a small minority who are born with congenital disorders of sexual development, often referred to as “intersex” (we’ll get to “intersex” shortly), “biological sex can still be defined strictly in terms of the structure of the reproductive systems.”10 Again, to try and be clear, one’s “sex” is determined by one’s body.

Birth sex is a term often used in this discussion, and it refers simply to one’s sex at birth. (Note: I believe one’s birth sex is simply one’s biological sex, and “biological sex” is the term I will use in this booklet.) Birth sex is also referred to as “natal sex,” and “sex assigned at birth.”

Often during an ultrasound, the technician will ask the parents, “Do you want to know the sex?” Or, in the delivery room the doctor or nurse declares, “It’s a boy!” Or, “It’s a girl!” In either case, a quick glance to the south of the baby’s bellybutton provides sufficient evidence for the announcement.

Sex is a little more complicated than that, however. Sex is determined by chromosomes, hormones, gonads (ovaries or testes) and genitals. Sex is traceable all the way down to our cells.

Nevertheless, with rare exceptions, no blood test is necessary for either “boy-ness” or “girl-ness” to be heralded and celebrated. A

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split-second survey of the screaming little one will, almost always, suffice.

Gender is more subjective than “sex.” In the transgender conversation, “gender” refers to masculinity and femininity—the traits, characteristics, and culturally-defined distinctives typically identified with one’s sex. Mark Yarhouse defines “gender” as “the psychological, social, and cultural aspects of being male or female.”11 Gender encompasses a person’s thoughts, desires, and perceptions of sexuality which can differ from one’s sex.

One’s gender identity is one’s thoughts, or inner experience— how one sees or senses one’s self—as male, female, or neither. So, one might be born a male, but feel like, or identify as, a female. In that case, one’s sex would be male and one’s gender identity would be female.

Transgender “Transgender” is a very broad, widely encompassing term for people whose gender identity (internal feeling of masculinity or femininity) is not the same as their sex. “Transgender” is often shorted to “trans,” and some people add an asterisk (trans*) to communicate the idea that a person’s gender is not fixed or welldefined.

The term, “transgender,” is an adjective that covers a wide spectrum of people, from those who are uncomfortable because their gender and sex don’t seem to match…to those who live totally as the sex opposite to their biological sex. Caitlyn Jenner is transgender, for example, and so is the man who is married to a woman but secretly feels like a woman trapped in a man’s body.

This inclusive term, “transgender,” may also include… one who believes one’s sex is “fluid,” or variable… the man who occasionally dresses like a woman…

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one who has undergone sex-reassignment surgery… the 10-year-old girl who is taking puberty-blockers to buy time to decide which sex she ultimately wants to choose… and many others.

The term, “transgender,” is broadly inclusive.

It’s hard to determine how many people are transgender. For one thing, many do not openly share their transgender experience.

Furthermore, the term is broad, and is used differently by different people. Recent estimates by the Williams Institute of the UCLA School of Law put the number of adults identifying as transgender at 0.6%, or 1 in 166.12 The number of youth identifying as transgender is higher. According to the CDC in 2017, nearly 2% of high school students in the U.S. identify as transgender. Some polls suggest the number of young people identifying as transgender is even greater. And, as confirmed to me by pediatricians and teachers, the number is growing.

Transgender is the “T” in the “LGBTQ” (Lesbian, Gay, Bisexual, Transgender, Queer & Questioning) formula. But, to be clear, “transgender” is not about being attracted to one’s own sex.

Again, it is about the internal sense that there is a lack of congruence between one’s biology and one’s psychology.

One of my struggles in this booklet has been when to use “transgender” and when to use “those who identify as transgender.” On the one hand, I believe gender dysphoria for some is so profound it is inescapable and a defining factor in their lives. They are, from my perspective, truly transgender. Others find themselves not knowing what to think or say about their gender confusion, and simply identify as transgender.

I admit that I also struggle to be consistent in the usages of “gender” and “sex.” As you read, you might catch me using one when I should be using the other.

I aim to be clear in my terminology but admit I sometimes struggle for the right words. In all candor (and in my own defense) I find 15

even those most experienced in this conversation often are a bit inconsistent in their uses of terms. And, to make things worse, the vocabulary keeps changing!

Other Important Terms Here are other words and phrases necessary to engage in the Transgender conversation. I offer these in alphabetical order.

Bi-sexual “Bi-sexual” describes one’s physical/sexual attraction to both males and females, and the sexual choices related to that attraction.

Pansexual is a near-synonym, meaning one might be attracted to people of any gender, or “neither.”

Brain-Sex Theory “Brain-Sex Theory” is one conjecture as to why there is a mismatch between psychology and biology in some people. I include it in this list of important terms because it comes up so often in the transgender conversation.

The theory states that, in utero, the brain’s sexual development is distinct from the body’s sexual development. The sexual development of the brain, then, occurs apart from development of the genitalia.13 On rare occasions, according to the theory, there is a discrepancy between the brain and the body. In those cases, the wiring and the plumbing don’t match.

Cindy Meston and Penny Frohlich expressed it like this: “A discrepancy may exist between prenatal genital differentiation and brain differentiation such that the external genitals develop, for example, as male while the brain develops as female.”14 If this theory is accurate, then one could have a “male brain” and a “female body,” or vice versa, and it is easy to see how that would result in gender dysphoria.15 16

Although the “Brain-Sex” theory is widely attractive, the data available is not sufficient for any conclusion. It is wise to employ the theory with caution.16 Cisgender (or, simply, “cis”) A “cisgender” person is one who identifies with his or her biological sex. (A “cis male” is a man who identifies as a man, and a “cis female” is a woman who identifies as a woman.) A cisgender person does not experience dissonance between his or her sex and his or her gender identity.

Cross-dresser, or Transvestite A “cross-dresser,” or “transvestite,” is one who dresses (including clothes, wigs, undergarments, makeup, etc.) like the opposite sex.

This usually refers to a man who dresses like a woman, and the cross-dressing could be habitual or occasional.

Transvestites often cross-dress for the sake of sexual arousal. For example, a man might know he is, indeed, a man, but finds pleasure in dressing as a woman. However, there are those who cross-dress not for sexual arousal but, rather, for what one man referred to simply as the “peace, well-being and pleasure, as one expresses the feminine feelings inside.”17

Gender Dysphoria “Gender dysphoria” is a professional diagnosis that refers to the anxiety, the dissonance, the tension that people experience when they feel their gender (their feeling of “maleness” or “femaleness”) is different from their biological sex. (“Dysphoria” is simply the opposite of “euphoria” in the same way that “dystopia” is the opposite of “utopia.”)

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Here’s another way to put it: gender dysphoria is the troubling sense that there is a mismatch between one’s psychological, emotional identity and one’s biological sex. Some describe feeling like a man in a woman’s body, or a woman in a man’s body, and that feeling causes distress. This dysphoria ranges from slight to severe.

How can we try to imagine what that distress is like? Well, you might remember the movie, Big. In that movie, Tom Hanks’ character went to sleep as a boy and woke up as a full-grown young man. Obviously, it was very awkward for him.

So, if you are a man, imagine waking up one morning in a female body. The whole works. Would that feel odd? Would it be stressful? Of course, it would. Or, if you’re a woman, imagine what it would be like to wake up one morning with a male anatomy. Certainly, you’d feel some angst. Maybe that helps us understand at least a little bit of what gender dysphoria is like.

Transgender people do not “all of a sudden” feel like a man in a woman’s body, or a woman in a man’s body, but perhaps the movie analogy will give us a little insight into what it feels like for transgender people.

What causes gender dysphoria? We simply do not know in all cases. There is probably, at least potentially, a combination of “nature” and “nurture.” 18 By that I mean there may be some variant in the development of an infant in the womb (nature), possibly combined with some later sort of environmental “trigger” in the home or in other important relationships (nurture). Both biological and psycho-social factors may play into the early life of the person who is gender dysphoric.

Gender Expression Gender expression is the way we demonstrate our gender identity through such things as what we wear, how we style our hair, and how we act. We tend to sit, to walk and to gesture in certain ways, based on whether we identify as male or female.

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Gender roles overlap with “gender expression.” Gender roles are the choices and behaviors expected of males and females, and are based largely on their culture’s stereotypes. Or, in the words of Preston Sprinkle, gender roles are “culture’s expectation for how males and females should act.”19 Vocations, as an example, have gender role expectations. When we see a female official in a football game, or a male administrative assistant to an executive, it seems unusual to us because we are accustomed to seeing male football officials and female administrative assistants. Gender roles may be based on cultural stereotypes, but some vocations and hobbies really do attract far more of one sex than the other.

Hormone Treatment “Hormone treatment,” in the transgender conversation, usually involves the administration of testosterone for females wishing to transition to male, and estrogen or androgen blockers for those wishing to transition from male to female. The purpose is to acquire characteristics common to the sex to which one is aspiring.

Puberty Blockers are drugs used to delay the onset of puberty or to interrupt puberty in children experiencing gender dysphoria or gender confusion.

Intersex (Disorder of Sexual Development) “Intersex” refers to a medical condition in which a baby is born with “ambiguous genitalia due to genetic abnormalities.”20 The sex of the baby may not be easily identified due to altered development of genitals.

Babies with this rare (<0.02%) disorder have genitals that appear abnormal, or female genitals despite male chromosomes, or, in the rarest of cases, both male and female chromosomes and genitals.

The physicians and parents can face a difficult task of properly 19

identifying DSD (Disorder of Sexual Development) babies as male or female.

The term “hermaphrodite” has been too broadly used to describe any individuals with ambiguous genitals. “Hermaphrodite” should only apply to the rarest cases of individuals with male and female chromosomes and genitals.

The condition of ambiguous genitals may be surgically mitigated by medical professionals and the baby might not have significant problems resulting from that condition.

Non-binary “Non-binary” is a term reflecting the belief some people have that not everybody fits easily into the “binary” categories of male and female.

“Binary” simply means two clear and distinct options, such as either “this” or “that.” In this conversation, “binary” has to do with sexuality. Many people deny there are two fixed, distinct, “binary” categories of male and female, and contend, rather, that sex is on a continuum. A person identifying as non-binary would balk at having to check “male” or “female” on a form.

Genderqueer is often used almost synonymously with “nonbinary.” Someone identifying as genderqueer might describe themself as “somewhere in between.” Not so long ago the term queer was a derogatory reference to someone who was gay or lesbian or who simply did not conform to cultural expectations of sexuality, “e.g. a sissy.” But “queer” is now embraced by many as a badge of honor. A number of people proudly refer to themselves as “queer.”

I was speaking at a gathering in the Western U.S. when a pastor confided in me that his wife had come out to him as queer. When I asked what that meant, he told me his wife had explained that, should something happen to him, the next time around she might 20

be attracted to another man, or, she might be attracted to a woman.

Her sexuality, she said, is not easily categorized.

Similarly, someone might identify as agender, meaning they don’t see themselves fitting any particular sexual category. They might express that by dressing androgynously—in ways that don’t match cultural expectations of what is male and female.

Gender fluid is a term which expresses the belief that an individual’s gender is not fixed as either male or female. People who identify as “gender fluid” might say they “float” (vary, maybe even day to day) along that continuum between the extremes of male and female.

You can see the overlap in these “non-binary” identities.

Sexuality “Sexuality” is our sexual thoughts and expressions—our physical attraction to, and intimate relationships with, others.

Sexual orientation One’s “sexual orientation” is the sex of the persons to whom one is physically/sexually attracted. For example, a homosexual is attracted to persons of the same sex, while a heterosexual is attracted to persons of the opposite sex, and a bi-sexual is attracted to both.

Sex-Reassignment Surgery21 We hear a lot about sex-reassignment surgery (also known as “gender confirmation surgery,” or “sex change operations”). This is the attempt to surgically alter one’s body to conform to one’s gender identity. There are various procedures available, including breast augmentation or mastectomies, removal of testes or ovaries, and construction of genitals.

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According to the American Society of Plastic Surgeons, around 11,000 sex reassignment surgeries were performed in the U.S. in 2019, with about 70% performed on females. That constitutes a relatively small number of those experiencing gender dysphoria.

