Transgender: Caring for those who experience issues with gender identity

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Genesis 1:26-27

INTRODUCTION: Today is the last Sunday in our series on Hot Button Topics. In the first part of this series we looked at four topics – abortion, assisted suicide, alcohol and racism. In the second part of the series we have looked at living together, divorce and homosexuality. Today we come to the topic of transgender. As Christians how do we care for those who experience issues with gender identity? As with all the Hot Button Topics in the series, we will be looking at a number of passages from the Bible this morning, but let us begin with these verses here in Genesis 1. (Read Genesis 1:26-27 and pray.)


The transgender issue is not new, although it is a fairly new issue in the church and in our culture. It’s not that there haven’t always been people who struggle with gender identity, but it is only in recent years that the church and the culture have begun addressing the issue more publicly.

I think it’s good that we are all talking about it more, because this involves real people with real issues, and the Bible has real answers for us in this area. I also think it is good and healthy that people who experience issues with their gender identity have greater freedom to talk about their struggles and feelings in an open and honest way.

Because issues of gender identity are now more out in the open in our culture, we must know how to respond as Christians and as a church. We will be meeting more and more people who identify as transgender in our communities, and we will have people who identify as transgender coming to our churches. How will we respond? How would God have us respond? That’s what we want to talk about today.

We are going to approach this Hot Button Topic in three stages. First, I want to spend some time helping us understand what transgenderism is and the issues involved. Then we will look at what the Bible says. And then finally we will look at how we should respond.

I. Understanding transgenderism

First, because this is such an unfamiliar topic to so many of us, before we look at what the Bible says about transgenderism, we need to understand a little more about transgenderism itself.

   A. Understanding the terms

So, let’s begin with understanding the terms. There are many terms involved with this topic, so we will just focus on the major ones.

      – gender/sex; male/female; man/woman

First of all, we need to understand the terms gender and sex, male and female, man and woman. Now I know that all sounds pretty basic, but it is confusion on these basic terms that often causes confusion on the less familiar terms.

Let’s start with gender and sex. Although we often use these terms interchangeably, technically sex refers to your bodily, biological makeup, while gender refers more to the social aspects of being a man or a woman – how you express your biology in social relations.

So, the terms male and female correspond to your sex or biological makeup, while the terms man and woman refer to how we express our sexuality as human beings. That’s why we also use the terms male or female when talking about pets or other animals, but we do not call them men or women. Being a man or a woman is the human expression of the bodily reality of being male or female.

      – gender identity; gender dysphoria

The next two terms are gender identity and gender dysphoria. These are two newer terms, and so we are probably less familiar with them.

Gender identity has to do with how a person perceives their own gender. Do you see yourself as a man or a woman? Everyone has a gender identity, and for most of us our gender identity matches up with our biological sex. For most people, if you are biologically male, you see yourself as a man. If you are biologically female, you view yourself as a woman.

Now there is a wide spectrum of how men and women behave and feel, and we need to be careful not to get locked into cultural stereotypes here. Not every man has to like football. Not every woman has to like sewing. Those are stereotypes. Women can like football, and men can sew, and there is nothing wrong with either of those.

But for a number of people their gender identity – that is, their feeling of whether they are a man or a woman – their gender identity, for whatever reason, does not match up with their biological sex. When that mismatch occurs, they experience some form of gender dysphoria, which is our next term.

Now just because you feel a small sense of uneasiness or dissatisfaction with your gender, does not mean that you have gender dysphoria. Gender dysphoria is an actual diagnosis defined as a “marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months’ duration which causes significant distress.” (Vaughan Roberts, Transgender, Kindle location 114) It can be common for a person, especially growing up, to sometimes wonder about their gender, but that does not mean that you have gender dysphoria.

      – transgender; transsexual; intersex

That brings us to our final three terms: transgender, transsexual and intersex.

Transgender has to do with identity. A transgender person is someone who not only feels a sense of incongruence between their biological sex and their gender but chooses to identify their gender with the opposite sex. So, for example, a transgender man is a person who is biologically female but identifies as a man. A transgender woman is a person who is biologically male but identifies as a woman. So, transgender has to do with identity.

Transsexual has to do with bodily transition. A person could be transgender – that is, they could identify as someone of the opposite sex – and not make any physical changes to their body. They might simply choose to call themselves the opposite sex, or to dress as the opposite sex, or to change their name or preferred pronouns to someone of the opposite sex. But when you begin to change your body so that you resemble someone of the opposite sex, that would be transsexual.

