Running head: EMBRACING UNCERTAINTY 1

Embracing Uncertainty:

Evaluating the Traditional Christian Approach to Transgenderism

Samuel Myers

A Senior Thesis submitted in partial fulfillment

of the requirements for graduation
in the Honors Program
Liberty University
Spring 2017
EMBRACING UNCERTAINTY 2

Acceptance of Senior Honors Thesis

This Senior Honors Thesis is accepted in partial

fulfillment of the requirements for graduation from the
Honors Program of Liberty University.

______________________________
Richard Alan Fuhr Jr., Ph.D.
Thesis Chair

______________________________
Mark Allen, Ph.D.
Committee Member

______________________________
Fabio Freyre, Ed.D.
Committee Member

______________________________
James H. Nutter, D.A.
Honors Director

______________________________
Date
EMBRACING UNCERTAINTY 3

Abstract

The transgender movement has posed an ethical problem for societies around the world,

and has forced Christian communities to reconsider traditional conceptions of gender,

sex, and what makes someone a man or woman. The conventional approach that most

evangelical Christian communities have adopted towards individuals who experience

incongruence between their gender identity and physical sex characteristics has been to

condemn cross-gender living. To equip Christians to consider the morality of

transgenderism most effectively, this study begins by defining key terms, and provides a

brief survey of some of the scientific and medical background issues surrounding this

discussion. We then examine the biblical arguments underlying this traditional judgment

of transgender behavior as immoral and provides a critique of the use of the two primary

biblical texts utilized in this discussion to prohibit trans lifestyles. In conclusion, it

examines the advantages of abandoning a poorly reasoned argument against the

compatibility of trans lifestyles with the Christian worldview. The goal of this piece is to

pave the way for the development of ethical judgments based on biblical and scientific

truth, whether they permit or prohibit trans living.

Keywords: transgenderism, Christian ethics, theology and gender

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Author’s Note

I have been answer-obsessed since I was a child. In every area of my life I have

labored to resolve uncertainty and to discover truth, and I brought this disposition with

me as I began this project. When I originally decided to focus on transgenderism, my

intention was to offer a moral judgment on it to help Christians navigate the difficulties

of this challenge to traditional views on gender. I would seamlessly blend the latest in

scientific research with an exegetical, historically accurate hermeneutic to come up with

“the answer.” As I have examined the predominant response to this phenomenon by

conservative Christian groups, however, the goal of my thesis has evolved significantly. I

was surprised to discover that there was no shortage of “answers” to this moral question,

but that the majority of these were seriously deficient, exhibiting eisegetical

hermeneutical practices and a lack of understanding of transgenderism. Especially as I

grew to understand how complex of an issue transgenderism truly is and witnessed the

silence of the biblical authors on the topic, I began to realize that what this conversation

needs most is not another answer, but to acknowledge the complexity of making such a

moral judgment. There is no Bible verse about transgenderism, much as we can wish

there was. In the face of biblical silence, oversimplifying this issue or reading it into

unrelated texts – tempting as they are – will not result in a satisfactory answer, and too

many Christian approaches to transgenderism fall into exactly these traps. The purpose of

this thesis, then, is not to offer a new answer to this moral quandary, but to evaluate the

arguments underlying the prevalent conservative Christian answer.

EMBRACING UNCERTAINTY 5

It is not my intention to disagree with the conclusion that cross-gender living is

sinful, nor do I aim to agree with it. Rather, I believe that evaluating the relevancy of the

key arguments used to condemn this lifestyle will logically result in the development of

stronger moral conclusions and will give Christians the freedom to consider this question

less encumbered by presumptions. It is my hope that this piece will encourage Christians

to acknowledge the true complexity of this issue and to take a second look at why they

believe what they believe in areas of moral uncertainty such as transgenderism. I

especially hope that it will be a reminder of the preeminence of Christ in the midst of

ethical greyness, and that it will encourage Christians to admit uncertainty and embrace,

rather than fear, not having all the answers. May we be captivated by Jesus, instead of by

answers.

Thank you for reading this piece, and I hope that you are blessed by it.
EMBRACING UNCERTAINTY 6

Prelude

Chandler Wilson sits in front of a webcam wearing blue jeans and a black t-shirt

with a rainbow on it. Underneath the rainbow in large, round letters are three words: “It’s

all good.” They1 are in their living room; two blue suede couches, a bookcase, and a

vacuum cleaner form the background of the shot. For Chandler, this is an important and

terrifying day: they are about to come out to their mom as transgender. “I’m really

nervous,” Chandler breathes, “that’s why I’m talking so fast.” The video cuts to Chandler

and their mom sitting on the couches, the family dog on the floor, looking back and forth

between the two, as Chandler explains their journey to discovering their identity as

transgender. When Chandler finishes, their mom responds, saying, “You know what I

say? You have to be yourself, ‘cus that’s the only way you’re gonna be happy.” The two

stand up and hug, and, as the hug breaks, Chandler’s mom speaks again: “It’s hard for

me, but I think the thing that helps me is that, as a Christian, I know God made us and he

loves us all equally, and I think how much I love you and your sibling, and I know he

loves us way more than I can ever imagine.” Chandler hugs their mom once again as she

finishes her thought: “My whole thing with all of this is, if he has an issue with it, then

he’ll deal with you on it.” 2 At the time of writing, this video has been viewed almost two

million times.

1
Chandler identifies as agender, and prefers they/their/them as their personal pronouns. Agender
individuals identify as having no gender identity.
2
“Coming Out as Transgender Agender,” YouTube video, 9:28, posted by “ChandlerNWilson,”
Apr. 5, 2015,
[Link]
C&index=1.
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Embracing Uncertainty:

Evaluating the Traditional Christian Approach to Transgenderism

While sexual orientation debates have been raging between conservative and

liberal communities for the past few decades, a smaller minority group has been fighting

for acceptance in Western culture. These individuals, while physically male or female,

internally experience themselves as not being members of the gender they were born into.

This phenomenon, though sometimes overshadowed by discussions regarding the

morality of homosexual behavior, has come to the forefront especially in recent years,

with the publicity surrounding Caitlyn Jenner’s transition from male to female in 2015,

and North Carolina’s controversial 2016 law requiring individuals to use restroom

facilities consistent with the sex recorded on their birth certificates. What may have

seemed a passing phase relevant to only a tiny group of individuals has turned into a

battleground of ideologies and moral systems, with no easy answers to be found.

While media and secular culture have been outspoken regarding their takes on

morality of these actions, many Christian communities have only recently begun to

respond to the evolution of Western gender norms. A 2013 study showed that most

churchgoers who experienced tension between their gender identity and biological sex

reported that gender identity issues were never discussed directly in church, though

sexual orientation and abortion were common topics.3 Transgender individuals generally

3
Denise L. Levy and Jessica R. Lo, “Transgender, Transsexual, and Gender Queer Individuals
with a Christian Upbringing: The Process of Resolving Conflict Between Gender Identity and Faith,”
Journal of Religion & Spirituality in Social Work: Social Thought 32, no. 1 (2013): 70.
EMBRACING UNCERTAINTY 8

recount being ostracized and unwelcome in mainstream churches, and have departed

traditional church communities in exchange for individualized spiritualities at a much

higher rate than their non-transgender peers.4 Rather than being a mere imagining or a

negative reaction to having their lifestyles disapproved of, the prejudice trans individuals

report experiencing from Christian communities is verified by research; a 2012 study by

Norton and Herek showed that the more important a role religion plays in a person’s life,

the more likely that person is to express dislike toward transgender individuals.5 Clearly,

the current Christian approach to transgenderism has been ineffective, and in some cases

very harmful, both in the transgender and Christian communities. However, most

evangelical Christians will not be content with rationalizing away the clear separation

between male and female of the Bible as merely historical social understandings

irrelevant to the modern understanding of gender, as do many liberal theologians.6 For

Christians who see the Bible as inerrant and relevant today, there is a great need for an

approach to transgenderism that both honors biblical teachings on gender, and also

informs compassionate ministry to individuals who experience tension between their

physical sex characteristics and their internal identity.

This discussion will examine the validity of the traditional Christian critical

response to transgenderism by evaluating the primary underlying arguments used by its

4
Melissa M. Wilcox, “When Sheila’s A Lesbian: Religious Individualism among Lesbian, Gay,
Bisexual, and Transgender Christians,” Sociology of Religion 63, no. 4 (2002): 510-512.
5
Aaron T. Norton and Gregory M. Herek, “Heterosexuals’ Attitudes Toward Transgender People:
Findings from a National Probability Sample of U.S. Adults,” Sex Roles 68 (2013): 746.
6
Mohd. Shuhaimi Bin Haji Ishak and Sayed Sikander Shah Haneef, “Sex Reassignment
Technology: The Dilemma of Transsexuals in Islam and Christianity,” Journal of Religion and Health 53,
no. 2 (2012): 532.
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proponents. To begin, we will examine transgender issues generally, approaching this

from a scientific and medical standpoint in order to gain an accurate understanding of

transgenderism; as with any ethical discussion, the fuller understanding of the issue we

have, the better equipped we will be to evaluate it. From there, we will be equipped to

consider the traditional Christian approach to transgenderism and trans people. We will

conclude by examining the implications of our conclusions regarding the traditional

approach, and note some areas in which further consideration is necessary.