Transition In the present transgender conversation, a “transition” is the process by which a person born as one sex changes to live as the other sex. That process often begins with “social transition,” which involves dressing and otherwise behaving in ways consistent with the opposite sex, and often preferring a new name and pronouns.

More radical transitions might involve hormone treatments and/or surgery. Ongoing counseling might be involved, too. The transition may require legal changes, such as the sex listed on one’s driver’s license and medical forms, and/or name changes on bank statements, legal documents and library cards. The processes for making such legal and name changes vary from state to state. And, in addition to the legal and name changes, the individual has to navigate new relationships based on his or her new identity.

This transition is often represented as MtF (male to female) or FtM (female to male).

Transsexual “Transsexual” refers to someone who fully identifies as the sex opposite their biological sex. A transman is one whose biological sex is female but who lives one’s life as a male, and a transwoman is one whose biological sex is male but who lives one’s life as a female. This transman or transwoman may or may not have had hormonal treatment or sex-reassignment-surgery, but most uses of the term transsexual imply some medical involvement.22 22

A Few Common Questions What options does a person have who is experiencing gender dysphoria?

Remember: Gender dysphoria is the anxiety, the dissonance, the tension that people experience when they feel that their gender (their sense of masculinity or femininity) is different from their biological sex.

Broadly speaking, a gender dysphoric person has the following options. (I’m not advocating here, mind you; I’m just describing.)

1) One can figure out how to live according to one’s biological sex.

This probably will require therapy that helps the gender dysphoric person find healthy coping strategies to manage the psychological tension and learn to live in healthy harmony with one’s biological sex.

If option #1 is not considered viable, then options 2-4 are available: Options 2-4 have to do with what is referred to as transition. This transition could involve social behavior, hormones, and/or surgery.

2) One can transition socially.

That means the person can act, dress, and live as the opposite sex, either constantly or intermittently. (I spoke with one man who lived as a woman only on out-of-town business trips until he fully transitioned.) A man transitioning to life as a woman might use make-up, have the hair on his arms removed by lasers, and grow the hair on his head long. A woman transitioning to life as a man 23

might cut her hair and try to disguise her breasts. Transition often involves taking on a new name and requesting people use oppositegender, or gender-neutral pronouns to refer to them. Females wanting to live as males, or vice versa, might try changing the pitch of their voice and how they sit and walk.23 This “social transitioning” seems to be the most common, or frequent, way of dealing with one’s dysphoria. This “social” approach carries psychological risk, but is less risky and harmful than actually altering one’s body via hormones or surgery.

3) For pre-pubescent persons, or those in early stages of puberty, puberty-blocking drugs are sometimes used.

Puberty-blocking hormones delay or interfere with puberty, thus buying time for kids to decide whether they will transition or live as their biological sex. The long-term risks of such hormones on children are far-reaching.

(More about options for children below.)

4) For those who have experienced puberty, hormones and drugs that affect hormones are an option.

Hormone therapy produces physical characteristics of the sex opposite to one’s biological sex. Those hoping to transition from female to male would take testosterone, the hormone dominant in males; those hoping to transition from male to female would take estrogen, the hormone dominant in females, or other drugs that interfere with the results of male hormones.24 5) One might have sex-reassignment surgery (SRS).

This kind of surgery is an effort to do everything surgically reasonable to give someone the body that fits their gender identity.

The surgical team might consist of plastic surgeons, urologists, and gynecologists, depending on the extent of the surgery.25 24

Sometimes sex-reassignment surgery is broken down into “top surgery” (changes in breasts) or “bottom surgery” (changes in genitals).

A person might decide on any or all of the possible surgeries. A complete surgical transition requires multiple procedures, especially for people transitioning from female to life as a male.

Following the gender reassignment surgery, the person’s sexual orientation may change. It might be that the person who has transitioned from male to female would now be attracted to men, or might now be attracted to women and identify as homosexual.

Kris Fabick, who transitioned from female to male, described his experience as follows: “(Before my transition) I was homosexual due to my attraction to females while my gender identity was also female, and now I identify as heterosexual (aka ‘straight’) because I am still attracted to women sexually but my gender is male.” 26 Kris, in fact, is now married to a woman.

There is an apparent trend among younger transgender-identified persons not to seek surgery. Rather, many are simply embracing and celebrating their gender identity and living that out despite society’s gender expectations. They feel they don’t need surgery to “become themselves.”27

Is “transgender” the same thing as eunuchs in the Bible?

Transgender advocates have pointed to eunuchs in the Bible, particularly Jesus’ words in Matthew 19, as potential proof of nonbinary (neither male nor female) sexuality. But that, I believe, is a stretch. There is no evidence that eunuchs in the Bible represent transgender persons. However, the conversation about persons 25

who identify as transgender can be informed by references to eunuchs in the Bible.

Let’s take a look at what the Bible says about eunuchs.

In the Old Testament we see a progression in the way eunuchs are addressed. In Deuteronomy 23:1 (NIV) we read a pretty stern pronouncement: “No one who has been emasculated by crushing or cutting may enter the assembly of the LORD.” In Isaiah 56:4-5 (NIV), however, we read much more positive words: “To the eunuchs who keep my Sabbaths, who choose what pleases me and hold fast to my covenant—to them I will give within my temple and its walls a memorial and a name better than sons and daughters; I will give them an everlasting name that will endure forever.”28 Jesus spoke even more affirmatively of eunuchs. In Matthew 19, Jesus was asked about divorce, and he included the topic of eunuchs in his response.29 He referred to Genesis 1, affirmed the distinct sexes, male and female, and celebrated two-becoming-one in marriage. Jesus then responded to his friends’ observations that, since marriage is so difficult, it might be better not to marry at all.

Jesus acknowledged the difficulty of marriage done right, and then said the following: “Not everyone can accept this word, but only those to whom it has been given. 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.” (Matthew 19:11-12, NIV) Jesus, without encouraging the practice of castration, thus says we can learn a lot from eunuchs.

Eunuchs, in the New Testament world, were most often those who were castrated before puberty and thus had a reduced sex drive. In some cases, “eunuch” is the term for those who were infertile, or were not interested in sexual relations, or chose to be celibate.

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Jesus’ words about a “eunuch born that way” might be a reference to someone who was born “intersex,” but we cannot be sure.

Moreover, in the first couple of centuries after Jesus, as hard as it is to believe, there were Christian men who took Jesus’ words literally and emasculated themselves as a sign of their radical obedience to Jesus.

Jesus’ words in Matthew 19 are not the last the Bible has to say about eunuchs. Do you remember the story in Acts 8 about Philip and the conversion of the Ethiopian eunuch? The Ethiopian eunuch became a follower of Jesus, was baptized, and, according to tradition, preached the gospel in Ethiopia and planted the formidable Ethiopian Church.

Both Philip and the eunuch probably knew of the restrictions on eunuchs found in Deuteronomy 23:1 (see above). And yet there was nothing, not a thing, to prevent this eunuch from being baptized and embraced as a member of the family of God. The story of Philip and the Ethiopian eunuch in Acts 8 is an example of God’s open arms. Everyone should be welcomed into His family through faith in Christ, even those who do not fit the culture’s image of “the way a woman should be” or “the way a man should be.” The story of the Ethiopian eunuch ought to caution us about writing anyone off.

Preston Sprinkle is straightforward: Look, if a man who’s single, castrated, or has atypical features in his sexual anatomy (in other words, a eunuch) shows up at your church and is not accepted, then your church has some serious issues it needs to sort out with Jesus. Or if a woman who doesn’t fit feminine stereotypes (a gender variant) is not accepted at your church—or feels unwelcomed and out of place at your women’s retreat—then your church might be legalistically promoting human-made stereotypes in the place of Scripture. And if a trans* person comes to your church, they should be welcomed with open arms and accepted. Not just 27

accepted, but embraced, delighted in, listened to, learned from, honored, loved, cared for, and shown the heavenly kindness saturated with compassion.30 Would anyone argue that Sprinkle is wrong about that?

Does “intersex” signal a third sex?

Some transgender advocates contend that babies born intersex are proof that there are categories other than male and female.

However, I believe the birth defect known as “intersex” does not constitute a new category of sexuality. It simply means that some beautiful, wonderful babies are born with a disorder. It simply means that the determination of the child’s sex, male or female, may be difficult. “Intersex” does not signal a third sex, or some place on a continuum between male and female. I believe the questions surrounding the birth of an intersex baby still have to do with two distinct sexes, male and female.

What about sex-reassignment surgery?

Surgery requires a significant commitment, of course. The kind of surgery we are talking about here is very expensive, difficult to reverse, and generally leaves the recipient permanently sterile. It appears that most transgender persons live out their gender identity socially, or use hormones, without having surgery.

Obviously, there is a great deal of controversy surrounding sexreassignment surgery. A particular point of contention has to do with the “success rate” of such surgeries. The best I could find is that results of studies are conflicting, and it often depends on who is citing which studies. Some sources report major reductions in anxiety and depression following sex-reassignment-surgeries (SRS). Others report disastrous results. To quote a well-known 2015 Danish report, “generally SRS may reduce psychological morbidity for some individuals while increasing it for others.”31 28

The most definitive report on the effectiveness of sexreassignment-surgeries I have found is in “Sexuality and Gender: Findings from the Biological, Psychological, and Social Sciences,” a 2016 paper by Lawrence S. Mayer (an MD and PhD on the faculty of Harvard) and Paul R. McHugh (a Psychiatrist at Johns Hopkins University).

Mayer and McHugh considered the plight of transgender persons as a matter of public health, and their survey of many studies on post-surgery transgender persons led them to conclude that the promise of post-procedure satisfaction is unrealistic. At best, Mayer and McHugh determined, “the patients’ pre-treatment beliefs about an ideal post-treatment life may sometimes go unrealized.”32 Moreover, Mayer and McHugh wrote, “(P)ostoperative transgender individuals continue to be at high risk of poor mental health concerns.” These mental health concerns they reference include alarmingly high rates of psychiatric hospitalizations, even suicides. One could argue that the risk of mental health problems already existed in these patients before the medical procedures, and that would be true. Perhaps the hormones and surgeries did not exacerbate the risks. But, in an alarming number of cases, the medical procedures also did not lower the risks.

Mayer and McHugh concluded the following: The scientific evidence summarized suggests we take a skeptical view toward the claim that sex-reassignment procedures provide the hoped-for benefits or resolve the underlying issues that contribute to elevated mental health risks among the transgender population. While we work to stop maltreatment and misunderstanding, we should also work to study and understand whatever factors may contribute to the high rates of suicide and other psychological and behavioral health problems among the transgender population, and to think more clearly about the treatment options that are available.33

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A number of people have “de-transitioned” after having had sexreassignment-surgery. They have had the surgery, regretted the surgery for whatever reason, then have had another surgery to attempt to realign their bodies with their biological sex. To cease hormone treatment also is to de-transition, and the long-term impact of the treatment can be dreadful.34 The stories of those who have de-transitioned are told often by those who believe transition by hormones and/or surgery is unhealthy and/or immoral. There are groups such as Detransition Advocacy Network, Pique Resilience Project, and Post Trans that have gotten a lot of publicity for their warnings about sexual transitions. A study of 237 people who have de-transitioned showed that the decision to de-transition “was most often tied to the realization that their gender dysphoria was related to other issues (70%), health concerns (62%), and the fact that transition did not alleviate their dysphoria (50%).”35 Transgender advocates, on the other hand, often point to surveys which reveal a high satisfaction rate among those who have transitioned, either via hormones or surgery. Justin Sabia-Tanis suggests the negative results of surgery are from the “old days,” and cautions us to “recognize that recent studies reflect more effective medical procedures that have evolved over the past few decades.”36 I believe the risks, and the lack of hard data supporting claims of positive, long-term effects from hormonal and surgical interventions, ought to give us significant pause. My survey of the data, with a clear intention to be unbiased, leads me to believe that hormonal and surgical attempts hold limited promise for improving the lives of those who identify as transgender. Moreover, the “irreversible damage” (to quote Abigal Shrier) to people’s bodies is sobering. 37 So, what is my final word on sex reassignment surgery? I simply believe the surgery is unwise, unduly risky, promises more than it can deliver, and contrary to God’s intentions.