Now it’s important to understand that you can never truly change your biology from how you were born. Surgery changes your appearance, but it does not change your biological makeup. Each of us is born either male or female, with the rare exception of those who are born intersex, and we can never change our genetics. Intersex is a very rare condition where a person is born with physical characteristics of both sexes. In most cases the child is assigned a sex at birth and continues to live out that gender identity.

I have presented these terms in the order of decreasing numbers in society. For most people their gender identity matches their biological sex. For a smaller number of people, they feel a sense of dissonance between their gender identity and their biological sex. For many of these it is never a problem, but for some it is, and they experience actual gender dysphoria. But not all who experience gender dysphoria choose to identify as transgender. And not all who identify as transgender choose to bodily transition as transsexuals.

   B. Understanding the issues

So those are the basic terms we need to know. Now let’s talk briefly about the various issues involved.

      – medical issues

Medical issues include causes, effects and treatment. As far as causes, at this point we simply do not know what causes a person to experience issues with gender identity or gender dysphoria.

As far as effects, people with gender dysphoria are at much greater risk for negative outcomes – including suicide, depression and anxiety disorders. This is true even for those who choose to bodily transition. Ryan T. Anderson reports, “These problems do not seem to be alleviated much by sex reassignment procedures…. The poor outcomes can’t be blamed on a hostile or bigoted society, since they are reported even in the cultures most accepting of people who identify as transgender.” (Ryan T. Anderson, When Harry Became Sally, Kindle location 1,932) And so, if people who are struggling with these issues have these negative outcomes in their lives, as Christians who care for people and who love our neighbors as we love ourselves, that should be important to us. We should care about people who are experiencing suffering.

As far as treatment, the current debate centers on whether to treat the body or the mind. Treating the body with hormones or surgery is becoming more common, even with young children and the use of puberty blockers. Still, many psychiatrists believe we should treat gender dysphoria similar to other mind-body disorders, such as anorexia, where instead of changing the body, we help the person to bring their mind into alignment with the physical reality of their body.

      – cultural issues

Cultural issues include such things as cultural views of gender, gender roles and gender stereotypes, as well as the growing idea in society that every person should be free to decide for themselves who they really are.

Now we’ve already touched on gender and stereotypes, so let’s talk about this whole idea of self-definition. For example, when you fill out your Facebook profile, Facebook will ask you for your gender. In the early years Facebook gave you two choices – male or female. Then they created a category called “other” where you could choose from over 70 different options including bi-gender, transgender, androgynous and trans-sexual. However, the options kept changing and the numbers kept growing, so they eventually changed it to male, female or custom. Under “custom” you can write down anything you want. When you choose “custom” as your gender, you also designate your preferred pronoun.

There’s a video on YouTube with over two million views where a white male interviewer who is 5 feet 9 inches in height goes around interviewing people on a college campus. First, he asks them how they would respond if he told them he was a woman. Most of them reply, “Sure, whatever you want is great with me.” Then he asks them, “What if I told you I was Chinese?” Once again, they say, “Sure, if you feel like you’re Chinese, that’s great. You be Chinese.”

Then he asks them, “What if I told you I was 6 feet 5 inches tall?” At this point some of them say no. He asks them why not? They reply, “Because you’re not six foot five. You’re just not.” He responds, “So I can be a Chinese woman. But I can’t be a 6′ 5″ Chinese woman?” And they respond, “Yes.” Although some of them were just fine with him being six foot five, too. “If you want to be six foot five, you go ahead and be six foot five. It doesn’t bother me.” (YouTube; “Gender Identity: Can a 5’9, White Guy Be a 6’5, Chinese Woman?”

It’s a fascinating exploration of how our culture increasingly values self-definition over reality. And it raises the very important question, “Who gets to decide who you are?” We’ll return to that question shortly.

      – political issues

So those are some of the medical and cultural issues. Finally, there are the political issues. And this is important because how people identify who they are have important repercussions in policy, which affects us all. Ryan Anderson identifies five distinct areas of concern surrounding such policies:

(1) privacy interests when men who identify as women can enter female-only spaces;

(2) safety concerns when predators abuse gender-identity access policies;

(3) equality concerns when biological males can compete against females in sports and other arenas where sex differences are relevant;

(4) liberty interests when people are forced to speak or act in ways contrary to their best judgment and deeply held beliefs; and

(5) ideology concerns about confusing messages that schoolchildren receive when they are taught that gender is fluid, falls along a spectrum, and is essentially detached from bodily sex. (Ryan T. Anderson, When Harry Became Sally, Kindle location 219)

II. What does the Bible say?

So, now that we have looked at the terms and the surrounding issues, what does the Bible have to say about these things? There are four things in particular I would like to share with you this morning from the word of God.