Part One: Building Understanding

Before beginning a discussion on the ethics of transgenderism and related issues

from a Christian perspective, it is vital to develop a familiarity with the wide array of

complexities involved with this conversation. A typical denunciation of the traditional

Christian response to trans people is that it relies on blanket moral judgments without

adaquetely understanding of the uniqueness of this phenomenon. This approach to

transgenderism, writes Jonathan Merritt, Christian author and contributor to The Atlantic,

will ensure that “conservative Christians will be the authors of their own demise” if

continued.7 While it may prove necessary to judge transgender behavior as inconsistent

with the Christian worldview, this decision must be based on a thorough consideration of

the issues rather than dogmatic adherence to the familiarity of gender binarism. Thus, this

section will serve as an introduction to the current scientific and clinical issues

surrounding transgenderism. We will begin by briefly providing working definitions of

7
Jonathan Merritt, “3 Reasons Conservative Christians Will Lose the Transgender
Debate,” Religion News Service, May 14, 2016, accessed January 27,
2017, [Link]
debate/.
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some key terms involved in this discussion. As will be seen, this is incredibly important

to engaging with trans individuals in an effective and compassionate way.

A Vocabulary of Transgenderism

Fraser Watts, lecturer at the University of Cambridge, begins his discussion of

transsexualism this way: “Transsexualism is a minefield. … Even how you frame the

issues and begin to ask questions about it can already show what perspective you are

coming from.”8 Understandably, trans individuals, who have experienced a great deal of

judgmentalism from Christians, tend to be very sensitive to the verbiage used by religious

individuals in discussions regarding gender identity. A single wrong word can effectively

end such a dialogue and convey, correctly or incorrectly, a great deal of prejudice and

disapproval to a trans person. Additionally, the terminology related to transgenderism has

changed significantly over recent years, and there is overlap between some terms. To

effectively minister to trans individuals and take an ethical stance one way or another,

Christians must be well-versed in the appropriate language to do so, as must any visitor

from one culture to another. Already we have introduced several terms: transgender(ism),

trans, transsexual(ism), gender, and sex; others still will be referred to in this discussion.

The following is a brief discussion of the meaning of some of the most important terms,

with emphasis on the distinctions between them.

Holistic gender. The word “gender” is a word with a complicated history that has

been discussed for decades by many endeavoring to define it. It has historically been used

roughly interchangeably with the term “sex” to refer to one’s physical characteristics, but

8
Fraser Watts, “Transsexualism and the Church,” Theology and Sexuality 9, no. 1 (2002): 63.
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research on transgenderism and intersex disorders have shown that that the relationship

between sex and gender is more complex than treating these terms as synonyms

recognizes.9 Problematic though it is, gender is an important concept in Western society,

if a difficult one to pinpoint. While respondents to a 2000 study about the meaning of the

word “gender” noted the complexity of trying to define it, over 95% of respondents stated

that gender was an important social concept.10 Clearly, gender is an aspect of society that

cannot be abandoned, but also one that must be further defined. Using Watts’ breakdown

of this concept, we will delineate four primary aspects of gender: biological sex, gender

identity, gender behavior, and sexual orientation. While most people experience concord

among these four parts of gender, some experience great conflict between two or more of

them.11 For clarity, we will use the term “holistic gender” to refer to the aspect of a

person’s identity made up of these four facets. We will also use the terms “true gender”

and “designed gender” to refer to the holistic gender that God views a person as a

member of when there is conflict between the four aspects of gender described below.

Biological sex. Perhaps the simplest term in this list, biological sex refers to the

physical characteristics that are associated with maleness and femaleness. These include

genitalia, secondary sex characteristics, and chromosomal makeup. One’s biological sex

is related to what is known as a person’s assigned gender, which refers to the gender one

is identified as a member of based on his or her physical characteristics at birth.

9
Jayde Pryzgoda and Joan C. Chrisler, “Definitions of Gender and Sex: The Subtleties of
Meaning,” Sex Roles 43, nos. 7/8 (2000): 554.
10
Ibid., 561.
11
Watts, “Transsexualism,” 64.
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Gender identity. A person’s gender identity describes how one perceives oneself

as a male or female. It is the experience of being a male or female, and, while usually in

agreement with one’s biological sex, can differ in some cases.

Gender behavior. This term represents the way an individual’s lifestyle reflects

societal norms of maleness or femaleness. Examples of gender behavior can include style

of dress, method of speech, vocational aspirations, and many others, depending on a

given society’s gender roles.

Sexual orientation. An individual’s sexual orientation refers to his or her sexual

desire for others based on their holistic gender. Heterosexual individuals are sexually

attracted to members of the “opposite” sex (i.e., males are sexually attracted to females,

and vice versa). Homosexual individuals are sexually attracted to members of their own

biological sex, while bisexual individuals experience sexual desire for both males and

females. There are other sexual orientations in addition to these two, but these are not

necessary to enter into the discussion at hand.

Transgenderism. Transgenderism is an umbrella term that refers to individuals

who experience a disconnect between their gender identity and biological sex. It can be

abbreviated as “trans,” and is also known as gender dysphoria (GD) or gender identity

disorder, though the latter has fallen out of favor as of late.12 Individuals who do not

experience incongruence between their gender identity and biological sex are known as

cisgender. Transgenderism includes several subgroups of people, including those who

12
American Psychological Association, “Gender Dysphoria,” in DSM-V: Diagnostic and
Statistical Manual of Mental Disorders; Fifth Edition (Washington, D.C.: American Psychological
Association, 2013), 451.
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identify as neither of the two binary genders (male or female), as possessing aspects of

both, as having no gender, or as having more than one gender identity. This discussion,

however, will focus on transgender individuals who identify with the gender opposite that

of their biological sex.

It is important not to confuse transgenderism with other activities or lifestyles. A

frequent misunderstanding is to see transgenderism as a sexual orientation, perhaps as a

more extreme manifestation of homosexuality.13 This, however, is an incorrect

understanding of transgenderism, as there are both heterosexual and homosexual

transgender individuals. Additionally, transgenderism should be distinguished from both

transsexualism and transvestitism, which will be discussed below.

Transsexualism. Transsexualism falls under the broader category of

transgenderism, and refers specifically to transgender individuals whose desire is “to live

… permanently in the social role of the opposite gender,” and who desire to obtain

surgery to become as physically similar to the opposite sex as possible.14 Because it is a

subtype of transgender, discussions regarding transgender individuals often apply to

transsexual individuals, but transsexual individuals face a unique set of concerns that are

often not applicable to non-transsexual transgender individuals. Furthermore, not all

transgender individuals will develop a desire to permanently transition into the other

13
Ishak and Haneef, “Sex Reassignment Technology,” 530.
14
P.T. Cohen-Kettenis and L.J.G. Gooren, “Transsexualism: A Review of Etiology, Diagnosis and
Treatment,” Journal of Psychosomatic Research 46, no. 4 (1999): 316.
EMBRACING UNCERTAINTY 14

gender; in fact, research indicates that transgenderism usually does not persist throughout

an individual’s entire life.15

Transvestitism. Also known as cross-dressing, transvestitism refers to the action

of dressing in the attire of the opposite gender. Individuals who engage in this behavior

do not necessarily experience a disconnect between their gender identity and biological

sex, and as such, a person who cross-dresses is not necessarily transgendered. While

transvestitism can be an indication of or precursor to GD, many engage in these

behaviors fetishistically, that is, for sexual arousal.16 Thus, while often related to

transgenderism, transvestitism by itself is not evidence of this type of identity discord.

Sex reassignment surgery (SRS). Sex reassignment surgeries are medical

procedures intended to alter an individual’s physical body to cause it to conform more

closely to that of a member of the opposite sex. The two most complete sex reassignment

procedures commonly performed are vaginoplasty, the creation of a vagina on a

biologically male person, and phalloplasty, in which a penis is constructed on the body of

a biological female. There are other procedures as well, but in this discussion the term

SRS will be used to discuss surgical sex reassignment in general rather than a specific

surgical procedure. This surgery is available to varying extents throughout the world. It is

generally legal to obtain SRS in most Western countries, and is governmentally

subsidized in some countries, such as the Netherlands17 and Iran.18

15
American Psychological Association, “Gender Dysphoria,” 455.
16
Ibid., 458.
17
Ishak and Haneef, “Sex Reassignment Technology,” 531.
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Intersex disorders.19 An intersex disorder is a birth disorder in which a person’s

physical sex characteristics are not clearly male or female. Intersex disorders may be

diagnosed at birth, or may become apparent during puberty. It is important to note that

the birth genitalia of intersex individuals “does not predict the future gender identity” of

these individuals with consistency.20 Individuals with intersex disorders have historically

been referred to as hermaphrodites, and the condition itself as hermaphroditism.21

There are several causes of intersex disorders. While most people are born with

two sex chromosomes, women with two X chromosomes (XX) and men with one X and

one Y chromosome (XY), at least one in 400 individuals is born with what is known as a

sex chromosome abnormality (SCA).22 Individuals with SCAs sex chromosomes make-

ups other than XX and XY. The most common SCAs are trisomy X (XXX), Klinefelter

syndrome (XXY), XXY syndrome, and Turner syndrome (X0).23 Other SCAs exist,

18
Elizabeth M. Bucar, “Bodies at the Margins: The Case of Transsexuality in Catholic and Shia
Ethics,” Journal of Religious Ethics 38, no. 4 (2010): 602. The case of Shia Islam’s approach to
transgenderism and SRS will be discussed later.
19
The ethical issues surrounding intersex individuals are not the focus on this discussion, and will
not be covered at length. However, the existence of intersex individuals provides an important conceptual
consideration for discussing transgenderism, so some examination of this disorder is necessary.
20
Margaret H. MacGillivray and Tom Mazur, “Intersex,” Advances in Pediatrics 52 (2005): 295.
21
Stephen Kerry, “Intersex Individuals’ Religiosity and Their Journey to Wellbeing,” Journal of
Gender Studies 18, no. 3 (Sept. 2009): 277.