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What about the term “assignment,” as in “sexreassignment-surgery,” or a common phrase in this conversation, “sex assigned at birth”?

“Assignment” is a tricky word in this conversation. Let me try to explain the tricky-ness like this. If a soldier is assigned to a unit, that means someone with authority made the decision: “This soldier is going to work here.” Whether it was based on qualifications, needs, or simply quotas, the soldier was named to a unit. The soldier wasn’t “born into” that unit. The assignment was an external decision. Get the picture?

Likewise, sex is not “assigned,” as I see it. It is not a label given, or a designation decided upon, or a title conferred. Rather, I believe sex is an immutable, biological reality determined at conception. Sex is then identified, proclaimed, and recorded in medical records and on the birth certificate. We are “born into” our sex, as it were. One’s sex is not, as I see it, “assigned,” at least not in the way that we usually use that word. For that reason, although there is no good option, I have had a hard time using the phrase, “sex-reassignment-surgery.” I also use “biological sex” instead of the common phrase, “sex assigned at birth.”

However, that’s just one way of looking at it. When I asked Dr. Bradley Shaefer, a trusted pediatric geneticist, to read the draft of this booklet, the only thing he challenged me on was my take on “assignment.” This was his response: The only thing I really would suggest being different than what you said in the booklet has to do with the topic of assignment. I understand what you wrote, but I would opine that we are indeed assigned sex at birth. The first question asked when a child is born is “is it a boy or girl?” People want to know, and the parents have to declare it. In the case of ambiguous genitalia, the answer from the doctors is “We don’t know just yet.” The parents then have the difficult thing of telling their families they don’t know. At some point most of the parents 31

(now-a-days with the help of the Disorder of Sexual Development [DSD] team,) make an assignment.

Furthermore, some parents these days – even for their children without Disorders of Sexual Development – will chose to not assign a gender at birth and leave it to the child to decide when “they” are ready A very fascinating situation involves a population of people in the Dominican Republic who have a high incidence of a genetic condition called 5-alpha reductase deficiency which causes a DSD. The condition is so prevalent that their culture has a socially-contexted "third sex.” The children are raised as female with anticipation of a change to male at puberty. So indeed, there is some social molding of gender.

You see? I told you “assigned” is a tricky word.

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Children and Their Parents About three-fourths of adults who identify as transgender say they felt from their childhood they were “born in the wrong body.”38 Several studies find that gender dysphoria, when it occurs, first occurs between the ages of seven and ten. Some report such dysphoria even earlier.

In 2019, NPR did a story on the 50-year anniversary of violent police raids on “Stonewall,” a gay bar in NYC’s Greenwich Village. A celebration covered in the story included this excerpt from a speech by a transgender girl: “My name is Chase, and I just turned 12 yesterday. And I've been living as my true self for the last four years. I have the ability to be me because of the movement that began right here at the Stonewall Inn.” That means Chase’s parents allowed Chase to identify and live as a person of the “other sex” when she was an 8-year-old.

Teens and even pre-teens are having their bodies altered by hormones in an effort to treat their dysphoria. In Oregon, children as young as 15 can medically transition without their parents’ permission.39 Often parents are told that if they don’t consent to hormonal or surgical transitions, they are unloving, unfit parents.

And there are political efforts underway to limit parental rights, making medical interventions available at children’s requests without the consent of parents.

The World Professional Association for Transgender Health released a draft of recommendations in December, 2021, including the recommendation that adolescents “must undergo mental health assessments and must have questioned their gender identity for ‘several years’ before receiving drugs or surgeries.”40 Although the recommendations are being hotly debated, they spotlight the risks of medical treatment of children and teens.

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And yet, many transgender advocates think of parents who refuse medical interventions for their transgender children in much the same way that many of us think of religious people who refuse blood transfusions for their children, or the way we think of socalled faith healers who shun modern medicine altogether.

The pressure on parents is tremendous.

One parent of a transgender child told me about the literature she had read which encourages parents to follow their children’s lead.

A July 28, 2020 article in the Washington Post indeed was titled, “Follow their lead, and other ways parents can support their nonbinary children.”41 But allowing children to serve as experts on their sexual development seems naïve, risky, and imprudent.

We don’t let them drink alcohol when they are underage. And we don’t force them to follow the career path they announced when we asked them as preschoolers, “What do you want to be when you grow up?” And yet many would want, even force, parents to follow their children’s lead in decisions about sexual identities— decisions that will have a lasting impact on their lives.

It seems to me that parents need to be parents, loving guides, not mere supporters of their kids’ ideas. After all, who knows who else is feeding thoughts into the children’s heads?

Being a parent of a child who identifies as non-binary is a rough row to hoe. And yet, “the best predictor of transgender teens’ well-being over time is the quality of their relationships with their parents.”42 The pressure on parents is tremendous.

Distinctions It’s important at this point to make two important distinctions.

The first distinction is between gender dysphoria and confusion.

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On the one hand, there are young people who suffer from the diagnosable mental health condition we know as gender dysphoria.

On the other hand, there are those who are trying out variant gender identities in a desperate search for a place to belong.

Of course, figuring out what is truly going on with children is difficult, and expert help is needed. One of the dangers, made evident by folks like Abigail Shrier, Erica Anderson and the 4th Wave Now group (see below), is that there are people who prey on confused young people, girls in particular, and draw them into decisions with lasting negative repercussions.

The second distinction is between militant transgender activists and gentle people who are transgender and/or who advocate for transgender people.

There are, indeed, radicals, militant activists, for whom there seem to be no limits. They would like to do away with traditional sexual values and institute an “anything goes” kind of sexual culture.

And yet, there are many who identify as transgender who simply want not to be marginalized and bullied. Many transgenderidentifying persons want to blend in with people, not to change people. From the transgender people and parents with whom I spoke, I heard requests not for agreement, but for respect.

Whatever our personal positions on this topic, it would be wrong to paint all transgender persons with the same brush. It’s like someone told Mark Yarhouse—a saying he likes to repeat: “If you know one transgender person…you know one transgender person.”43

Three basic approaches specific to children who say they feel uncomfortable with their sexuality.44 (Again, I’m not advocating or recommending here; I’m just describing.)

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The first approach is known as gender realignment. This is an effort to align children’s thoughts and behaviors with their biological sex. Simply put, it means helping boys act like typical boys and girls act like typical girls. It might involve strengthening the child’s relationship with the parent of the same sex, reinforcing behavior that fits with the child’s sex, and age-appropriate therapy.

The second approach is gender affirmation. This is affirming the child’s gender identity and helping him or her to transition socially to a life befitting that gender identity. This could include clothing styles, hair styles, toys, and changes in name and pronouns. For example, if a nine-year-old biological male identifies as a girl, the parents would allow the child to live as a girl, even referring to the child with a new female name and using female pronouns in referring to the child.

Some go beyond social transition to the use of hormones that interfere with normal puberty, and with the changes in the child’s body that would accompany puberty. The idea is to buy time for the child to make a lasting decision about their sex at a later point.

Then, about the time they can get a driver’s license in many states, kids can decide to live either according to the sex on their birth certificates or transition (even including sex-reassignment surgery) to their alternative gender identity.

In most cases, those children who choose puberty blockers go on eventually to choose the next steps, either hormones or surgery, toward living as a sex other than their biological sex.45 So, instead of buying time for a better-informed decision, to me it seems more like kicking the proverbial can down the road.

The potential side-effects of puberty-blocking hormone treatments and sex-reassignment-surgery are many and significant.

The third approach is simply watchful waiting. The parents neither encourage nor discourage the child to engage in behavior different from his or her biological sex. The parents simply wait and see how the child develops in terms of gender identity.

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Struggling kids. Struggling parents.

What do parents do when their elementary-school-aged son announces he believes he really is a girl? Or when their middleschool-aged-daughter declares she really is a boy?

In some cases, those children really are experiencing gender dysphoria. Other children are simply looking for ways to fit in—to make sense of their social awkwardness. Children, as early as elementary-school-age, are hearing about transgender people, and how loving and accepting the LGBTQ community is, and then declaring that is where they belong. “If I’m not good at sports,” a boy might think, “I must be transgender.” “If I can’t stand dolls,” a girl might think, “I must be transgender.” Or, they might have stumbled across an online site that seems inviting and encourages them to identify, or at least experiment, as transgender.

This is often referred to as Rapid-Onset Gender Dysphoria (ROGD). ROGD describes a teenager who is shaped by the opinions of peers and culture and rather suddenly identifies as transgender. Social influences are likely behind the announcements by young persons that, out-of-the-blue, they are trans. Furthermore, scores of online influencers are convincing kids that their parents are ogres and the only people who understand the kids’ struggles are members of the trans community.

As a side note, it was not long ago that a boy who felt more feminine than he thought he should, or a girl who felt more masculine than she thought she should, might assume they could be gay. Now that same boy or girl might think, “I could be trans.”

It seems “trans” is replacing “gay” in some circles as the first assumption by kids who are confused about their sexuality.

Abigail Shrier's book, Irreversible Damage, is an important warning against this transgender craze that is so harmful to teenage girls in particular. Shrier refers to this as a “social contagion,” an “epidemic of teenage trans identification.” She does not doubt real gender dysphoria, but she sounds the alarm against the movement 37

drawing confused girls into a dangerous journey of irreversible medical decisions.

Abigail Shrier convincingly lays the blame for this toxic transgender craze at the feet of irresponsible medical professionals, activist educators, and aggressive online communities. Under such banners as “inclusion” and “anti-bullying,” there are influencers drawing our daughters and granddaughters into a destructive lifestyle that cannot deliver on the hope it promises.

To be fair, there is a lot of pushback against Shrier’s methodology and conclusions.46 Shrier’s methodology and conclusions seem legitimate to me, however. She has no axe to grind. Moreover, she is by no means alone in sounding the alarm about girls being misled by peers or activists. And it’s not just conservative Christians who are sounding that alarm. (Shrier, by the way, is Jewish.)

A really interesting group is called 4th Wave Now. 4th Wave Now was founded by Denise, a selfdescribed left-leaning mom. Their website states: “We are not in accord with conservative, religious-fundamentalist views about sexuality.

We are strong supporters of gay, lesbian, and bisexual people.” Yet, Denise founded the group because of her “deepening skepticism of the everaccelerating medical and media fascination with the phenomenon of ‘transgender children.’” 4th Wave Now believes social contagion is behind the “rush to diagnose young people as ‘transgender,’ then to give the message that medical treatment is the answer.”47 Moreover, a January 3, 2022 article in the San Francisco Examiner was titled, “When it comes to trans youth, we’re in danger of losing our way.” The lead sentence of the article reads, “Fueled by isolation and social media, some youth rush toward gender identity as answer to distress.” The author, Erica Anderson, wrote,

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As a trans woman and therapist to trans and gender creative people, I’ve worked hard to advance acceptance of trans identities, including those of trans youth. But increasingly I’m worried that in our zeal to identify and protect these special children and adolescents, we may have strayed from some core principles and we are in danger of losing our way.48 COVID and smartphones have accelerated the migration of young people to the internet, and much of what they are finding there is not healthy. On sites like YouTube and TikTok, kids (particularly girls, it seems) are reading, and seeing videos of, influencers who are pushing them toward hasty and unhealthy choices. Ms. Anderson’s observations are so alarming I include a lengthy quote from her San Francisco Examiner article here.

Some influencers are literally encouraging the idea that one’s psychological distress may be because a young person is trans and is suffering from gender dysphoria. The remedy, they say, is to come out as trans or non-binary, which the influencers advise will alleviate their suffering. Welcomed into the company of other trans and gender creative persons, such young people may have found acceptance — though virtual acceptance, since much of this rapport is online.

They also may be coached on how to navigate and/or control these issues with their parents, who they are told may not “get it.” Among the advice from these influencers is to make a quick social and gender transition, which may include a new chosen name and pronoun and access to gender-affirming hormones.

Many of these influencers are literally dispensing medical advice.