   A. God created us male and female
      – Genesis 1:26-27, 2:23; Deut 22:5; Matt 19:4,11-12

First of all, the Bible tells us that God created us male and female. We read in Genesis 1: “Then God said, ‘Let us make man in our image’…. So God created man in his own image, in the image of God he created him; male and female he created them.” (Genesis 1:26-27) Once again, this is that same foundational Scripture we keep returning to throughout this series on Hot Button Topics. This is now the sixth time out of eight messages that we have returned to this Scripture for various reasons. Here it is because this verse establishes for us God’s norms for gender at the very beginning of creation.

God created us male and female. And God said that what he created was good. As Andrew Walker states: “Maleness and femaleness, according to the Bible, aren’t artificial categories. The differences between men and women reflect the creative intention of being made in God’s image.” (Andrew Walker, God and the Transgender Debate, p. 53)

Furthermore, the Bible introduces the terms “man” and “woman” in the context of God creating us male and female. Genesis 1 introduces the creation of man and woman. Genesis 2 then expands on that account. After the creation of the woman from the man, we read Adam’s words in Genesis 2:23: “This is now bone of my bones and flesh of my flesh; she shall be called ‘woman,’ for she was taken out of man.” (Genesis 2:23) So the Bible says we are created male and female, and we are to fulfill our gender roles according to our bodily sex. In other words, who gets to say who you are? God gets to say who you are. It is part of his created order.

This, by the way, is why the Old Testament forbids cross dressing. We read in Deuteronomy 22:5: “A woman must not wear men’s clothing, nor a man wear women’s clothing, for the LORD your God detests anyone who does this.” (Deuteronomy 22:5) The Bible forbids cross dressing because gender is a calling God calls us to fulfill on the basis of our biological sex. It’s interesting to note that the New Testament also addresses distinctions in dress between men and women in 1 Corinthians 11 and 1 Timothy 2.

Jesus also affirmed God’s creation of humans as male and female in Matthew 19:4 when he said, “Haven’t you read that at the beginning the Creator ‘made them male and female.” (Matthew 19:4) So we can’t just say this is Old Testament. The Old Testament is the foundation for the New, and Jesus affirms the foundational principles from Genesis concerning gender.

Jesus also affirmed that some people are born intersex, that is with dual or ambiguous sex organs. In Matthew 19:11-12 Jesus talks about eunuchs and says: “Some are eunuchs because they were born that way; others were made that way by men; and others have renounced marriage because of the kingdom of heaven.” (Matthew 19:11-12)

Now people were very familiar with eunuchs in Jesus’s day. The Romans called those who were born with sexual ambiguity “eunuchs by nature.” The Jews called them “eunuchs of the sun” since “they were discovered to be eunuchs at the moment the sun shone upon them.” Jesus called them eunuchs who were born that way. (The Gospel and Gender Identity, p. 23)

You might wonder how this could be since God created everything good. Well, that brings us to our second point.

   B. God’s created order is distorted by the fall
      – Romans 8:20-21

Yes, God created us male and female, but God’s created order is distorted by the fall. We read in Romans 8:20-21: “For the creation was subjected to frustration, not by its own choice, but by the will of the one who subjected it, in hope that the creation itself will be liberated from its bondage to decay and brought into the glorious freedom of the children of God.” (Romans 8:20-21)

When humanity fell into sin, it brought disorder into God’s perfect creation. Part of this disorder is physical, for example, when people are born intersex. And part of this disorder is psychological, for example, when people feel that their gender does not match their sex. If there had been no fall, there would be no intersexual conditions and there would be no gender dysphoria. There would be no disorder in creation, and there would be no mismatch in people’s minds between their sense of gender and their bodily sex.

Experiencing feelings of gender dysphoria is not sinful, any more than experiencing feelings of depression is sinful. These are just real effects of the fall in this world. We are all born disordered in some way. We are all created in God’s image, but that image is distorted because of the effects of sin.