Mary G. Linden, Bruce G. Bender, and Arthur Robinson, “Sex Chromosome Tetrasomy and
22

Pentasomy,” Pediatrics 96, no. 4 (Oct. 1995): 672.

23
Orlando J. Miller and Eeva Therman, Human Chromosomes, 4th ed. (New York: Springer,
2001): 284. The Xs and Ys in parentheses refer to the chromosomal make-up that characterizes each SCA.
Note that X0 (Turner syndrome) denotes a single X chromosome, the 0 marking the absence of the second
sex chromosome. While there is genetic information on the Y chromosome, the X chromosome is vital to
human life, carrying much more genetic information than the Y, and as such all SCAs include at least one
X chromosome, because a fetus cannot develop without at least one X chromosome. This is why, for
example, there is no SCA characterized by the genotype Y0.
EMBRACING UNCERTAINTY 16

though the addition of more than one extra chromosome is rare.24 Intersex disorders can

also result from insensitivity to the hormone androgen, or its over or underproduction en

utero, as well as several other developmental problems.25 It is difficult to estimate the

prevalence of intersex disorders, partially because this involves defining what constitutes

intersex and what does not. While an exact number is hard to come by, DeFranza’s

comparison of intersex disorders with other common disorders is helpful to understand

the frequency of this phenomenon, and also begs an important question regarding

Western society’s lack of awareness of intersex individuals:

Intersex is rare, but it may not be as rare as we [Link] least as common as

Down syndrome. … Intersex may be as common as schizophrenia, which occurs
in 1 percent of births. It is at least as common as Down syndrome (0.125 percent),
and more common than albinism (1 in 20,000). These other conditions are
typically accepted as rare but regularly occurring phenomena, while intersex is
not. Why are people more likely to be familiar with albinism, Down syndrome,
and schizophrenia than with intersex?26

Intersex individuals’ gender identity has historically been assigned to them in

infancy, with ambiguous genitalia being surgically conformed to one of the two binary

genders, usually with the child’s parents making the final decision.27 There is currently

significant discussion among medical professionals and activist groups regarding the best

24
Linden et al., “Sex Chromosome Tetrasomy,” 672.
25
For a helpful background to the common causes of intersex disorders, see Megan K. DeFranza,
Sex Differences in Christian Theology: Male, Female, and Intersex in the Image of God (Grand Rapids:
William B. Eerdmans, 2015), 25-44.
26
DeFranza, Sex Differences, 46. The answers to her questions, though important, are beyond the
scope of this discussion; see her historical and cultural analysis of the representation of intersex individuals
(46-56).
27
MacGillivray and Mazur, “Intersex," 300.
EMBRACING UNCERTAINTY 17

way to encourage gender identity formation in intersex individuals, and whether

ambiguous genitalia should be surgically altered in childhood or when the intersex

individual is mature enough to choose one’s biological sex oneself. As medical

technology and the understanding of the mechanisms of gender identity formation

continue to develop, the usual approach to intersex disorders will likely continue to

evolve.28

A Brief Background to Gender Dysphoria

Having covered the basics of the language relevant to this conversation, we can

now begin to discuss the scientific and clinical underpinnings of GD. There are several

considerations here, including understanding the causes of transgenderism, examining the

treatment options available to trans individuals, evaluating the efficacy of SRS, and

examining some of the general ethical approaches to this phenomenon. We will begin

with a survey of current research into the causes of GD, also known as its etiology.

The causes and prevalence of transgenderism. Especially in an ethical

discussion of transgender behavior, it is crucial to ascertain as accurately as possible the

origins of the incongruence between sex and gender identity trans individuals experience.

It is exactly this ethical debate that is currently fueling extensive research into the

etiology of GD. There are two primary types of factors under investigation: genetic

factors, and factors relating to upbringing, lifestyle, and societal pressures. Essentially the

question is this: is transgenderism a result of nature or nurture?

28
MacGillivray and Mazur, “Intersex," 302.
EMBRACING UNCERTAINTY 18

Unfortunately, the answer to this question does not seem to be a simple one, as

both nature and nurture appear to influence the development of GD. Reporting on several

studies into the causes of transsexuality, Cohen-Kettenis and Gooren note links between

certain familial factors and GD in children, most notably parental psychological

problems, parental emotional coldness, and overprotectiveness of the parent of the same

sex as the child.29 Other research, however, has shown that MtF transsexual individuals

report relationships with their fathers that are as healthy as those reported by cisgender

homosexual males.30 Studies of the comparative rates of abuse in transgender and

cisgender individuals has shown that transgender individuals are likelier to have

experienced abuse, but whether this abuse was part of the formation of GD or a result of

gender variant behavior is unclear.31 Ultimately, Cohen-Kettenis and Gooren conclude

the following regarding the role of upbringing in the development of GD: “For the

development of certain, perhaps mild, forms of gender disturbance, [environmental

factors] represent sufficient conditions. For the development of other conditions,

environmental factors may be necessary, but not sufficient.”32

Many biological factors have been investigated regarding their relation to GD.

The best-demonstrated biological mechanism for the development of transgenderism is

29
Cohen-Kettenis and Gooren, “Transsexualism,” 317-318.
30
Jaimie F. Veale, David E. Clarke, and Terri C. Lomax, “Biological and Psychosocial Correlates
of Adult Gender-Variant Identities: A Review,” Personality and Individual Differences 48, no. 4 (March
2010): 363.
31
Ibid.
32
Cohen-Kettenis and Gooren, “Transsexualism,” 318.
EMBRACING UNCERTAINTY 19

exposure to amounts of the hormone androgen en utero that are inconsistent with one’s

biological sex. Androgen is a hormone that stimulates the development of male traits both

prenatally and postnatally, and studies have provided significant evidence that

inappropriate uterine androgen levels contribute to the development of GD.33

Additionally, there is evidence that certain brain structures in both pre and postoperative

transsexual individuals resemble those of members of the opposite sex more closely than

those of members of their birth sex.34 However, further research into the biological

factors related to transgenderism is necessary to demonstrate a conclusive causative

relationship, as current research is inadequate to show that this identity incongruence is

fundamentally biological.35 Cultural factors seem to play the smallest role in the

formation of a gender identity discordant with one’s biological sex, with GD or roughly

equivalent phenomena being reported across national and cultural lines, including in

societies with different gender categories and roles than Western nations.36

Ultimately, current research shows stronger – though not conclusive – evidence of

causal links between biological factors and GD than between upbringing factors and this

condition. While multiple biological differences between trans and cisgender individuals

have been documented, differences between upbringings of members of these groups are

less consistent, and an individual with no upbringing abnormalities may still develop

33
Veale, Clarke, and Lomax, “Biological and Psychosocial Correlates,” 364.
34
Victoria S. Kolakowski, “Toward a Christian Ethical Response to Transsexual Persons,”
Theology and Sexuality 6 (1997): 16.
35
American Psychological Association, “Gender Dysphoria,” 457.
36
Ibid.
EMBRACING UNCERTAINTY 20

GD.37 Upbringing abnormalities associated with GD may also reflect responses to an

individual’s gender-variant behaviors rather than causes of these behaviors. At the same

time, this does not mean that upbringing factors have no role in the formation of GD,

especially given recent evidence that gender identity is fluid, especially in trans

individuals.38 Based on the available evidence, however, the best conclusion is to

understand biological factors as more influential than environmental factors in the

majority of cases of GD; at the very least, it is clearly improper to say that GD is a

choice, or solely rooted in upbringing in all cases.

Accurately measuring the prevalence of GD is a challenging task, as attempts to

measure this often only include those who have sought clinical or medical treatment, or

transsexual people rather than all transgender individuals. Furthermore, transgender

individuals living as members of the opposite gender tend to identify with their gender

identity rather than as transgender.39 The American Psychological Association (APA)

estimated in 2013 that 0.005 to 0.014 percent of biological males and 0.002 to 0.003

percent of biological females are gender dysphoric40; this number, however, is likely

much lower than the number of individuals who experience tension between their gender

identity and biological sex, as it only includes those who meet the organization’s

classifications for GD. A 2016 survey of several studies on the prevalence of GD

37
Veale, Clarke, and Lomax, “Biological and Psychosocial Correlates,” 362-363.
38
Kenneth J. Zucker, Anne A. Lawrence, and Baudewijntje P.C. Kreukels, “Gender Dysphoria in
Adults,” The Annual Review of Clinical Psychology 12 (2016): 235.
39
Kolakowski, “Towards a Christian Ethical Response,” 13.
40
American Psychological Association, “Gender Dysphoria,” 454.
EMBRACING UNCERTAINTY 21

provides a range of about 0.5% to 1.2% prevalence, with men more likely than women to

experience this type of incongruence.41 While this may seem a relatively insubstantial

portion of the population, the authors of this survey put it this way:

If one of the lower estimates … the 0.5% reported as an overall mean for birth-
assigned males and females, is extrapolated to a global population of 5.1 billion
people aged 15 years or older … we arrive at a figure of around 25 million
transgender people worldwide. This gives some idea of the potential worldwide
(and currently largely unmet) need for transgender health care.42

Treating transgenderism. The psychiatric and medical treatments available for

those who deal with the type of identity crises GD causes are currently in a major state of

flux. While trans individuals have historically received therapeutic treatment aimed at

eliminating feelings of GD, it is now widely acknowledged that psychiatric treatment of

this type is ineffective.43 Most psychiatric approaches to GD now focus on providing

trans individuals with a safe and supportive environment in which GD can “unfold of its

own accord.”44 This is becoming the predominant approach to dealing with GD due to

growing awareness that this experienced identity incongruence usually does not persist

throughout one’s entire life. Again, there is no agreed upon proportion of trans

individuals who will experience the desistence of their identity discord; studies have