Remember: Erica Anderson is a transgender woman and a transgender advocate. Yet Ms. Anderson is warning against the dark side to the transgender movement.

Even feminist activists are warning against the transgender movement: 39

As a leader of the radical feminist organization group Women’s Liberation Front, Natasha Chart doesn’t agree with conservatives on much. But when it comes to the transgender movement and protecting children from transgender ideology, she’s standing side by side with conservatives.49 So, we have seen the role of social influences in the rise of transgender identities among young people. Besides social influences, there might also be some mental illness contributing to the Rapid Onset Gender Dysphoria. A study by Lisa Littman of Brown University (who coined the phrase, “Rapid-Onset-GenderDysphoria”) noted the presence of myriad psychological diagnoses in almost two-thirds of the teens who experienced ROGD.50 Other studies have likewise noted the elevated presence of mental health issues such as anxiety and depression, self-harm and eating disorders, among children and youth who identify as transgender.51 Of course, I don’t know, and no one knows, how many sons and daughters are genuinely gender dysphoric and how many are trying to explain the awkwardness that naturally comes with the “tweenage” and teenage years. I don’t want to imply that every child or teen who expresses incongruence between their bodies and their feelings is simply bowing to peer pressure. And I’m certainly not suggesting they are just weird. But what is certain is that parents (most often well-educated, upper middle-class, progressive parents) are being shaken by what children and teens are saying about their gender identities.

By the way, some parents probably overreact when their son picks up a doll or their daughter picks up a frog. Some parents shame their children if their children’s behavior does not conform to cultural stereotypes. Other parents freak out, or rush the children to counselors.

Granted, gender dysphoria is a real, if rare, thing, even among children. Parents, however, should not panic when their children exhibit behavior and interests that do not fit stereotypes. It might, indeed, be a “phase.” Often, children whose interests and behavior fit stereotypes more typical for the opposite sex do not carry those 40

interests and behaviors into adulthood. Experts observe that threeout-of-four cases of gender confusion are resolved on their own if the child’s natural process of maturity is not tinkered with. The Christian Medical and Dental Association puts the number at 85%.52 “Resolved” does not mean they all grow up to function as heterosexuals, mind you. Over half of those children and teens whose dysphoria fades eventually identify as gay, lesbian or bisexual as adults.53 Again, parents should not assume that if their son likes dolls and their daughter likes football their child is transgender. I’m going to confess something here. When I was a little boy, I played with “Johnny West” dolls. They were called “action figures” but, let’s face it, they were dolls. My point in that confession is that my fun with Johnny West dolls didn’t send my parents into a panic.

Our stereotypes, and parents’ insistence that their children adhere to the stereotypes, might be part of the confusion over children’s sexuality. As Preston Sprinkle said, “I do wonder whether gender stereotypes are only exacerbating the problem.”54 And as Mark Yarhouse and Julia Sadusky said, “We wonder if, for some teens, adopting an emerging gender identity is a way of making meaning out of the sense that they do not fit into rigid stereotypes of masculinity and femininity.”55 This matter of stereotypes is so important, I am going to devote an entire section to it below.

My primary concern, having studied the transgender conversation as I have, is for the most vulnerable—our children. I am burdened for children and teenagers whose psychosocial struggles subject them to the lure of transgender influencers, and the irreversible damage that bad decisions bring. I am burdened for those young people who genuinely struggle with a painful confusion of sexual identity.

I also am burdened for parents who are losing sleep over their kids, who are being painted by activists as cruel unless they 41

sign off on medical interventions, and who feel alone in their struggles. I am troubled by the move by states like California, New Jersey, and Massachusetts, that are passing laws that take away parental rights to know what their children are doing with their bodies and to get appropriate psychiatric help for their precious, vulnerable, sons and daughters.56 There are resources available for parents whose sons and daughters are identifying as transgender. The Sexual and Gender Identity Institute at Wheaton College, led by Dr. Mark Yarhouse, is one such resource.

Yarhouse and other Christian professionals have done extensive research into the topics we are considering here and offer consultations.57 Finally, the kind of church FBC chooses to be will make the journey either more difficult or more manageable for parents. If we are the kind of church who talks about the hard topics, voices our beliefs about biblical morals, loves everyone no matter what, and shuns no one no matter what…then the parents within our church family are going to feel more supported in their journey.

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Stereotypes Preston Sprinkle, as quoted above, suggests that gender stereotypes are exacerbating the problem. I believe he is right.

We all know girls who prefer playing softball to playing Barbie…and boys who prefer playing with girls and doing the things most girls prefer. Kids often use pejorative terms to refer to such children. And some roles assigned by culture to “male” and “female” are just that: assigned by culture. Those roles are not biblical; they are social and vary from culture to culture. And kids who don’t fit our stereotypes are not necessarily transgender or homosexual.

As an example, there are a few girls who prefer softball to Barbie who eventually recognize themselves as homosexual. A few of those girls who prefer softball will identify as transgender and will always feel like they were born in the wrong body. However, there are also lots and lots of girls who prefer softball and are simply heterosexual ladies who are good athletes. They end up happily married to young men and the stars of the co-ed church softball team!

Imagine with me a 7-year-old boy we will call “Matt.” Matt never has been a “typical” boy. To quote from an old limerick, Matt seems not to have been made of snakes and snails and puppy dog tails. Matt has not been interested in frogs and footballs. Matt loves playing “dress-up” with his older sister and her friends.

Imagine also with me a 10-year-old girl we will call “Annette.”

Annette never has been a “typical” girl. Annette, unlike Matt, does seem to be made of snakes, snails and puppy dog tails.

Annette never has played with a Barbie, and when the neighborhood kids play together she always will be found with the boys. She can hit a baseball farther than any boy she knows, and she can tell you more about her favorite college football team than her brother and father can.

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Both Annette’s parents and Matt’s parents wonder what they should do. Are their kids gay? They’ve been reading a lot about transgender children, and so they’re also wondering if perhaps their children are transgender. In the end, both Annette’s and Matt’s parents choose to just wait and see.

Fast forward several years.

Annette is now a college junior who feels like she is a male trapped in a female body. She spends a lot of time on web sites that champion sex-reassignment surgery and thinking perhaps one day that will be her best option. She is a young lady we would refer to as “transgender.”

Matt, however, is now an offensive tackle on the high school football team. He laughs like most boys do at bodily functions and is, in every way, a “typical” teenage boy. He is a little bit embarrassed by the fact that he once preferred Barbies, but laughs good-naturedly when his sister teases him about playing with her and her friends when he was 7. Matt has a girlfriend he hopes to marry one day, and often has the kind of thoughts about girls that typical hormone-driven teenage boys have.

Certainly, my experience is that, without being prompted, boys are more likely to pick up toy trucks and girls are more likely to pick up dolls. Boys and girls tend to be drawn, naturally, in different directions. But some really healthy kids enjoy things that defy the boilerplate, at least for a while. And, for some reason, we are more okay with a little girl who likes football than with a little boy who likes tea parties. “Tomboy” is not a terribly disparaging term (assuming people still say “Tomboy”). But you know the names people call little boys who have traits we consider feminine.

“Sissy” is about the only one I can include here.

Oh, and by the way, “manly men” don’t always own German Shepherds and Rottweilers. After all, my dog is a 12-pound bundle of Bischon fluff named “Gracie.” So, there.

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Male and female stereotypes are culturally-driven, not biblically driven.

Is it sinful for males to be sensitive and females to be assertive?

Of course not.

Think about Jacob and Esau. Do you remember that Jacob is described in the Bible in what our culture would consider feminine terms? Yet it was Jacob, not “manly” Esau, who was given the name Israel and from whose descendants the nation of Israel was formed.

Don’t forget the female business leader, Lydia (Acts 16:14), and the female political military leader, Deborah (see Judges 4)! And remember the female deacon, Phoebe (Romans 16:1), and the female apostle, Junia (Romans 16:7)!

Jesus Himself broke stereotypical barriers by letting women support him financially (Luke 8:1-3), by calling children together around him, and by washing people’s feet. In Jesus’ day those things didn’t fit the male stereotype.58 Yet, despite those biblical examples, there are some Christians who still confuse cultural stereotypes with biblical mandates.59 Don’t get me wrong; I am not a unisex advocate. I love it that my wife is beautiful and that she and I complement each other as male and female. I appreciate men who hold doors open for ladies, and ladies whose gift of hospitality makes everyone feel welcome. I recognize that testosterone produces different characteristics than does estrogen. I do not, however, equate traditional, cultural gender roles with biblical guidelines for men and women.60 Russell Moore said it well: We reject “both a spirit of the age that would erase created distinctions between men and women and those that would exaggerate them into stereotypes not revealed in Scripture.”61 Traditional practices associated with one’s biological sex should be celebrated, to be sure. But culturally-shaped practices should not be equated with divine directives. It should not be considered 45

unbiblical for girls to do woodworking or for boys to cross-stitch, just like it was not unbiblical for Danica Patrick to crawl into a racecar or for Bo Jackson to love the kitchen.

It’s important not to confuse “unconventional” with “unbiblical.”

Moreover, “unconventional” should not be re-labeled “nonconforming.” That re-labeling is happening far too often, however, especially to girls and young women.

When young ladies excel in leadership, athletics, or science, some trans activists label them “non-conforming.” Thus, the idea is planted in their impressionable minds that perhaps they really are boys, since boys are supposed to be the leaders, athletes, and scientists. That is insulting to females and, in fact, exasperating for feminists who have battled those pigeonholes for a long time.

The use of stereotypes to manipulate kids into questioning their sexual identity is shameful.

I probably have written too much about stereotypes, but it is important for parents not to over-react. Some parents’ insistence that their children adhere to stereotypes might be adding to their children’s confusion and exacerbating their children’s anxiety.

That’s not to mention the fretfulness of the parents!

Parents should neither be terrified nor disgusted if their son or daughter does something not typical of his or her sex. And kids should not be led to believe they are transgender simply because they don’t fit a cultural stereotype.

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“Nothing About Us Without Us” A number of people in the LGBTQ community invoke the term, “Nothing About Us Without Us.” I think that’s fair. If I don’t listen to their voices I dehumanize them; they become an “issue” to me, instead of people. Furthermore, I cannot know what it is like to see sexuality from any perspective other than my own, and I need to hear other perspectives.

An interesting debate is whether or not hearing from LGBTQ persons makes one more likely to have the appropriate perspective.

It could be argued that what one gains in empathy one loses in objectivity. Of course, it also could be argued that a close relationship with an LGBTQ person offers insights that are impossible without such a relationship.

I simply could not, in good conscience, write about people without listening to people. So, I read works of Christian people who identify as transgender. I read Austen Hartke (Transforming: The Bible and the Lives of Transgender Christians), and Christina Beardsley and Michelle O’Brien in This Is My Body: Hearing the Theology of Transgender Christians. I read Justin Sabia-Tanis in Understanding Transgender Identities: Four Views, and the 30day “diary” of a transgender man, Kris Fabick, from June, 2020, posted on his Facebook page.

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To read the thoughts of transgender writers was helpful; but I also wanted to hear directly from transgender people. And I did. I spoke with a number of transgender people and with parents of transgender sons and daughters.

I want to be clear. The people with whom I spoke are not radical activists. They are not angry, although some feel hurt by their home churches. The people with whom I interacted are kind, gentle people who want simply to be understood and respected.

(Or, in the case of parents, want their children to be understood and respected.)

Spencer grew up in a church I previously served as pastor. During his college years, Spencer transitioned from female to male, and is now a student at Yale Divinity School.

I had a beautiful conversation with Spencer and his mom. They know of my traditional position on sexuality and yet, just as I expected them to be, they were kind, gracious, and transparent. I asked Spencer the two questions I asked everyone: “What is your story?” and, “What would you want a church to know?” In response to the second question Spencer quoted Brene Brown: “People are hard to hate up close. Move in.”

That’s an important insight. Spencer didn’t expect me to agree with him on everything. He didn’t try to convince me of anything.

But he did appreciate the opportunity to tell his story. That was true of every conversation I had.

I heard from a young man who knew early on there was something “different”—that his body and his sense of self did not line up.

Every time he hinted at that subject in his church youth group he was shamed. He eventually dropped out.

I met Kailey, who remembers, as a boy (Kevin) being bullied at a very young age because he was not like other boys. She 48

remembers wearing her mom’s make-up and clothes in late elementary school.

Kevin always was rather conservative theologically, and very prolife. He was ordained as a pastor in the Anglican church as a young man and, in the ordination service, prayed God would take away those feelings that he was really a girl.

Kevin was married to a lady he described to me as “his best friend,” but eventually felt he could not continue living as he was.

He struggled to the point of serious thoughts of suicide, and transitioned to female, Kailey, in 2018. The marriage ended amicably and Kailey now works for a ministry to homeless persons. She believes part of her calling is to reassure people who have been hurt by churches that God loves them.

I was able to engage in multiple exchanges of ideas with the mom of aa transgender son from the Southwest. She was willing to hear my perspective because she knew I had read literature written by transgender advocates and that I was eager to hear her story.

I heard the following story from a young man in the Western U.S. I think it is helpful for us all to hear. I’ve changed the names but kept all other details the same.

Suzanne, an eighth grader, made an appointment to see her youth minister. Suzanne’s mother was on staff at their church, and Suzanne’s best friend was the youth minister’s daughter.

Suzanne told the youth minister she was attracted to girls, and thought she might be gay. Suzanne also expressed a recurring feeling of wanting to take her own life. The youth minister responded with a prayer that God would remove the same-sex attraction, but neither addressed the suicidal thoughts nor contacted Suzanne’s parents.

Suzanne was immediately removed from the youth praise band, of which she was a leader. And when word got out about 49

Suzanne’s attraction to girls, she was shunned by her small group—a circle of Christian friends that meant so much to her.

Soon Suzanne wanted nothing to do with her church.

During Suzanne’s sophomore year she began to feel that “gay” did not describe her sexual identity, but she was confused about her feelings. On the internet she found a story about a transgender young man, and it “clicked.” Transgender is what seemed to fit for Suzanne, and so she shared that with her parents.

Suzanne continued to live as a girl until Christmas of her senior year in high school, at which point she asked her parents to refer to her as Sam and to use male pronouns. The following February, Suzanne, now Sam, had top surgery to minimize her breasts. By the way, Suzanne, now Sam, was president of the student body and had gained admission to two military academies.

His mom looks back now at Sam when he was 2-to-4-year-old Suzanne. Suzanne dressed like a boy and even, at age 4, said, “Call me J.D.” At age 6, when the kids were asked what they wanted to be when they grew up, Suzanne said, “I want to be a boy.”

Sam is now a student at a state university and living as a male.

He wants nothing to do with any church and no longer believes in God. The story probably raises several questions for us all, and that’s a good thing. No matter how you and I answer those questions, the story is a good reminder that this is a conversation about real people; not an “issue.”

That’s the thing I was reminded of most in my exchanges. This is about more than laws and traditions. It’s about more than bathrooms and track teams. It’s about people. I would encourage anyone reading this to get to know someone who identifies as transgender. Personalize this conversation.

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Now, to what I believe Here I want to share my basic convictions about the transgender conversation.

The Bible speaks to this question.

Genesis 1:27 and 5:2 describe the intentional distinction in the creation story between male and female. Does the Bible say more?

Well, the Bible does speak about cross-dressing. In Deuteronomy 22:5 (NIV) we read, “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.” The church I grew up in took this passage seriously. Women didn’t wear pants, for example, at least not to church services. I still remember going on a Sunday night to another church where I had a date with a girl who attended there.

And she was wearing slacks! To church! I thought, “My mother wouldn’t like this!”

But we have to be careful with passages like Deuteronomy 22:5.

After all, three verses later, in Deuteronomy 22:8 (NIV), we read, “When you build a new house, make a parapet around your roof so that you may not bring the guilt of bloodshed on your house if someone falls from the roof.” I didn’t know what a parapet is until I Googled it, and, alas, my roof does not have one.

I don’t mean to be flippant, but you get my point. The Book of Deuteronomy is addressing a world very different from ours, and the prohibition of “cross-dressing” might be related to something like the pagan practices of Israel’s national neighbors. The principles remain guidelines for us, but the specifics are not always applicable.

Then there is 1 Corinthians 11:14 (NIV), which warns us that “if a man has long hair, it is a disgrace to him.” I remember this verse 51

being quoted a lot in the church I grew up in during the 1970s and as my hair kept creeping down toward the bottom of my ears.

Do those words about the length of men’s hair for first century Corinth really apply, literally, to us today? Most of us would answer, “No.” Isaiah 29:16 (NIV), on the other hand, offers a powerful, culturally-transcendent message to those of us who would question the work of God in shaping us: “Shall what is formed say to the one who formed it, ‘You did not make me’? Can the pot say to the potter, ‘You know nothing’”?

It is important that we recognize God as the only One qualified to determine our “form.” It seems to me we should be the best man or woman, boy or girl, that God, the perfect “Potter,” formed us to be.

Psalm 139 reminds us of the intentionality behind our bodies: For you created my inmost being; you knit me together in my mother’s womb. I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well. My frame was not hidden from you when I was made in the secret place, when I was woven together in the depths of the earth. Your eyes saw my unformed body; all the days ordained for me were written in your book before one of them came to be. (Psalm 139:13-16, NIV) Our frame itself is the work of the Creator’s hand. Every baby is fearfully and wonderfully made. We cannot improve on the work of our Grand Weaver.

We also should pay careful attention to Romans 12:1-2 (NIV): Therefore, I urge you, brothers and sisters, in view of God’s mercy, to offer your bodies as a living sacrifice, holy and pleasing to God—this is your true and proper worship. Do not conform to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and 52

approve what God’s will is—his good, pleasing and perfect will.

We are to offer our very bodies in worship to God. I believe we are to offer them as God gave them to us, and not follow cultural trends despite tension between “gender” and “sex.” Perhaps it sounds naïve, but I believe the mind can be “renewed” to minimize that tension. A good therapist may be able to help a gender dysphoric person feel better about his or her body. I’m not talking about “conversion therapy,” by the way. I’m talking about professional help in minimizing the dysphoria that transgender persons feel. And even if the dysphoria persists, I believe life at its best is in conforming to the will of God which, to me, means living as our biological sex.

I don’t like the idea of “proof-texting.” As you probably have heard, anyone can make the Bible say whatever he or she wants it to say. But the three above passages (Isaiah 29:16; Psalm 139:1316; Romans 12:1-2) seem pivotal to me. They speak to the sacredness of each body. The passages should caution us against the changes to both our identities and our bodies that occur in the transitions spoken of in this booklet.

Biology determines one’s sex.

Let’s consider a question raised by Preston Sprinkle, in Embodied: “If someone experiences incongruence between their biological sex and their internal sense of self, which one determines who they are—and why?” Let’s put it another way: If your friend, a biological male, feels and thinks like a woman, is your friend a woman or a man? Is it the body, or is it the mind, that is more definitive for determining who we are?

Simply put, I believe our biological sex, our body, determines whether we are male or female. The concept of gender identity is simply too nebulous—too “squishy,” if you will. Gender identity is based too heavily on the stereotypes of a culture, and the interpretation of an individual. I honestly do not doubt the feelings 53

of anxiety that transgender persons feel. And yet, gender, as it is used in the transgender conversation, is too subjective an idea to justify lifestyle, hormonal and/or surgical transitions.

I believe we are to live a life corresponding to our biological sex. It is no small thing that God created us male and female.

I actually believe that a “sex change” is biologically impossible.

Following what is known as sex-reassignment-surgery a biological male may live as a female, or vice versa, but men do not change to women and women do not change to men.62

Sex is binary, not a continuum.

I believe Genesis 1:27 and 5:2 state unequivocally that God created, and creates, humans as either male or female, men or women. The naming of two distinct sexes in the Creation story, and then re-stated by Jesus as quoted in Matthew 19 and Mark 10, is explicit and intentional.

I do not embrace the suggestion that there is simply a boundaryfree continuum of “more male” and “more female.” A continuum implies there are no boundaries, but I believe Genesis tells us there are indeed boundaries—two distinct (binary) categories: Male and Female.

I do believe there are variations within the two sexes. Some boys and men fit the cultural stereotype of “male” more than do others.

The same is true of girls and women. But variations among or within a sex—male or female—are very different from the idea that there are no boundaries.

It is not insignificant that in the first chapter of the Bible our identity as humans is linked closely to our sex. Our “sex”—our “maleness” or “femaleness”—is a feature of our “self” as designed by our Creator.

I agree with this statement by the Christian Medical and Dental Association: 54

Sex is an objective biological fact that is determined genetically at conception by the allocation of X and Y chromosomes to one's genome, is observable at birth, is found in every nucleated cell, and is immutable throughout one's lifetime. Sex is not a social construct arbitrarily assigned at birth and cannot be changed at will.63 Maria Keffler described sex in this memorable way: When a human skeleton is unearthed by archeologists 30,000 years post-mortem, analysis of the bones and the DNA will tell those archeologists whether that skeleton belonged to a man or a woman, and it won’t matter one whit whether the man liked to hunt or rock babies, or whether the woman liked to make tools or weave baskets.64 Our sex, then, is determined at conception. It is an objective fact.

Gender identity, however, is a terribly subjective concept. There is little science behind the idea of an inborn gender identity.65

The move toward mainstreaming and normalizing transgender identities among kids is unhealthy for both individual children and our culture.

Children lack the maturity to make life-altering decisions. I do not believe it is wise to allow children to transition socially to live as the “other sex,” and I am particularly concerned about pubertyblocking drugs for children. It is one thing for an adult to choose hormone therapy or sex-reassignment-surgery. It is quite another, in my opinion, to allow a child to determine that he or she is transgender and to initiate hormones to delay the onset of puberty.

I do not doubt that children and teens often get confused about their sexual feelings. It is true that a very small percentage of those children and teens will grow to be transgender adults. But it is also true that we all, including kids, like to have a cause and we like to belong. Many LGBTQ influencers are taking advantage of those natural inclinations in order to encourage kids and teens to 55

experiment with their sexuality. And that's before they are old enough for us to trust them to drive a car!

Earlier I noted the conclusions drawn by Lawrence S. Mayer and Paul R. McHugh in “Sexuality and Gender.” Their conclusions regarding medical treatment of children are sobering: “We are disturbed and alarmed by the severity and irreversibility of some interventions being publicly discussed and employed for children.”66 Mayer and McHugh state further: (D)espite the scientific uncertainty, drastic interventions are prescribed and delivered to patients identifying, or identified, as transgender. This is especially troubling when the patients receiving these interventions are children. We read popular reports about plans for medical and surgical interventions for many prepubescent children, some as young as s6, and other therapeutic approaches undertaken for children as young as 2.

We suggest that no one can determine the gender identity of a 2-year-old. We have reservations about how well scientists understand what it even means for a child to have a developed sense of his or her gender, but notwithstanding that issue, we are deeply alarmed that these therapies, treatments, and surgeries seem disproportionate to the severity of the distress being experienced by these young people, and are at any rate premature since the majority of children who identify as the gender opposite their biological sex will not continue to do so as adults. Moreover, there is a lack of reliable studies on the long-term effects of these interventions. We strongly urge caution in this regard.67 Where is this transgender kids movement headed? Obviously, no one knows, but some believe the trend will be mitigated by a flurry of lawsuits. Some experts believe kids who are now being allowed, or even encouraged, to undergo medical interventions are going to resent that one day. They are going to ask physicians, “What were you thinking giving me hormones and altering my body? I can’t have babies, and I don’t look right, and I’m still 56

unhappy.”68 If those predictions are right, physicians might be forced by the threat of lawsuits to become more cautious in the future.

Gender dysphoria is a matter of mental health and a result of the “Fall.”

I believe real gender dysphoria is not something people choose.