41
Sam Winter et al., “Transgender People: Health at the Margins of Society,” The Lancet 388, no.
10042 (July 2016): 392.
42
Winter et al., “Transgender People,” 392.
43
Watts, “Transsexualism,” 68.
44
Jack Drescher and Jack Pula, “Ethical Issues Raised by the Treatment of Gender-Variant
Prepubescent Children,” The Hastings Center Report 44, no. 5 (2014): S18.
EMBRACING UNCERTAINTY 22

shown that from 63%45 to 90%46 of children presenting with GD will not identify as trans

in adulthood. While factors associated with the persistence and desistence of GD are

being studied, there is currently no evidence that psychotherapy can result in “complete

and long-term reversal of cross-gender identity.”47

Currently, the treatment regimen for trans individuals begins with psychotherapy,

the goal of which is not to eliminate GD, but to determine if an individual’s cross-gender

urges result from a source other than true GD. This can be challenging, as the symptoms

of GD can be indistinguishable from cross-gender behaviors resulting from sexual

trauma, psychotic disorders, and other sources.48 If one’s cross-gender urges seem to be

rooted in a genuinely discordant gender identity, the next phase of treatment involves

hormone treatments and cross-gender living in order to determine if one is satisfied living

as a member of the opposite sex. Ideally, this phase of treatment will give both the patient

and his or her care providers clarity into whether SRS will be a beneficial treatment for

his or her GD symptoms. If lifestyle alteration and hormone treatments effectively reduce

symptoms and the individual has the desire to permanently live as a member of the

opposite sex, surgical options will be considered.49 Surgical options are always a type of

45
Thomas D. Steensma et al., “Factors Associated with Desistence and Persistence of Childhood
Gender Dysphoria: A Quantitative Follow-Up Study,” Journal of the American Academy of Child &
Adolescent Psychiatry 52, no. 6 (June 2013): 583.
46
Kristina R. Olson, “Prepubescent Transgender Children: What We Do and Do Not Know,”
Journal of the American Academy of Child & Adolescent Psychiatry 55, no. 3 (March 2016): 155.
47
Cohen-Kettenis and Gooren, “Transsexualism,” 321.
48
Drescher and Pula, “Ethical Issues,” S18.
49
Cohen-Kettenis and Gooren, “Transsexualism,” 326.
EMBRACING UNCERTAINTY 23

last resort treatment for GD, as the surgeries are complicated, sometimes accompanied by

serious postoperative problems, and are, of course, more permanent than other

treatments.

Treating trans individuals is a complicated endeavor because of the complexity of

cross-gender urges in general. Additionally, trans individuals are extremely likely to

experience suicidal ideation, and are between two and four times more likely to attempt

suicide than non-trans individuals.50 They are also more likely to be autistic, struggle

with anxiety,51 and be HIV positive than cisgender individuals.52 All of these

comorbidities urge those treating trans individuals to exercise greater caution in treating

these people, and especially in recommending SRS.

Sex reassignment surgery. Sex reassignment surgeries, also known as sex

change operations, are medical procedures with the goal of modifying one’s physical sex

characteristics to imitate those of the opposite sex. There are two aspects of SRS relevant

to our discussion here: the medical effectiveness of these procedures (i.e., whether they

lead to health complications), and their success in alleviating GD.

Data on the effectiveness of SRS can be difficult to collect because this

demographic typically has a low response rate to questionnaires.53 What evidence is

50
Ilan H. Meyer and Mary E. Northridge, eds., The Health of Sexual Minorities: Public Health
Perspectives On Lesbian, Gay, Bisexual, and Transgender Populations (New York: Springer, 2007), 492.
51
American Psychological Association, “Gender Dysphoria,” 459.
52
Meyer and Northridge, The Health of Sexual Minorities, 492.
53
Griet De Cuypere et al., “Sexual and Physical Health After Sex Reassignment Surgery,”
Archives of Sexual Behavior 34, no. 6 (Dec. 2005): 689.
EMBRACING UNCERTAINTY 24

available, however, seems to indicate that sex change operations are largely successful in

most measures. Meyer and Northridge report that only 6% of postoperative MtF

transsexuals expressed any regret following surgery, and no respondents expressed total

regret.54 Cohen-Kettenis and Gooren also found high satisfaction rates among

postoperative transsexuals, but noted that regretful individuals often experienced severe

psychological problems55; according to Ishak and Haneef, about 7% “requested for a

reversal [sic], require psychiatric hospitalization or commit suicide.”56 Reversal surgery

is available, but extremely uncommon, and most regretful postoperative transsexuals seek

non-surgical treatment.57 Overall, self-reporting by transsexual individuals indicates that

SRS is psychologically beneficial in the vast majority of cases.

Medical complications are common for recipients of SRS, with some procedures,

namely female-to-male (FtM) sex change operations, resulting in problems more

frequently than others. Generally, about 25% of male-to-female (MtF) transsexuals

experience postoperative medical problems, while about 40% of FtM transsexuals

experienced them.58 The majority of complications are minor and readily treatable,

though some are chronic or require more serious medical intervention.59 Sexual problems

54
Meyer and Northridge, The Health of Sexual Minorities, 483-484.
55
Cohen-Kettenis and Gooren, “Transsexualism,” 327.
56
Ishak and Haneef, “Sex Reassignment Technology,” 535.
57
Miroslav L. Djordjevic et al., “Reversal Surgery in Regretful Male-to-Female Transsexuals after
Sex Reassignment Surgery,” Journal of Sexual Medicine 13, no. 6 (2016), 1000.
58
Gennaro Selvaggi and James Bellringer, “Gender Reassignment Surgery: An Overview,”
Nature Reviews Urology 8, no. 5 (May 2011): 279.
59
Anne A. Lawrence, “Patient-Reported Complications and Functional Outcomes of Male-to-
Female Sex Reassignment Surgery,” Archives of Sexual Behavior 35, no. 6 (Dec. 2006): 724.
EMBRACING UNCERTAINTY 25

are the most common problem following SRS; however, the vast majority of individuals

report that their sex lives improve as a result of SRS.60 Health problems are becoming

less common as medical technology improves, with recipients of sex change operations

in later years reporting complications less frequently than recipients of these procedures

when the technology was less developed.61

While SRS is certainly not without its dangers, and is frequently accompanied by

physical, sexual, or social difficulties, most transsexuals report that they are glad to have

received them, even when complications arise.62 Nicholas Mason, a FtM transsexual who

received SRS in the 1970s, sums up the general experience of operative transsexuals

eloquently: “… all these problems, real and imagined, have been worth tolerating in order

to live a life freed from the conflict which was making existence so unhappy. No longer

do I feel that I am acting a part but am free to be myself.”63

Part Two: Evaluating the Traditional Approach

Having briefly covered the ins and outs of transgenderism, we are now equipped

to begin to evaluate the ethical judgment on transgenderism that has dominated

mainstream evangelical Christendom, specifically the arguments that underlie this

judgment. To start, we will summarize this approach. From here, we will critique this

traditional approach, and then discuss the importance of having a more solidly rooted

60
De Cuypere et al., “Sexual and Physical Health,” 684.
61
Lawrence, “Patient-Reported Complications,” 722-723.
62
Ibid., 724.
63
Nicholas Mason, “The Transsexual Dilemma: Being a Transsexual,” Journal of Medical Ethics
6 (1980): 87.
EMBRACING UNCERTAINTY 26

Christian moral judgment on transgenderism. We will also examine some more

convincing arguments against cross-gender living, and note some areas in which further

consideration would be helpful.

The Traditional Christian Approach to Transgenderism

Summarizing the so-called “traditional Christian” approach to trans individuals is

difficult, as Protestant churches tend to hold varied views on social issues, and many

denominations have not released official statements regarding this issue. Therefore, rather

than addressing every published doctrinal statement, we will explore this approach by

examining the theological bases of the typical Christian approach to transgenderism.

The creation account. In general, the Christian response to transgenderism has

been to label living as the opposite gender as morally wrong. The main basis for this

stance is in the created order, specifically Gen. [Link] “So God created man in his own

image, in the image of God he created him; male and female he created them.”64 In the

same way that God intentionally created Adam as a male, and Eve as a female, the

traditional Christian approach to trans issues holds that this account is “paradigmatic for

God’s intention” for all people.65 “Male and female” in Gen. 1:27 is understood as being

manifested most clearly through one’s biological sex; thus, John Piper writes, “Genitalia

is a revelation of God’s design.”66 Because physical sex is understood to be the visible

64
Unless otherwise noted, biblical references refer to the English Standard Version (ESV).
65
Kolakowski, “Toward a Christian Ethical Response,” 16-17.
66
John Piper, “‘Genitalia Are Not Destiny’ – But Are They Design?,” Desiring God, last modified
June 2, 2014, accessed Feb. 1, 2017, [Link]
they-design/.
EMBRACING UNCERTAINTY 27

sign of God’s design of an individual as male or female, transgender feelings are

understood as a psychological problem. This is often accompanied by the belief that GD

is not rooted in an individual’s biology, but in one’s upbringing and personal choice, with

the attached understanding that gender dysphoric feelings can be lessened, if not totally

removed, by spiritual or psychological counseling. Other Christian approaches to these

people accept that GD may have significant biological roots, but still disapprove of

transgender behavior, being careful not to overestimate genetic underpinnings as an

indication of moral goodness.67 Additionally, Christian approaches that accept biological

factors as a cause of transgenderism also note that, while biology can predispose someone

to a certain type of behavior, biological proclivity is wholly different from biological

determinism.68 While acting on transgender urges is usually seen as sinful, being tempted

to live as the opposite sex is not, as temptation by itself is not sinful (Heb. 4:15).