Gender dysphoria causes an intense anxiety and terrible awkwardness. I also believe gender dysphoria is a mental health issue worthy of treatment. That does not mean the person is “crazy”; it means there is a disorder, a psycho-pathology, perhaps due to a biological variant that occurred in one’s pre-natal development, and/or some sort of life-altering experience, resulting in a lack of congruence between one’s biology and one’s psychology.

Preston Sprinkle, who is very sympathetic toward transgender people, wrote, “Certainly, people with gender dysphoria have a real psychological condition which causes them to think and feel like they are a different sex.”69 It is commonly acknowledged that many people who identify as transgender exhibit mental health problems, from eating disorders to substance use disorders to depression to autism.70 But, are those mental health problems the cause of, or the result of, the incongruence between people’s biology and their identity? The answer is probably Both. More than likely, some sort of diagnosable disorder is both behind the gender dysphoria and exacerbated by the gender dysphoria.

The likelihood (in my opinion) that gender dysphoria is a mental health matter should shape how we approach the subject. Frankly, I see gender dysphoria, and transgender persons, differently than I see same-sex intimacy.

Think about it. Most of us view such conditions as anorexia or depression as “amoral,” or “non-moral” conditions. We don’t see them as “immoral,” or “sin.” If, likewise, gender dysphoria 57

is a matter of mental health, not a sin, that ought to evoke in us compassion, not judgmentalism.

If gender dysphoria is a mental health issue, it also helps us think about treatments, particularly sex-reassignment-surgery. Dr. Paul McHugh, an early expert in the matter of sex-reassignment surgery, suggested that a person who feels like he/she is trapped in the body of the opposite sex is like the anorexic who feels obese despite her emaciated body. Just as we would not perform liposuction or a gastric bypass operation on an anorexic, McHugh believes that to harm and re-do the body of a transgenderidentifying person is the wrong solution.71 Abigal Shrier also likens the treatment of kids who identify to a physician as trans to the one who identifies as anorexic. I believe McHugh’s and Shrier’s comparison of gender dysphoria to eating disorders, and the resulting conclusions about surgery, are sound.

I believe gender dysphoria is another unfortunate result of the “Fall” as it is described in Genesis 3. The disobedience of Adam and Eve resulted in a number of things being not as God originally intended. As with eating disorders, depression, and many other unfortunate matters of human health, gender dysphoria is not what God planned for us. The disconnect some people experience between their anatomies and their gender identity is simply another result of our imperfect, fallen world in which sometimes things just “don’t work right.”

This does not mean transgender persons are “mistakes.” God does not make mistakes. Transgender persons are beautifully and wonderfully made, as we all are. And yet we all also bear the consequences of living in a fallen world. Those consequences vary from person to person. Gender dysphoria is but one of those consequences.

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Again, I believe true gender dysphoria is not a personal choice.

Why, after all, would anyone choose such anxiety? The experience of incongruence is not an act of willful rebellion.

I believe the experience of gender dysphoria is not a sin. What one does about that dysphoria, however, is a different matter.

On the one hand, I believe that from the beginning God has created us male and female, and that our God-given sex is the way God intends us to live our lives. Therefore, I cannot support hormonal and surgical treatments that attempt to alter one’s sex. Even less radical approaches to resolving gender dysphoria, most often referred to as “social transitioning,” seem unwise to me, and less than what God would want for us.

Sincere Christ-followers will view this differently. And just as we must be compassionate toward persons who identify as transgender, we must be civil toward fellow believers who hold a different perspective than our own.

The Private, the Public, and the Political: What we should do.

Mark Yarhouse and Julia Sadusky have noted for us three levels of engagement: private, public, and political.

In private relationships we must be gracious. If we meet a young person who identifies as transgender, we must lead with grace.

That person might truly be struggling with the overwhelming inner pain due to an incongruence between “sex” and “gender,” as those terms are used in the transgender conversation. Or, that young person might be struggling to find an identity, and being lured by influencers toward a dangerous journey of social and medical experiments. Either way, the only way to offer meaningful counsel is to genuinely care about people.

If we meet a person who has transitioned, to whatever degree that transition is, our response must be kindness. We can, to quote a 59

beautiful hymn, “be as Christ to them,” and trust God’s Spirit to lead them to the best next steps for them.

Think of it this way: Most of us would agree that God’s ideal is one man, one woman, forever in marriage. We also realize that marriage, even between good people, doesn’t always work. Yet we stick with people (I hope) no matter their choices. If we have friends who are divorced, we don’t ask that they return to their previous spouses as a qualification for our friendship. We love them where they are. Hear me; I’m not equating divorced people and transgender people. I’m simply talking about the priority of relationships.

Asking people to tell us their stories, and listening to learn, is a great way to establish a relationship built on trust. If we don’t get up close and personal with people, we never will have the opportunity to share our hope that they follow God’s beautiful design for them. And we will miss out on opportunities to love them when they make choices with which we disagree.

In public spaces, including workplaces, schools, neighborhoods and social media, we must treat others with respect and kindness.

There is no place for bullying or ridicule. Of course, church is a public space where we must make everyone feel welcomed, even if we cannot affirm their choices.

Remember: “The human spirit can endure in sickness, but a crushed spirit who can bear?” (Proverbs 18:14, NIV). Let’s never be guilty of crushing someone’s spirit.

In the political arena a good place to start is reading Abigail Shrier’s book, Irreversible Damage: The Transgender Craze Seducing Our Daughters. It will alert you to the way some activists and influencers are manipulating the feelings of kids and introducing dangerous confusion.

We can educate ourselves on legislation such as Arkansas’ SAFE Act, and we can support similar legislation in Alabama. We can keep abreast of the Equality Act presently before the U.S. Senate.

The Equality Act would supplant the 1993 Religious Freedom 60

Restoration Act and could, for example, force medical providers to provide therapies that violate the belief that God created us male and female. The Equality Act also has the potential to force churches who have a practice of renting our facilities to host events with which we disagree.72 We can support legislation that 1) preserves the rights of parents to know about, and to determine, treatments of their children who identify as transgender; 2) shields responsible medical professionals who refuse to violate their convictions regarding the best treatments for their patients; and 3) protects impressionable young people from the opportunists who prey on their vulnerability.

Churches must respond compassionately.

That is why I do this work, Travis, to help stem the tide of harm done to this community and help them heal from what society and the church has done and keeps doing to them. I was a faithful evangelical Christian for 20 years, where my husband and I faithfully raised our children, homeschooled them, taught them "the ways of the Lord." Then when our daughter came out I experienced the dark underbelly.

That’s what a lady who advocates for transgender people told me.

And I believe her.

Multitudes of people who identify as transgender have been hurt by, or angered by, the Church. Many of them want nothing to do with us. Others, however, still long for a church home and to be loved by a church family. We must respond compassionately to all persons, including those who are transgender.

Mark Yarhouse encouraged an “integrated framework” in response to people who identify as transgender. Essentially, Yarhouse’s “integrated framework” declares: 1) Gender dysphoria is a disability, a result of our fallen world.

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2) Some transgender people make choices that violate God’s plan for our bodies. And, 3) Transgender people should be loved as they are.73 Taken together, I believe these three constitute an appropriate church response to the transgender conversation.

I believe the choice of transgender-identifying Christians to transition, either socially or medically, goes against God’s design.

I also believe I have a responsibility as a Jesus-follower to try and help those who, by no choice of their own, experience anxiety over their sexual identity. That is true even if that anxiety is a result of a false self-diagnosis.

I am deeply disappointed that people who are gay and transgender find far greater acceptance in the LGBTQ community than in some churches. Jesus, I believe, is also disappointed. I’m not suggesting anyone should affirm sexual behaviors and decisions that conflict with our understandings of what the Bible says. I am suggesting, even pleading, that we choose to love like Jesus.

Jesus’ love for people on the margins earned for him the right to say to a woman caught in adultery, “I don’t condemn you; go and sin no more,” (John 8:11). Jesus is our model for balancing truth and grace.

Both sanctimonious exclusivism and indiscriminate inclusivism are easy. The integration of truth and grace, on the other hand, is hard. And it is into that hard, risky, messy integration that I feel called.

I hope you do, too.

At FBC we must be a welcoming family, without encouraging that which violates God’s intentions for our bodies. That is a difficult balance, especially given the polarization of our society. Yet, we have to work hard to strike that balance.

Our kids are particularly vulnerable. Social awkwardness, embarrassment about their bodies, interests that don’t correspond 62

to cultural expectations of their sex, combined with social media and peer influence, all make some question, “Am I transgender?”

We must embrace them as a church family. If we shame them or shun them we will lose them. The landscape is littered with people born in God’s image who feel like church orphans because of their sexual orientations and identities.

I would hope that, as FBC, Huntsville, we would welcome everyone with open arms to our worship, fellowship, and membership. I also would hope that we could encourage people to find healthy ways to deal with their dysphoria and would provide support and love as they navigate this complex journey.

Walking with people through their gender dysphoria would/could/will be rather chaotic. But if we are afraid of chaos, we will miss out on many ministry opportunities.

Should a congregation’s response be based on our convictions about morality, or should it be based on our concern for pastoral care? The balance is ideal, but I believe it is rare. Too often churches end up on one extreme or the other. Either they condemn, without any empathy, those who experience gender dysphoria and their attempts to deal with it, or, on the other extreme, in the name of love and cultural relevance, they simply affirm all choices without offering biblical and reasonable critique.

I believe Christian discipleship—our journey toward the likeness of Christ Jesus—has much to do with our sexuality. For the heterosexual who is tempted by pornography, or a person other than one’s spouse, discipleship means the discipline to be sexually holy. For the person who is attracted to the same sex, or is not yet married, discipleship means celibacy. And for the Christian who feels like a woman in a man’s body or a man in a woman’s body, discipleship, I believe, requires learning to love one’s self as God created him or her.

And yet, the truth is that lots of transgender persons who are Christians have done the Bible studies, have prayed and pleaded 63

for relief, and still experience a troubling mismatch between their sex and their gender identity. Some even say their fervent efforts to overcome their dysphoria have added to their anxiety.

Therefore, we have a responsibility to walk with transgender persons through their hard decisions, and love them even when they make decisions with which we disagree. Much like I would counsel someone against co-habitation, or a same-sex relationship…then love them no matter their decision.

So, what is a church to do? It is possible for a church to balance conviction and compassion. A church can offer spiritual and social support, without affirming moral ambiguity.

It’s just not easy.

“Identity in Christ” is key.

I have found this important truth of who we are in Jesus to be a key concept with multiple applications. In Bon Air Baptist’s ministry among people in recovery I learned it is tremendously helpful for Christ-followers struggling with addiction to remember that they are defined by their identity in Christ, not their addiction.

In my study of same-sex intimacy I read Mark Yarhouse’s reminder of how important it is to help Jesus-followers understand our “identity in Christ.” We can remind people that same-sex attraction is part of some people’s experience, but that is not what defines them (or us). Rather, our identity in Jesus is that which should determine how we view ourselves.74 In Washed & Waiting, Wesley Hill explains his decision, as a gay man, to be celibate and declares he has found fulfillment in his identity in Christ.75 I find the truth about our identity in Christ to be helpful once more.

For Christians struggling with gender dysphoria, this is crucial.

“Conversion,” Rene Padilla wrote decades ago, “was never a merely religious experience; it was also a means of becoming a member of a community in which people find their identity in Christ rather than in race, social status, or sex.”76 Our sexuality is 64

not unimportant, but it is not what defines us. Who we are in Jesus defines us.

Pronouns and Restrooms are not easy topics.

The conversation about transgender people is far more complex than “pronouns and restrooms.” However, because so much energy goes into trying to figure out what to do about these two questions, before I conclude I’ll offer my perspective briefly here.

Pronouns What if you are in a Zoom meeting and beside one of the participant’s name you see pronouns? Maybe it looks like this: “Sue (she/her).” Or if, on someone’s nametag or social media profile, you see pronouns, what does that mean? It means either they identify as transgender and are letting you know the pronouns they prefer, or they are supporting the rights of transgender persons and want to send that signal.

You see, persons who are transgender often prefer the non-gender pronouns, “they,” “them,” or “their,” as opposed to “he/she,” “him/her,” or “his/hers.” That causes great discomfort for grammarians, I know. But the main point is people, not grammar.

Furthermore, men who identify as women often ask to be referred to with feminine or gender-neutral pronouns, just as women identifying as men prefer masculine or gender-neutral pronouns.

How should we respond to the request from trans persons that we refer to them using pronouns that do not match their biological sex.

One response is simply to agree gladly, and not give it a second thought. That’s a no-brainer for someone who celebrates LGBTQ identities.

But what about those who believe people should live according to their biological sex? To refer to persons with non-gender-specific pronouns (they, them, or their), or to refer to a biological male as 65

“she,” or to biological female as “he,” might seem disingenuous.

In fact, lots of Christians choose only to use pronouns that refer to a person’s biological sex so as not to condone someone’s choice to transition. Words matter and, for many, to use pronouns that do not correspond to a person’s biological sex is tantamount to surrendering to cultural pressure and encouraging people to live a lie.77 I believe, however, that relationships matter more than words. So, I will use the pronouns and the names that a transgender adult prefers. (Regarding children and teenagers, I will follow the parents’ lead.)

I believe a biological male should live as a boy or man, and a biological female should live as a girl or woman. I’m not going to abdicate my moral, ethical, and spiritual convictions on that. And yet, I believe any effort I can make at building relationships is a good thing. I understand we always must strike the balance between truth and grace, between convictions and compassion.

But if I err on this question of pronouns, I want to err on the side of grace and compassion. I never want to close a door on a relationship.

Restrooms This is a tricky question, because people’s safety could be at stake.

It is certainly possible, for example, that a man would claim to identify as a woman as an excuse to go into a ladies’ restroom for nefarious purposes. And yet, for one who is indeed transsexual, the restroom corresponding to one’s birth certificate is a terribly awkward place.

I believe a person should use the restroom of his or her biological sex. But, I have to admit it’s rather complicated. For a female who has fully transitioned to male, and who looks like a man, to go into a ladies’ restroom would cause the ladies there to feel uncomfortable, would it not? The same would be true about a 66

trans female (who has “male” on the birth certificate but looks like a woman) going into a men’s restroom, right?

The best answer I know for everyone concerned is the unisex or “Family” restroom that has space for only one person. And, by the way, I am really grateful that our FBC building includes some “Family” restrooms.78

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CONCLUSION I acknowledge the awful feeling of dysphoria that so many people experience. I believe the painful problem of incongruence between gender identity and sexual biology is real for many people, and I cannot imagine how disruptive that must be to their lives. And yet, I do not believe the answer is to live as if one is the “other sex.” I believe the solution to the dilemma of gender dysphoria is not hormone therapy, or sex-reassignment surgery. I believe a social transition (acting, dressing and living as the opposite sex) is not healthy either.

Nevertheless, I want to be loving and kind. I want to be part of the solution to the bullying and marginalization that transgender people have to endure. I want to assuage the fear and repulsion that many people feel toward transgender people.

If we do not love and embrace transgender people, shame on us. If we insist that they acknowledge and accept their God-given sex, but refuse to walk with them in their struggles, we are not demonstrating the love of Jesus.

There are many transgender people who would not welcome the help of a Christian community. But for those who will, we must befriend them. And our love must never be limited to those who make the choices we believe to be best.

Even as I have written this booklet I have imagined it being read by people who identify as transgender. I want to share my beliefs without sacrificing relationships. I hope and pray my words about LGBTQ persons will not drive any wedges or burn any bridges between us.

I know that people on the margins of 1st century society felt at home in Jesus’ presence. I know that I have my own hurts, habits and hang-ups that could easily make me unappealing to some 68

people. And I know that a church is supposed to be a loving, welcoming family. As I read somewhere, “Biology is complicated.

Kindness and respect don’t have to be.”

If a person who identifies as transgender shows up at FBC, Huntsville, I intend to welcome that person as warmly as I would welcome anyone else. If it is a child or teenager, I will honor the parents’ wishes about how I relate to him or her.

I am not a trained counselor, and I will not assume the role of psychological “fixer.” I do intend to respond, if the opportunity arises, that I believe we are created as male and female and that I believe God’s intention is that we live out our gender identity in alignment with our biological sex.

I also plan to fulfill my calling as pastor, which means being as present and supportive as is practical as someone navigates the struggles of gender dysphoria. I will be a friend and pastor to whatever extent that is welcomed.

Loving people well, for me, means truly loving people who suffer from gender dysphoria, while simultaneously warning against activists and influencers who prey on vulnerable kids, leading them down an irreversibly destructive path. Loving people well, for me, means speaking what I understand to be the truth and speaking that in love…even when love is not returned.

Let none of us forget that beautiful line from Joseph Cooke: “Grace is the face that love wears when it meets imperfection.”

I especially hope you will remember that line when you encounter me.

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SPECIAL THANKS I am deeply grateful for the friends listed below who read the draft of this booklet (the entire booklet or sections of it) and gave me great suggestions. This booklet is so much better than it would have been without them. In the end, however, the booklet reflects my opinions and not necessarily the opinions of these readers.

Mrs. Myrna Boyd, Dr. David Bramm, Dr. Mike Crouch, Dr. Scott Field, Dr. Joseph Hicks, Mr. Andy Jones, Dr. Patrick Lappert, Dr. Jack Ragland, Mrs. Diane Singer, Mrs. Anne Stone, Dr. Mike Klemm, Dr. Robbie Klemm Dudley, Dr. Bradley Shaefer, and many members of the FBC ministerial staff.

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Major Resources Beardsley, Christina, and O’Brien, Michelle, eds., This is My Body: Hearing the Theology of Transgender Christians (London: Dartman, Longman & Todd), 2016.

Beilby, James K., and Eddy, Paul Rhodes, eds. Understanding Gender Identities: Four Views (Grand Rapids: Baker Academic), 2019.

Christian Medical and Dental Association, “Bridging the Gap: Where Science and Church Meet. Gender Identity.”

Hartke, Austen. Transforming: The Bible & the Lives of Transgender Christians. (Louisville: Westminster John Knox Press), 2018.

Mayer, Lawrence S, and McHugh, Paul R., “Sexuality and Gender: Findings from the Biological, Psychological, and Social Sciences,” pub. Center for the Study of Technology and Society, 2016.

Shrier, Abigail. Irreversible Damage: The Transgender Craze Seducing Our Daughters (Washington D.C.: Regnery Publishing), 2020.

Sprinkle, Preston, Embodied: Transgender Identities, the Church, & What the Bible Has to Say. (Colorado Springs: David C. Cook), 2021.

Yarhouse, Mark. Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture (Downers Grove: IVP Academic), 2015.

Yarhouse, Mark and Sadusky, Julia, Emerging Gender Identities: Understanding the Diverse Experiences of Today’s Youth. (Grand Rapids: Brazos Press), 2020.

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ENDNOTES 1

https://www.christianitytoday.com/news/2021/may/hhs-christiandoctor-transgender-reassignment-court-cmda.html 2

See Mark Yarhouse and Julia Sadusky, Emerging Gender Identities: Understanding the Diverse Experiences of Today’s Youth, p. xii.

3

There is some disagreement over which was the first sex-reassignment surgery. Some point to the 1906 mastectomy of Martha Baer, who transitioned to Karl. Others point to Lili Elbe, born Einer, and the series she underwent beginning in 1930 as Einer transitioned to female.

4

https://www.ajc.com/news/court-again-rules-for-transgender-studentin-bathroom-access-case/VXH2GUWRZ5DCVG6CPD5YHBPMTU/ 5

https://www.al.com/news/2021/11/alabama-ag-marshall-defendsarkansas-law-banning-gender-transition-treatments-for-minors.html 6

https://www.aldailynews.com/committee-moves-transgender-bill/

7

https://www.nytimes.com/2022/01/13/health/transgender-teenshormones.html?searchResultPosition=1 8

Money was the one behind the well-known and disastrous attempt to have Bruce Reiner raised as Brenda. Bruce’s penis was terribly damaged in a circumcision-gone-wrong. Money then convinced Bruce’s parents to allow surgeons to construct a vagina for Bruce, to give him female hormones, and raise Bruce as a girl, Brenda. The whole thing was disastrous, and when “Brenda” found out what had happened he reverted to living as a boy, going by the name, David. The trauma was so devastating, David Reimer took his life as a young man in his thirties.

9

Austin Hartke, Transforming, p. 28.

Lawrence Mayer and Paul McHugh, “Sexuality and Gender,” p. 91; “Surgeons are becoming more capable of constructing artificial genitalia, but these ‘add-ons’ do not change the biological sex of the recipients, who are no more capable of playing the reproductive roles of the opposite biological sex than they were without the surgery…No degree of supporting a little boy in converting to be considered, by himself and other, to be a little girl makes him biologically a little girl. The scientific definition of biological sex is, for almost all human beings, clear, binary, and stable, reflecting an underlying biological reality that is not 10

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contradicted by exceptions to sex-typical behavior, and cannot be altered by surgery or social conditioning.” (Mayer and McHugh, p. 93) 11

Mark Yarhouse, Gender Dysphoria, p. 7.

12

Yarhouse and Sadusky, p. 21.

“The background to the brain-sex theory is that scientists have established that ‘the presence of testosterone in utero leads to the development of external male genitalia and to a male differentiated brain.’ But these are two distinct processes; they do not occur at the same point in fetal development. In other words, sex differentiation of the genitals and sex differentiation of the brain take place at different stages of fetal development. Proponents of the brain-sex theory identify this discrepancy as significant for gender incongruence: ‘As sexual differentiation of the genitalia takes place much earlier in the development (i.e., in the first two months of pregnancy) than sexual differentiation of the brain, which starts in the second half of pregnancy and becomes over upon reaching adulthood, these two processes may be influenced independently of each other.’ Is it possible, then, that ‘a discrepancy may exist between prenatal genital differentiation and brain differentiation such that the external genitals develop, for example as male while the brain develops as female’”? Yarhouse, Gender Dysphoria, p, 67.

13

Quoted by Mark Yarhouse and Julia Sadusky in “The Complexities of Gender Identity,” Understanding Gender Identities: Four Views, Beilby and Eddy eds, p. 106.

14

It appears that “Brain-Sex” theory was first posited by Stanford professor of biology, Robert Sapolsky, in a 2013 Wall Street Journal article titled “Caught Between Male and Female.” Sapolsky set forth the theory that one can have the brain of one sex and the anatomy of the other. (Mayer and McHugh, p. 98) If the Brain-Sex Theory were to be demonstrated as accurate, one could argue that an attempt to align one’s body and mind through a new lifestyle, and even through hormonal or surgical treatment, is warranted in certain extreme cases. Some take that position.

15

“The available evidence from brain imaging and genetics does not demonstrate that the development of gender identity as different from biological sex is innate. Because scientists have not established a solid framework for understanding the causes of cross-gender identification, 16

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ongoing research should be open to psychological and social causes, as well as biological ones.” (Mayer and McHugh, “Sexuality and Gender,” p. 105).

In This is My Body, Beardsley and O’Brien, eds, p. 175. Drag is the term most often used for someone dressing in the clothing associated with the opposite sex for entertainment purposes. Drag kings are women who dress as men, and drag queens are men who dress as women, impersonating the opposite sex as a performance.

17

When people refer to “nature or nurture” they are wondering whether a person experiences gender dysphoria because of what happened in utero (nature) or because of experiences in one’s early childhood (nurture). It is impossible to determine whether one’s sexual identity is a matter of nature, or nurture, or both. The research is inconclusive, and the topic is exceedingly complex.

18

19

https://www.livingout.org/resources/articles/83/5-things-everychristian-should-know-about-the-transgender-conversation 20

Mayer and McHugh, p. 96.

21

This term appears in quotation marks because it is so controversial.

On the one hand, transgender advocates prefer the term, Gender Confirmation Surgery. On the other hand, those who believe sex is unchangeable contend that the word “reassignment” implies that sex was assigned by a parent or physician, which they believe not to be true. Sex, they contend, is determined at conception, not “assigned” at birth.

A number of persons who fall under the “transgender” umbrella do not fully transition to the sex opposite their biological sex, or “birth sex.”