Ultimately, whether GD is biologically or experientially rooted, it is seen as a symptom

of the brokenness of creation; specifically, it is trans person’s gender identity that is

viewed as a consequence of the Fall, while one’s biological sex is accepted as God’s

design.

Christians have traditionally insisted on strong gender binarism. Thus, most

conservative Christians strongly reject arguments that biological sex is unimportant as

inappropriate minimizations of the intentionality of the created order.69 Therefore, while

67
Joe Dallas, “The Transsexual Dilemma: A Dialogue about the Ethics of Sex Change,” Christian
Research Journal 31, no. 1 (2008): 3.
68
Watts, “Transsexualism,” 67.
69
Dallas, “The Transsexual Dilemma,” 5.
EMBRACING UNCERTAINTY 28

some liberal Christians would see gender as “experienced and expressed along a wide

spectrum,” Christians largely endorse gender binarism, even in communities that see GD

as an inborn trait.70

Other biblical arguments. Unlike most Christian moral judgments, the

transgenderism discussion does not rely on a Scripture passage allowing or prohibiting

this behavior. The closest the Bible comes to clearly addressing cross-gender behavior is

Deut. 22:5, which the ESV renders, “A woman shall not wear a man’s garment, nor shall

a man put on a woman’s cloak, for whoever does these things is an abomination to the

Lord your God.” However, there is significant disagreement regarding the meaning of

this verse. Ancient Near East historian Harold Vedeler argues that this verse does not

address crossdressing at all, but the protection of the exalted social status of warrior-men

in the Israelite community.71 Tobi Liebman, after studying the interpretive history of this

verse, notes its use to prohibit a huge range of culturally gendered activities, including

women studying the Torah and men “looking in mirrors, dying white hair black, or

plucking out white hairs from black ones.”72 She concludes thus: “This study of the

history of Jewish exegesis on the verse has demonstrated that Deut. 22:5 and the practice

70
James D. Whitehead and Evelyn Eaton Whitehead, “Transgender Lives: From Bewilderment to
God’s Extravagance,” Pastoral Psychology 63, no. 2 (2014): 173.
71
Harold Torger Vedeler, “Reconstructing Meaning in Deuteronomy [Link] Gender, Society, and
Transvestitism in Israel and the Ancient Near East,” Journal of Biblical Literature 127, no. 3 (2008): 471.
Vedeler argues that this verse uses geber instead of the more common ish to refer to the male because the
author had in mind not men in general, but the “superior man.” He proposes that the simlat isha are “the
garments of a woman,” and that the keli gebed refers to a type of tool, specifically a weapon, that
symbolized the status of the accomplished man in that society. He offers this translation of Deut. 22:5 “A
woman shall not be associated with the instrument of a superior man, and a superior man shall not wear the
garment of a woman, for whoever does these things is a cultic abomination to Yahweh your God” (476).
72
Tobi Liebman, “The Jewish Exegetical History of Deuteronomy [Link] Required Gender
Separation or Prohibited Cross-dressing?” (M.A. thesis, McGill University, 2002), 107.
EMBRACING UNCERTAINTY 29

it proscribes are unclear, and its practical application is not at all straightforward.”73

Because of the ambiguity of the behavior this verse condemns, and its reason for

condemning it, most conservative statements on transgenderism avoid relying on this

verse.74

Other biblical texts that have been used historically to address transgender

behavior include texts referring to eunuchs, who were usually men who were castrated as

a punishment for a crime. The primary eunuch text used in this discussion is Deut. 23:1,

which reads, “No one whose testicles are crushed or whose male organ is cut off shall

enter the assembly of the Lord.” Some argue that this text clearly condemns SRS.75

However, the position of this verse in a set of commands regarding protecting the

assembly of God (see vv.1-7) strongly suggests that this is a cultic instruction, not an

absolute moral law. This is clearer considering the role of handicapped individuals in the

religious ceremonies of Israel’s pagan neighbors; Eugene Merrill summarizes this

instruction in its cultural context well: “Their exclusion from the worship assembly, as

discriminatory as such a policy might seem, was to underscore the principle of separation

from paganism, where such deformities were not only acceptable but frequently central to

the practice of the cult.”76 Thus, while some argue that this verse provides a clear biblical

73
Ibid.
74
James M. Childs, “Transsexualism: Some Theological and Ethical Perspectives,” Dialog: A
Journal of Theology 48, no. 1 (Spring 2009): 35.
75
Childs, “Transsexualism,” 36.
76
Eugene H. Merrill, Deuteronomy, The New American Commentary 4 (Nashville: Broadman &
Holman Publishers, 1994), 307.
EMBRACING UNCERTAINTY 30

condemnation of SRS, most commentators view this is a poor interpretive option. More

generally, texts relating to eunuchs, such as Isa. 56:4-5, Matt. 19:12, and others, have

limited usefulness in this conversation. Firstly, biblical eunuchs, with one clear

exception, did not become eunuchs by choice, but were eunuchs from birth or because of

the actions of others. The exception to this, Jesus’ “eunuchs who have made themselves

eunuchs for the kingdom of heaven” (Matt. 19:12), refers to becoming voluntarily

celibate (see v. 10), not living in a role other than one’s assigned gender. This is the

largest problem with applying a biblical eunuch text to the transgender discussion: none

of these passages refer to the desire to live as a member of the opposite gender; this

simply was not a concern of the biblical authors.77 Transgenderism is not analogous to

biblical eunuch-hood, and any moral judgment on it based on such passages should be

met with skepticism.78

A more frequent defense of the traditional Christian approach to transgenderism is

to cite passages such as Psa. 139:13-16, in which David writes, “For you formed my

inward parts; you knitted me together in my mother’s womb. I praise you, for I am

fearfully and wonderfully made” (vv.13-14a). Similar texts include Jer. 1:5, where God

tells Jeremiah, “Before I formed you in the womb I knew you,” and the announcement of

Jesus’ birth, as in Luke [Link] “And behold, you will conceive in your womb and bear a

son” (cf. Matt. 1:21). The Annunciation texts are especially useful to some in this

77
Merrill, Deuteronomy, 307.
78
Megan K. DeFranza’s appropriation of these texts to intersex issues is much more welcome
here, as the situation of an intersex individual is significantly more similar to that of a biblical eunuch than
that of a trans person. See her Sex Differences, ch. 2.
EMBRACING UNCERTAINTY 31

discussion, as they include the gender of the unborn baby, evidencing that God is aware

of gender separate from cultural norms and an individual’s gender identity (also Gen.

18:10; Judg. 13:3).79 If God has intentionally designed an individual, how could he give

an individual the “incorrect” physical body? So the traditional Christian argument goes. It

naturally follows, then, that the discordant aspect of a dysphoric individual’s identity is

not his or her physical body, but his or her mind.

Summary of ethic and practical applications. In general, the Christian approach

to transgenderism has been critical, and has prohibited gender dysphoric people from

living in a role other than that of their assigned gender. This is based on the

understanding that an individual’s biological sex is the physical manifestation of an

individual’s true gender, that is, the gender God views one as a member of. We can group

the arguments used by proponents of the traditional approach into two categories, both of

which involve the nature of God’s creation of individual. The first and more foundational

argument is that from the original creation account, that is, God’s creation of mankind as

“male and female” (Gen. 1:27). The second category is arguments from biblical texts

related to God’s intentional creation of each individual from passages such as Psa.

139:13-16 and birth annunciation texts.

Practically, then, godly behavior for an individual with transgender urges is that

which aligns with his or her assigned gender, as this is how a person lines up with God’s

desires for him or her. While some liberal Protestant denominations, such as the Anglican

and Episcopalian churches, have allowed the ordination of trans clergy and blessed

79
Dallas, “The Transsexual Dilemma,” 5.
EMBRACING UNCERTAINTY 32

marriages of trans men with birth or trans women, and vice versa, the majority of

denominations and evangelical churches do not.80

For trans individuals currently living in the role of the opposite gender,

repentance is returning to the role of one’s assigned gender. In his account of counseling

a transsexual, Joe Dallas tells the story of James, who had previously received a sex

change operation to become physically a woman, and identified himself as Mandy when

he encountered Christ and became a part of a church. As Mandy, James told his pastor

about his past life and surgery, and while the pastor explained to him that God’s will for

him was to live in the role of his birth sex, he and the congregation supported and cared

for James as he sought to understand himself. As he naturally grew in spiritual maturity

he grew into the masculine role he was born into, and eventually “Mandy” asked to be

reintroduced to the church as James. Just over a year later, James, still a postoperative

MtF transsexual, was engaged to a woman in the congregation.81 In general, James’ story

represents the ideal process of repentance that Christians have traditionally prescribed

trans individuals. It is unclear whether postoperative transsexuals would be encouraged to

receive reversal surgeries; these surgeries would likely be allowed if an individual had

the desire and means to receive them, but not required as part of the process of

repentance. Russell Moore, president of the Southern Baptist Convention’s Ethics and

80
“Denominations,” Transgender Christians, accessed Feb. 2, 2017,
[Link]
81
Dallas, “The Transsexual Dilemma,” 8.
EMBRACING UNCERTAINTY 33

Religious Liberty Commission, unites the following regarding surgically reversing a sex

change operation:

On the question of whether “Joan” should go reverse her “gender reassignment”

surgery, I’m inclined to say no in this case. After all, no surgery can reassign
gender. The surgery mangled John and sought to create an illusion of a biological
reality. There’s no way this surgery can be “reversed,” only another cosmetic
illusion created on top of the old one.82

Moore’s comment reveals another important aspect of the view many Christians hold

regarding SRS: rather than seeing SRS as an attempt to do what is medically possible to

align one’s physical characteristics with his or her gender identity, it is seen as a repulsive

charade, a sinful acquiescence to one’s mental delusions.

Of course, the ideal of a transgender individual ceasing to experience their cross-

gender urges does not always unfold; in cases where GD does not dissipate, trans

individuals are generally instructed to embrace celibacy à la Jesus’ voluntary eunuch in

Matt. 19:12, and desist any activities that are heightening their cross-gender behaviors,

including transvestitism, taking cross-sex hormones, etc.83

Evaluating the Traditional Approach

In our summary of the traditional Christian approach to transgenderism, we

grouped the arguments for prohibiting cross-gender living into two categories: those from

the created order generally, and those from God’s purposeful creation of every person

individually. Here we will evaluate these two foundations of the traditional approach, and

82
Russell Moore, “Joan or John?,” The Gospel Coalition, last modified Oct. 8, 2014, accessed
Feb. 2, 2017, [Link]
83
Ibid.
EMBRACING UNCERTAINTY 34

consider the efficacy of basing a Christian ethical judgment on transgenderism on these

arguments.

Gender, sex, and the Fall. The Genesis creation account, in particular Gen. 1:27,

is the foundation for two understandings that are pillars of the traditional Christian

approach: gender binarism, and the creation of each individual as unalterably male or

female. The basis for gender binarism in the passage is clear, and represents a proper

interpretation of the text. A natural reading of Gen. 1:27 makes this clear: gender is not a

continuum or “simply a matter of the individual’s decision.”84 Part of the design of

humanity, per Genesis 1-2, is the maleness or femaleness of individuals, a delineation

God viewed as “very good” (v.31). Gender binarism is not merely a result of social

norms or a certain upbringing; it is an intrinsic characteristic of humanity. This is

evidenced most clearly and consistently in physical and anatomical ways, but is also

confirmed in the social, emotional, and other behavioral differences between men and

women, though of course these are prone to cultural variance.

The second major conclusion the traditional approach draws from Gen. 1-2, that

each individual is inherently male or female, is also a valid application of this text;

however, viewing biological sex as the most reliable indicator of maleness or femaleness

is much more tenuous. Earlier, we referred to “holistic gender” as a sort of catch-all term,

inclusive of gender identity, biological sex, gender behavior, and sexual orientation. It is

clear upon reading the creation account that when Gen. 1:27 recounts that “male and

female he created them,” what the author is referring to is not merely anatomical

84
Ishak and Haneef, “Sex Reassignment Technology,” 535.
EMBRACING UNCERTAINTY 35

maleness and femaleness, but holistic maleness and femaleness. While our four aspects of

gender are not explicitly referenced in Gen. 1-2, all four can be seen functioning in

concord in Adam. Adam’s heterosexual orientation is, while not questioned, assumed in

God’s command to him and Eve in [Link] “Be fruitful and multiply” (also see 2:24). His

male gender behavior is shown in his naming of the animals (2:19), which is contrasted

with Eve’s role as a “helper fit for him” (2:20). Adam’s male gender identity is seen in

his clear understanding of Eve’s uniqueness in his song about her: “This at last is bone of

my bones and flesh of my flesh; she shall be called Woman, because she was taken out of

Man” (2:23). Notice how he does not refer to her physical characteristics as the reason for

giving her the name “Woman,” but rather understands the difference between male and

female based on Eve’s origin and purpose. Biological sex is actually the least prominent

aspect of gender in this passage, only implied in the phrase, “the man and his were both

naked and were not ashamed” (2:25). Clearly, the focus of this passage is the creation of

male and female as holistic creatures, different and complementary in each of the four

aspects of gender identity, not simply as creatures with different genitalia.

It is strange, then, that the primary use of this text in relation to transgenderism is

to argue that biological sex is a certain indicator of holistic gender, when biological sex is

the least prominent aspect of gender in the creation account. In reality, the purpose of this

text is not to explain why men have one anatomy and women have another, but to explain

the origin of the two genders. Acknowledging the effects of the Fall on maleness and

femaleness, proponents of this approach see this account as an affirmation of the claim
EMBRACING UNCERTAINTY 36

that, while one’s gender identity may be discordant, one’s biological sex cannot be.85

However, the Fall caused a complete shattering of creation’s design, including its

physical aspects. Consider the curse God pronounced on Eve in Gen. [Link] “I will surely

multiply your pain in childbearing; in pain you shall bring forth children. Your desire

shall be contrary to your husband, but he shall rule over you.” Here God promises that, as

a result of her sin, she will experience both physical (“pain in childbearing”) and

psychological (“Your desire shall be contrary to your husband”) incongruence from

God’s initial design for her. Why should this not also be our understanding of the Fall’s

effects on gender? There is no reason for the Genesis creation and Fall accounts to lead

us to believe that one’s gender identity can be discordant with God’s design for a person,

but one’s biological sex infallibly concurs with God’s design for him or her.

The existence of individuals with intersex disorders should strongly discourage a

biological sex-centric identification of holistic gender as well. As previously noted,

intersex disorders result in physical sex characteristics that are either ambiguous, or that

do not align with one’s chromosomal maleness (XY) or femaleness (XX). These

disorders alone are evidence that biological sex characteristics are prone to distortion

because of the Fall and, from this, that it is not the infallible indicator of gender that some

take it to be. The church historically has not taken seriously the implications intersex

disorders on the complexity of gender, for centuries assigning people with these

conditions genders and, if these people behaved in a way that did not fit their assigned

85
Dallas, “The Transsexual Dilemma,” 80.
EMBRACING UNCERTAINTY 37

roles, putting many to death for sodomy.86 The traditional approach also does not

adaquetely account for intersex individuals; for example, Russell Moore stated that

intersex disorders are not relevant to transgender issues because “only a miniscule

number of cases involve persons of indeterminate gender.”87 While intersex individuals

do represent a small portion of the population (though not as small as Moore implies, as

we have discussed), the existence of these individuals unavoidably calls into question the

traditional dogmatic identification of gender with physical sex characteristics.

As we have seen, there is no contradiction between acknowledging the possibility

that a trans individual’s biological sex is the aspect of his or her person that is “out of

place” and the Genesis creation account. In fact, this seems perfectly plausible when

considering the fullness of the brokenness resulting from the Fall. This is also no threat to

gender binarism or complementarianism, as it still affirms both these doctrines. In

summary, a proper understanding of transgenderism and the Genesis creation account

leaves sufficient room for the validity of the experienced incongruence of trans

individuals, and Christians should not reflexively dismiss the idea that it is a trans

person’s physical body, and not his or her mind, that is the cause of his or her identity

incongruence.

Design and disability: individual creation and the Fall. While the previous

section examined the implications of the Genesis creation account on transgenderism, we

86
Kerry, “Intersex Individuals’ Religiosity,” 278.
87
Quoted in Jonathan Merritt, “3 Reasons Conservative Christians Will Lose the Transgender
Debate,” Religion News Service, May 14, 2016, accessed January 27,
2017, [Link]
debate/.
EMBRACING UNCERTAINTY 38

turn our attention now to the use of individual creation texts in this discussion. These

include Psa. 139:13-16 and Jer. 1:5, which specifically speak of God’s knowledge of an

individual before birth, and, less so, texts in which God announced the gender of a baby

that would be born, such as Gen. 18:10, Judg. 13:3, Matt. 1:21, and Luke 1:31.

We will briefly address the texts in which God made known to someone the

gender of a baby before it was born, as they are less impactful for this discussion. In each

of the passages mentioned, God reveals that the baby to be born will be a male, and in

none of these cases is the gender of the baby the focus of its identification as a male.

Rather, each of these children is denoted as male because of the significance of being a

male in the given context, whether the context is providing the barren Sarah with a son so

that Abraham’s line could continue (Gen. 18:10), foretelling the birth of a male judge for

Israel (Judg. 13:3), or announcing the birth of the Messiah, whose maleness is

theologically important (Matt. 1:21; Luke 1:31).88 Furthermore, while these texts show

that the Lord is aware of a person’s gender, none of these make statements regarding

what the determinant of gender is, as this was not a phenomenon that we have reason to

believe the authors of Scripture were aware of.89 While these texts are useful in

confirming that the Lord knows a person’s true gender, to extrapolate from these texts

that the physical sex characteristics a person is born with are infallible indicators of that

person’s designed gender is to read eisegetically, rather than exegetically.