One such person said, “I am happy in my male role, at work, as a husband, father and grandfather. I don’t have a yearning to transition into the female role permanently. I just love to be able to express the two sides of me.” That person would be described by most as “transgender,” but not transsexual.

22

Also, there are “binders”—undergarments that make a woman’s breasts appear smaller when she is wanting to appear like a man. There are also “packers”—funnel-like instruments that allow a woman to urinate while standing like a man.

23

24

Mark Yarhouse and Julia Sadusky have an interesting take on hormone therapy: “We have sometimes likened these choices (hormones) to the

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choices of a parent whose loved one is diagnosed with seizures, neurofibromatosis, multiple sclerosis,or any other qualifying medical condition in which they might consider utilizing medical marijuana when they never would have thought of doing otherwise.” (Emerging Gender Identities, 89). .

25

For a male transitioning to life as a female, the surgeon might do breast implants and cosmetic surgery on the face. The surgeon might even attempt to construct vulva and vagina where scrotum and penis were previously. A female transitioning to life as a male might have breast reduction surgery, or a double mastectomy. The patient might have a hysterectomy or ovariectomy. Although it is not nearly as common, the surgeon might do a phalloplasty, the construction of a simulated penis.

26

"Kris Fabick FB trans posts"

27

Beardsley and O’Brien, eds. This is My Body, p. 103.

28

These words in Isaiah 56 may refer to the intentional inclusion of those who had been made eunuchs during the Babylonian captivity.

Some Pharisees came to him to test him. They asked, “Is it lawful for a man to divorce his wife for any and every reason?” “Haven’t you read,” he replied, “that at the beginning the Creator ‘made them male and female,’ and said, ‘For this reason a man will leave his father and mother and be united to his wife, and the two will become one flesh’? So they are no longer two, but one flesh. Therefore what God has joined together, let no one separate.” “Why then,” they asked, “did Moses command that a man give his wife a certificate of divorce and send her away?” Jesus replied, “Moses permitted you to divorce your wives because your hearts were hard. But it was not this way from the beginning. I tell you that anyone who divorces his wife, except for sexual immorality, and marries another woman commits adultery.” The disciples said to him, “If this is the situation between a husband and wife, it is better not to marry.” Jesus replied, “Not everyone can accept this word, but only those to whom it has been given. 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.” (Matthew 19:3-12, NIV) 29

30

Preston Sprinkle, Embodied, p. 110.

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31

Long-term follow-up of individuals undergoing sex reassignment surgery: Psychiatric morbidity and mortality, R. K. Simonsen, Annamaria Giraldi, Ellids Kristensen, & G. M. Held 32

Mayer and McHugh, p. 108

33

Mayer and McHugh, pp. 112-113.

34

Abigal Shrier, Irresistable Damage: The Transgender Craze Seducing Our Daughters, p. 201 35

https://segm.org/first_large_study_of_detransitioners

Justin Sabia-Tanis, “Holy Creation, Wholly Creative,” in Understanding Gender Identities: Four Views, Beilby and Eddy, eds., p.

213. Studies done in 2009 and 2021 reported the number of those who “de-transition” at 8%. (Beilby and Eddy, eds, p. 24; https://www.gendergp.com/detransition-facts) Of course, when we consider how very difficult it would be to undergo another series of surgeries to “undo” that which was done in the initial SRS, we have to believe the number of people dissatisfied with their transition is higher than 8%. Many would simply not have the resources to undergo a surgical reversal of their sexual transition.

36

37

Concerned Christians often warn of the significant risks associated with hormone treatments and sex-reassignment surgery. Megan K. DeFranza responded to those concerns with this: “Given the positive outcomes that so many transgender people describe, readers are asked to consider whether we would deny access to medical care to people whose pain could be similarly alleviated through surgeries or medications, even when those interventions come with health risks and unknown long-term effects. When my mother was diagnosed with a type of brain cancer for which there was no known cure, my family was faced with the difficulties of weighing the dangers of brain surgery and the risks of experimental drugs. Our churches prayed for her healing and for wisdom, but no one argued that considering risky trials was a failure to trust in God or accept God’s providence…we must consider whether we are being consistent in our judgments of those willing to accept the risks of transgender medical treatments, many of which have higher rates of success than new drugs for cancer. To be fair, I must also note that I harbor my own worries about the health risks being assummed not only by transgender adults but now also by transgender teens.” In

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Understanding Transgender Identities: Four Views, Beilby and Eddy, eds., p. 235.

38

Yarhouse, p. 70.

39

Sprinkle, 172.

40

https://www.nytimes.com/2022/01/13/health/transgender-teenshormones.html?referringSource=article 41

https://www.washingtonpost.com/lifestyle/2020/07/28/follow-theirlead-other-ways-parents-can-support-their-nonbinary-children/ 42

Yarhouse and Sadusky, 66.

43

Yarhouse, Gender Dysphoria, p. 81.

44

In Beilby and Eddy, eds, pp. 36ff.

45

Yarhouse and Sadusky, 54.

46

i.e. https://www.psychologytoday.com/us/blog/politicalminds/202012/new-book-irreversible-damage-is-full-misinformation 47

www.4thwavenow.com

48

https://www.sfexaminer.com/opinion/are-we-seeing-a-phenomenonof-trans-youth-socialcontagion/?fbclid=IwAR2zmQGHC6o6weO7ad_xbfnI2n8q8RB0VlBpdK6dNaXv11h-gopt8te-XM 49

https://www.dailysignal.com/2019/10/10/problematic-women-theradical-feminists-who-are-fighting-the-transgender-movement/ 50

Sprinkle, pp. 162-163.

51

Mayer and McHugh, p. 74.

52

CMDA Gender Identity Facilitator’s Guide, p.17.

53

Yarhouse, 105; This is My Body, eds. Beardsley & O’Brien, p. 89.

54

Sprinkle, 86.

55

Yarhouse and Sadusky, 26.

See Paul McHugh, Transgender Surgery Isn't the Solution,” Wall Street Journal, May 13, 2016 56

57

Emerging Gender Identities: Understanding the Diverse Experiences of Today’s Youth, written by Yarhouse and Julia Sadusky, offers helpful 77

insights for parents.

58

See Sprinkle, pp. 82-83.

59

As an example, in the book, Understanding Transgender Identities: Four Views, Owen Strachan, a former Southern Baptist seminary professor, offered this advice: We train our sons to be protectors, providers and leaders in the image of Christ. We train our girls to be feminine and to embody a gentle and quiet spirit as a demonstration of womanly beauty. When we live in these ways as believers, we may know with assurance that we are living as God intended. (p. 133) 60

There is one example of effeminate behavior by men being condemned in the Bible. In 1 Corinthians 11:14, God tells men not to wear long hair, even calling long hair on men a “disgrace.” That is because, in the first century, it was commonly understood that long hair on a man was a signal that he was available for same-sex relationships.

Members of the church in Corinth would have recognized that, in their context, a man with long hair was being “effeminate.” A man’s long hair was, in that place, an advertisement for a homosexual hookup, and God inspired Paul to condemn that. So, it would be wrong of us, in this book, to say that masculinity and femininity are not recognized at all in the Bible.

What we do claim is that confusing our culture’s ideas of masculinity and femininity with the Bible’s guidelines is dangerous.

Russell Moore, “After the Bostock Supreme Court Case,” June 15, 2020, https://www.russellmoore.com/2020/06/15/after-the-bostocksupreme-court-case/ 61

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62

In 2016 a major op-ed appeared in the Wall Street Journal titled, “Transgender Surgery Isn’t the Solution.” In that article, Paul McHugh says this: "Sex change" is biologically impossible. People who undergo sex-reassignment surgery do not change from men to women or vice versa. Rather, they become feminized men or masculinized women.

Claiming that this is civil-rights matter and encouraging surgical intervention is in reality to collaborate with and promote a mental disorder. By the way, the subtitle to McHugh’s article is, “A drastic

physical change doesn't address underlying psycho-social troubles.” One might argue that those “psycho-social troubles” are the result of living contrary to the Creator’s design for the individual.

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CMDA Position Statement, Transgender, p. 4.

64

Maria Keffler, Desist, Detrans, and Detox (Partners for Ethical Care, 2021), pp. 27-28.

65

See “Mayer and McHugh, p. 11.

66

Mayer and McHugh, p. 12.

67

Mayer and McHugh, p. 115.

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Paul McHugh, quoted in Shrier, Irreversible Damage p. 142

Sprinkle, p. 46. Until 2013 the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) referred to “gender identity disorder.” In 2013 the DSM changed its terminology to “gender dysphoria.” This change means the potential distress associated with gender incongruence as a disorder, but the incongruence or transgender identity is not considered disorders in themselves. There are ongoing efforts by transgender advocates to remove “disorder” from descriptions of transgender identity, so that transgender experiences will be normalized and simply associated with the broader LGBTQ+ community. (See Yarnouse & Sadusky, p. 34; See also Paul McHugh, Transgender Surgery Isn't the Solution,” Wall Street Journal, May 13, 2016.)

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See Mayer and McHugh, p. 73; “Many trans* people, especially teenagers, have co-occurring mental health concerns, sometimes several, like anxiety, depression, and eating disorders. Trans* people also experience borderline personality disorder, schizophrenia, obsessive 70

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compulsive disorder (OCD), attention deficit hyperactive disorder (ADHD), and autism spectrum disorder at a higher rate than the general public. For example, according to one study, people with gender dysphoria are ten times more likely to be on the autism spectrum than non-dysphoric people. Another study shows that 26 percent of trans” teenagers seeking sex reassignment surgery were diagnosed with autism.

Are these mental health issues a cause, a result, or simply correlated with being trans*? Specialists are divided…What we can say with confidence is that there may be other mental health concerns intertwined with a person’s trans* experience.” (Sprinkle, pp.55-56) “Researchers have found that conditions including ADHD, autism, affective and anxiety disorders, depression and schizophrenia occur at significantly higher-than-usual rates among transgender people.” (Beilby and Eddy, eds., p. 22) “It is not obvious how this patient’s feeling that he is a woman trapped in a man’s body differs from the feeling of a patient with anorexia nervosa that she is obese despite her emaciated, cachetic state. We don’t do liposuction on anorexics. Why amputate the genitals of these poor men? Surely the fault is in the mind not the members.” (Paul McHugh, quoted in Yarhouse, pp. 120-121.)

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See https://www.npr.org/2021/02/24/969591569/house-to-vote-onequality-act-heres-what-the-law-would-do; “Equality Act Lacks Religious Freedom Protections,” National Association of Evangelicals January 25, 2021; “Swinging the Pendulum Too Far,” Ed Stetzer, 2/25/2021 73

Yarhouse, pp. 46-60.

74

Yarhouse, Christianity and the Homosexual, 48-51

75

Wesley Hill, Washed & Waiting, 77

76

Rene Padilla, Mission Between the Times (Grand Rapids: Wm. B. Erdmans Publishing, 1985), p. 167.

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See, for example, this article from the Wall Street Journal: https://www.wsj.com/articles/asked-your-pronouns-dont-answer-lgbtqiasogie-gender-identity-nonbinary-transgender-trans-rights-sexismmisogyny-feminism-11643992762 78

Preston Sprinkle, in his book, Embodied, has a chapter titled “Pronouns, Bathrooms, and Sleeping Spaces.” Since I didn’t address 80

sleeping arrangements in the body of the booklet, I’ll address the question briefly here, in the footnotes.

With growing numbers of persons identifying as transgender, this has become quite the complicated topic. Take a summer camp for students, as an example. The close quarters of most camp settings cause leaders an understandable concern.

Dealing with their bodies is tough enough for teens already. Most are self-conscious and awkward. Add to that the possibility of someone who is gay or transgender and lots of kids might wonder where they belong.

The best answer is the most privacy possible for individuals and the most supervision possible by adults. If special accommodations are possible, that is a welcomed solution. For example, a boy who identifies as female, and his family, might ask for a private room, perhaps out of fear of harassment by other boys.

When special arrangements, such as “family” restrooms and separate sleeping arrangements are possible, that seems most ideal.

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