88
For prophecies pertaining to the maleness of the Messiah, see Gen. 3:15, Psa. 2:6-7. Jesus’
maleness was crucial for Him to fulfill the roles of Prophet, Priest, and King, to be the Son of God, to
reflect God the Father’s self-revealed maleness, and for other reasons as well.
89
Childs, “Transsexualism,” 36.
EMBRACING UNCERTAINTY 39

Psa. 139:13-16, on the other hand, contributes an important aspect to our

understanding of GD: as much as it is rooted in biology, it is something that God intends

for an individual who struggles with it. In the psalm, David praises the Lord for forming

him, for knitting him together en utero, for creating him, specifically his physical body,

intentionally. Though there is no evidence that David struggled with a physical or mental

disability, there is no reason to read this text as exclusively applicable to David, or those

without disabilities to speak of. John Knight offers a touching reading of this passage for

those with birth defects and other challenges:

For you formed my inward parts with Down syndrome;

you knitted me together in my mother's womb without eyes.
I praise you, for I am fearfully and wonderfully made with cognitive challenges.
Wonderful are your works in creating me without limbs;
my soul knows it very well though my ears will never hear a sound.
My frame was not hidden from you as you made me with Apert syndrome,
when I was being made in secret with autism,
intricately woven in the depths of the earth without Hexosaminidase A.
Your eyes saw my unformed substance with spina bifida;
in your book were written, every one of them,
the days that were formed for me with cerebral palsy,
when as yet there was none of them.90

Gender dysphoria, therefore, should be understood as a part of God’s design of an

individual who experiences it. Though referring to transgenderism as a disorder may be

controversial, this is an appropriate label as much as it is a disruption of healthy and

congruent function of the human body, and causes individuals who experience it a great

deal of pain and distress. God takes credit for creating individuals with disabilities from

birth in texts such as Exo. 4:11 and John 9:1-3; Knight does well to conclude thus from

90
John Knight, “Is God Sovereign Over Human Disability?,” Desiring God, last modified May 6,
2010, accessed Feb. 3, 2017, [Link]
Italics are original, and represent his additions to the ESV text.
EMBRACING UNCERTAINTY 40

these passages: “To be clear, God’s sovereignty doesn’t mean he merely permits

disability. These verses show us that he sovereignly intends it, both for his glory and for

our good.”91 This includes, of course, both mental and physical disorders. God’s

intentional creation of each individual, then, is not a guarantee that every aspect of an

individual will be perfect, but rather that the Lord purposefully designs all parts of a

person, including any disorders one may suffer from.

This brings us to two questions: whether transgenderism is biologically rooted,

and whether it is a mental disorder or a physical disorder, that is, if one’s gender identity

or biological sex is the cause of the identity incongruence. We addressed the first directly,

concluding that current research indicates that one’s biology certainly plays a part in

development of transgenderism, and likely a more important role than upbringing. The

second question is more difficult to answer, but the best conclusion seems to be that both

are possible. The low persistence rate of GD in children indicates that in many cases it is

a mental problem that is resolved as one’s identity develops, while the ineffectiveness of

psychiatric treatment and very high efficacy of SRS in eliminating or significantly

reducing GD suggests that one’s physical characteristics can be the source as well.

Further research into the causes of GD will likely provide a firmer answer to this

question, but current evidence suggests that the cause of transgenderism is not the same

in all cases.

Understanding the cause of transgenderism is crucial for developing an approach

to trans individuals, as it will determine what treatment should be recommended. If it is a

91
Knight, “Is God Sovereign Over Human Disability?”
EMBRACING UNCERTAINTY 41

mental disorder, we should treat it through psychiatric help as with other psychotic

problems, but if it is a physical disorder, then the most effective treatment is a physical

treatment.

Some object to the possibility that one’s functional sex characteristics could be a

defect. Consider, for example, Joe Dallas’ counsel to Kim, the FtM transsexual we

mentioned earlier, who proposed that his female physical characteristics might be

defective rather than his gender identity. Dallas’ response represents a common mindset

among proponents of the traditional approach, and warrants comment: “If something is

inherently wrong, it’s a flaw. But being male or female isn’t a handicap or a sinful

tendency. We can only call something a flaw if it’s defective in and of itself. Otherwise,

if something inherently natural about our body is at odds with our desires, then our

desires are the problem, not vice versa.”92 This definition of a defect exposes the primary

presupposition inherent in the traditional approach. Proponents of this approach, Dallas

included, take pains to avoid prioritizing the mental aspects of a person over the physical,

acknowledging that this distinction between material and immaterial is Platonic, not

biblical. Dallas goes so far as to identify transgenderism as a Gnostic concept, despising

the physical and favoring the mental.93 The traditional approach, however,

overcompensates and prioritizes the physical over the mental in a way the Bible does not.

This is called physicalism, which Watts defines as “a curiously dualistic theology of

creation in which the physical is seen as embodying God’s goodness more than the

92
Dallas, “The Transsexual Dilemma,” 6.
93
Ibid., 5.
EMBRACING UNCERTAINTY 42

psychological.”94 While it is certainly true that some trans individuals do embrace a

dualistically anti-physical worldview, the correct response to this is not to prefer the other

side of this duality, but to understand that God designed humans as whole beings with

different aspects of their humanity working in harmony. Because of the Fall, however,

there is now incongruence between the aspects of a person’s identity, and none of these

are immune to the effects of this shattering, including the physical. Dallas’ response to

Kim betrays exactly this unbiblical physicalism, which should not be allowed to drive the

Christian moral judgment on transgenderism.

Thus, Psa. 139:13-16 does not provide reason to conclude that transgenderism is

exclusively a mental problem, or a disorder based solely on upbringing. However, it does

add to our understanding of transgenderism by confirming that those who do struggle

with GD because of their biology have been intentionally designed with this condition by

God. He does not afflict individuals with biological or other challenges to punish or hurt,

but to test them in order to ultimately allow them to grow in their relationship with him

through their trials. This by no means should cause us to reject the idea of treating

transgenderism using available effective psychiatric or medical means, but should give

judgmental Christians pause, and encourage believers in Christ who struggle with GD

that they have been given this struggle by God on purpose, and ultimately for their eternal

good.

To summarize our critique of the arguments used by proponents of the traditional

approach, we have seen that the biblical texts cited as evidence that biological sex is the

94
Watts, “Transsexualism,” 80.
EMBRACING UNCERTAINTY 43

most reliable indicator of holistic gender do not in fact make this claim. The Genesis

creation account suggests that holistic gender was never supposed to be broken into

multiple parts, but has been because of sin, and that each of these aspects can be effected

by the Fall, including biological sex. Additionally, while the individual creation texts

reveal that individuals have the physical bodies and minds that God has designed them to

have, these texts do not rule out that God intentionally designs individuals with mental

and physical disabilities; in fact, the coexistence of these texts and individuals with

mental and physical defects requires this to be the case. Finally, we must be careful not to

counter a dualistic view of the body that favors the immaterial with a dualistic view that

favors the material, but hold a view of the Fall that affirms the potential of both the body

and mind to be defective because of sin.

Moving Towards a Better Approach

The purpose of our deconstruction of the primary arguments underlying the

traditional Christian ethical handling of transgenderism is not to argue that cross-gender

living is compatible with a godly lifestyle. Rather, we hope to set the stage for a

discussion of transgenderism in which the Christian approach is rooted more solidly than

it is currently. The ideal approach should succeed in three ways: firstly, responsibly

handling biblical teachings on gender; secondly, compassionately recognizing the

experiences of trans individuals, rather than minimizing or dismissing them; and thirdly,

being compatible with current scientific and medical understandings.95 The arguments

95
This is not to say that scientific arguments should be accepted uncritically, as Christians should
take care to examine the validity of these claims. However, scientific studies, despite being performed by
biased and fallen men and women, can be extremely valuable in developing an understanding of a complex
topic such as transgenderism, and Christians would do well to become acquainted with this issue through
EMBRACING UNCERTAINTY 44

traditionally used to forbid cross-gender living fulfill none of these, however, being

rooted in a physicalist interpretation of the creation account, viewing all transgender

experiences as evidence of mental disordering, and discounting research showing a

biological basis for GD.

Advantages of basing the Christian approach more effectively. The

advantages that accompany basing the Christian approach to transgenderism more

effectively correspond to the three standards of a strongly-rooted response. Firstly, these

arguments will be based on better interpretations of biblical texts. They will also avoid

the condescending view that all gender dysphoric individuals are mentally handicapped,

and acknowledge the experiences of these people in the way that scientific research is

confirming the reality of their identity incongruence. As Susannah Cornwall, professor at

the University of Exeter and expert on the intersection of theology and sexuality and

gender, writes regarding the failures of the current Christian approach, “holding as pre-

existent ‘known fact’ that all transgender people are mentally ill or delusional profoundly

undermines their legitimacy.”96 Especially as scientific findings are increasingly

recognizing the legitimacy of GD as more than a solely mental disorder, the Christian

approach should recognize the validity of the struggle these individuals face. This will

naturally lead to greater empathy and care towards these individuals, which is surely

preferable to prejudice and unwelcomeness. Additionally, approaching this issue in a way

these types of sources. When approached with a critical rather than skeptical eye, scientific understanding
can be a valuable aid in forming an appropriate and well-informed moral judgment on transgenderism.

Susannah Cornwall, ““State of Mind’ versus ‘Concrete Set of Facts”: The Contrasting of
96

Transgender and Intersex in Church Documents on Sexuality,” Theology and Sexuality 15, no. 1 (2009):
16.
EMBRACING UNCERTAINTY 45

that accounts for the growing body of scientific information regarding GD will allow the

Christian approach to be taken more seriously in non-Christian circles. While this should

not be the primary goal of a Christian ethical judgment, it is certainly advantageous for

Christians to exhibit logical reasoning and scientifically literacy in a culture that values

these attributes so highly; this recalls Paul in 1 Cor. [Link] “I have become all things to all

people, that by all means I might save some.”

Alternative arguments against cross-gender living. We have intentionally

avoided concluding that cross-gender living is ethical or sinful up to this point, because

the purpose of this discussion has been to examine some problems with the foundations

of the traditional Christian approach, rather than to propose a revised moral judgment on

transgenderism. However, it is important to note that there remain reasons to argue

against cross-gender living and SRS, even without misappropriating the creation account

and personal creation texts. Two examples of more appropriate arguments against cross-

gender living are the discord this transition could cause in church communities, and the

ethical questions regarding pursuing cosmetic surgery to alleviate mental suffering, even

if the mental suffering is based on the person having mismatched physical characteristics.

We will now briefly examine these considerations.

Though modern Western society values individual good over corporate good, this

individualism is foreign to the ethics of the New Testament. Consider, for example,

Paul’s instructions regarding eating meat sacrificed to idols in 1 Cor. 8:9-13:

But take care that this right of yours does not somehow become a stumbling
block to the weak. For if anyone sees you who have knowledge eating in an idol's
temple, will he not be encouraged, if his conscience is weak, to eat food offered to
idols? And so by your knowledge this weak person is destroyed, the brother for
EMBRACING UNCERTAINTY 46

whom Christ died. Thus, sinning against your brothers and wounding their
conscience when it is weak, you sin against Christ. Therefore, if food makes my
brother stumble, I will never eat meat, lest I make my brother stumble.

Of course, Paul did not have gender transitioning in mind when he wrote this passage, but

the underlying principle of a church-first individual mentality should be instructive for

Christians today. To my knowledge, no data exists regarding the effects of a churchgoer

transitioning into the role of the opposite gender on the health of church congregations.

However, it is easy to imagine the difficulty many in a congregation would face trying to

process this type of change. While there are certainly times where a church may be

embracing a sinful attitude that should be resisted, such as those that historically

rationalized racism and slavery, this does not seem to be an analogous situation to

resistance to transsexual behavior. Therefore, a Christian experiencing gender dysphoria

should be greatly cautioned against receiving SRS for the sake of his or her individual

psychological well-being if this transition will cause distress to his or her church

community.

While the previous objection to transsexual living is circumstantial based on the

composition of one’s church community, a more serious ethical concern is that of

receiving a cosmetic surgery on healthy tissue to correct identity incongruence. This

question is further complicated when we consider that individuals with biologically-

rooted GD have been designed by God as wholes, including both their physical bodies

and gender identities. Earlier, we compared inborn GD to other genetic difficulties

individuals face, some of which are manageable through medication, others of which

cause difficulty throughout one’s life. Very few Christians would argue that most
EMBRACING UNCERTAINTY 47

psychological or health problems should not be treated if an effective treatment is

available. Thus, two questions need to be answered to effectively answer this ethical

objection. Firstly, is GD a psychological or physical problem, i.e., is one’s gender

identity the deviation from his or her true gender, or is one’s biological sex? We have

addressed this question previously, and concluded that current research indicates that

there are some cases where GD is based on an incongruent gender identity, and other

cases where it is caused by a mismatched biological sex. Ultimately, further research is

needed to show more conclusively the root cause(s) of GD, and will be very helpful for

Christians looking to recommend an effective treatment to trans individuals. The second

question is, specifically if the cause of GD can be shown to be one’s physical sex, is

surgical treatment that will destroy the functionality of healthy genitalia ethical if it will

allow one to overcome GD? This is a complex question, and deserves significant further

consideration. It should be noted that determining that GD has physical roots is not

necessarily to determine that SRS is morally justified. While the Shia community in Iran

subsidizes SRS because of its view that gender identity is of a greater ontological priority

than biological sex, it is important to note that Christianity does not share the same

anthropological binarism that Islam does, instead holding that people are whole beings

shattered by sin.97 Because Christianity values the physical more highly than Islam, there

is a difficult set of ethical concerns that must be addressed to determine whether sex

change procedures are an ethical treatment for physically-rooted GD.

97
Bucar, “Bodies at the Margins,” 610.
EMBRACING UNCERTAINTY 48

Ultimately, more medical and ethical consideration is necessary before a moral

judgment can be made regarding whether a cross-gender lifestyle can be compatible with

the Christian worldview. DeFranza’s conclusion regarding the place of intersex

individuals in Christian theology is welcome as a concluding note in the ethical

uncertainties accompanying this discussion: “Certainly, the complexity of human

sexuality, coupled with the challenge of biblical interpretation and application, should

lead to humility on the part of all who wrestle with these issues.”98

Conclusion

The existence of transgender individuals challenges one of the most basic

assumptions about Western society: the certainty of an individual’s gender based on his

or her physical characteristics. Thus, it is no surprise that a 2013 study showed that

transgender people were the victims of the most discrimination of any minority sexuality

or gender group, significantly below even homosexual individuals.99 The church,

however, should take the lead in welcoming and supporting these individuals, showing

them the same care and hospitality that Jesus showed the social pariahs of first-century

Israel. Sadly, as previously noted, the opposite is currently true, with devout Christians

tending to show greater prejudice towards trans people than non-religious individuals.100

This should be a wake-up call to Christians, who are not called to judge nonbelievers for

their sin (1 Cor. 5:12), but to reach out to them in their sin in the same way that Christ

98
DeFranza, Sex Differences, 268.
99
Norton and Herek, “Heterosexuals’ Attitudes,” 746.
100
Ibid.
EMBRACING UNCERTAINTY 49

reached out to them (Mark 2:16-17). This does not preclude labeling sinful activities as

such, especially when an individual claims to be a Christian; however, Christians should

not be afraid to admit their own ethical uncertainties, and should be willing to enter into

dialogue with varying views to reach the best possible moral judgment. The goal of this

discussion has been to expose the serious flaws in the traditional Christian arguments

against transgenderism, and hopefully clear the way for stronger reasons to either

approve or disapprove of cross-gender living. Whether this discussion leads to the

prohibition or authorization of this lifestyle, love must remain the chief virtue of the

church, and should characterize all its dealing with trans people, regardless of whether

transsexual individuals are living sinfully or righteously.

As in all challenging areas of faith, Christians should look to Jesus as an

encouragement, example, and promise in regards to gender identity issues. Those who

struggle with their gender identity can see in Christ the ultimate example of tension

between one’s identity and physical body. Paul writes regarding this divine incongruence

to the church in Philippi: “Have this mind among yourselves, which is yours in Christ

Jesus, who, though he was in the form of God, did not count equality with God a thing to

be grasped, but emptied himself, taking the form of a servant, being born in the likeness

of men” (Phil. 2:5-7). God himself put on flesh and walked on the earth he created;

though not strictly a problem of gender, no more extreme disconnect can be imagined

that that of the Son of God, the second Person of the Trinity, being born as a baby in a

feeding trough and being put to death on a Roman cross. Christ is the great Empathizer

with all who struggle with feeling trapped in their bodies. This similarity between Jesus
EMBRACING UNCERTAINTY 50

and transgender individuals may go even further, as many commentators believe that

Jesus’ statement on the voluntary eunuch in Matt. 19:12 was his response to the crowd

mocking him for being unmarried, and thus falling short of the cultural model of

masculinity.101 Jesus also deviated from traditional gender norms, yet used his God-

ordained differences to glorify the Father on earth. This should serve as a great

encouragement to Christians struggling with transgender urges, and also a challenge to

not let these difficulties define them, but to instead see them as opportunities to glorify

God in ways that others may not be able to: “there are eunuchs who have made

themselves eunuchs for the sake of the kingdom of heaven.”

Furthermore, Jesus, in his revolutionary willingness to serve and be in the

company of sinners and social pariahs, instructs Christians who wish to minister to trans

individuals most effectively. Jesus reached out to individuals who were outcasts both

because of their sin, from tax-collectors to adulterous women, and because of

circumstances beyond their control, including the blind, leprous, and paralyzed.

Regardless of the moral judgment regarding transgender living, Christians have an

obligation to show intentionality and love to those who society most abandons, regardless

of gender, sexual orientation, or any other factor.

Finally, Jesus is the great promise for all believers, those who struggle with

transgenderism personally, and those who struggle with knowing how best to interact

with others who do. In Christ’s resurrection, there is a promise to all whose bodies make

their lives painful and confusing, whose minds war against them: their turmoil will not

101
DeFranza, Sex Difference, 246.
EMBRACING UNCERTAINTY 51

last forever. In Rev. 21:1-4, John foretells of the day when all that is broken by the Fall

will be made whole:

Then I saw a new heaven and a new earth, for the first heaven and the first earth had
passed away, and the sea was no more. And I saw the holy city, new Jerusalem, coming
down out of heaven from God, prepared as a bride adorned for her husband. And I heard
a loud voice from the throne saying, “Behold, the dwelling place of God is with man. He
will dwell with them, and they will be his people, and God himself will be with them as
their God. He will wipe away every tear from their eyes, and death shall be no
more, neither shall there be mourning, nor crying, nor pain anymore, for the former
things have passed away.”

And then the Lord, sitting on the throne, switches from the future tense to the present

tense, assuring his people, “Behold, I am making all things new” (v.5). Identity struggles,

moral confusion, and church discord will all be eliminated and replaced with joy,

belonging, and of the presence of God. While transgenderism will not endure eternally,

Christ’s people will be with him forever. This is the ultimate promise for all who believe

in Christ, including Christians who struggle with their gender identity. Christians should

bear this in mind when seeking to respond appropriately to a difficult moral issue like

transgenderism. For now, Christians should fix their eyes on Christ, trusting Him to

ultimately answer all questions at his return. As with all things, the primary response of

Christians to transgenderism, beyond the moral judgments of today, should be to echo the

church throughout history, and call out for the only One who can truly end the pain of

identity disorders once and for all: “Come, Lord Jesus!” (Rev. 22:5). He alone is

sufficient for all our moral unknowns, and Christians must trust in him and his grace to

be enough for them as they discern his will in the complexity of responding to

transgenderism.
EMBRACING UNCERTAINTY 52

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