   C. One day God will restore creation
      – Romans 8:22-25; Philippians 3:20-21

1) God created us male and female. 2) God’s created order is distorted by the fall. And then thirdly, one day God will restore creation. We read in Romans 8:22-25: “The whole creation has been groaning as in the pains of childbirth right up to the present time. Not only so, but we ourselves, who have the firstfruits of the Spirit, groan inwardly as we wait eagerly for our adoption as sons, the redemption of our bodies. For in this hope we were saved. But hope that is seen is no hope at all. Who hopes for what he already has? But if we hope for what we do not yet have, we wait for it patiently.” (Romans 8:22-25)

This is the hope that the Bible holds out to all who believe. One day the effects of sin will be reversed. Just as there would be no gender confusion apart from the fall, so there will be no gender confusion in the restored creation. The various ways we experience brokenness in the world now, both physical and psychological, will all be healed and restored when Jesus returns.

As Philippians 3 says: “We eagerly await a Savior … the Lord Jesus Christ who … will transform our lowly bodies so that they will be like his glorious body.” (Philippians 3:20-21) Or as Andrew Walker puts it: “We live in a Genesis 3 world with a Genesis 1 blueprint on the trajectory to a Revelation 21 future.” (Andrew Walker, God and the Transgender Debate, p. 88) One day God will restore creation.

   D. Jesus offers you abundant life now
      – John 10:10; Romans 8:1

Well, that’s fine for the future. But what about now? The good news of the gospel is not only hope for the future, but that Jesus offers you abundant life now. We read these words of Jesus in John 10:10: “The thief comes only to steal and kill and destroy; I have come that they may have life, and have it to the full.” (John 10:10) Romans 8:1 says: “Therefore, there is now no condemnation for those who are in Christ Jesus.” (Romans 8:1)

When you come to Christ, your sins are forgiven, and God gives you the strength to deal with the various aspects of brokenness in your life. God may or may not change your experience of gender dysphoria, but as you follow him and seek him first, he will help you and give you strength for the journey, and he will give you an abundant and full life even now.

III. How should we respond?

So, we have looked at the various terms and issues relating to gender identity. And we have looked at what the Bible says about gender identity. Finally, then how should we respond? As Christians, how do we care for those who experience issues with gender identity? Let me give you three words in closing: listen, learn and love.

   A. Listen – listen to those who struggle with gender identity
      – James 1:19

First of all, listen. James 1:19 says: “Everyone should be quick to listen and slow to speak.” (James 1:19) Listen to those who struggle with gender identity. Listen to their experience. Let them tell you what is like for them. Be quick to listen and slow to speak.

   B. Learn – learn more about the issues involved
      – Proverbs 18:13

And then secondly, learn. Proverbs 18:13 says: “He who answers before listening – that is his folly and his shame.” (Proverbs 18:13) In other words, we listen in order to learn. And we learn not only by listening, but also by reading and studying. We learn more about the issues involved so we are well-informed when we speak. I hope today’s message has been helpful to you in that regard.

   C. Love – accept the person; speak the truth; share the gospel; seek their good
      – Matthew 18:6, 22:39; John 8:31-32; Ephesians 4:15

And then finally, love. We end where we began last week. As Christians we are called to love, which means we accept the person, we speak the truth, we share the gospel, and we seek the good of other people, not their harm.

Jesus said, “Love your neighbor as yourself.” (Matthew 22:39) Transgender people are your neighbors, and as Christians we must love them because they are our neighbors. We must commit to treating them with full dignity as persons created in the image of God, and we must refuse to mock them or segregate them in any way. Even when you don’t agree with someone, you can still act towards them in love.

So, we must accept the person, and then we must also speak the truth. Ephesians 4:15 says we should “speak the truth in love.” (Ephesians 4:15) Jesus said in John 8: “If you hold to my teaching [which includes Genesis 1 – God created them male and female, man and woman], if you hold to my teaching, you are really my disciples. Then you will know the truth, and the truth will set you free.” (John 8:31-32) If we love people, we will want them to be free, which means we must speak the truth to them, and we should encourage people to live according to the truth, according to the reality of who they are. For those who struggle with gender identity, this would mean living out their gender in accord with their bodily sexuality and not according to what they feel in their mind.

What about children who express issues with gender identity? Most cases with children who express gender confusion resolve themselves by the time the child reaches adolescence or beyond. The physical treatment of children with puberty blockers can have damaging and irreversible effects and should not be used. We should remember that Jesus had harsh words to speak about those who would cause damage to children: “If anyone causes one of these little ones who believe in me to sin, it would be better for him to have a large millstone hung around his neck and to be drowned in the depths of the sea.” (Matthew 18:6)

CONCLUSION: There is so much more to say about this issue, but we will have to close here. As with all the Hot Button Topics in this series, my prayer is that we would be faithful to God’s word, loving towards people and sensitive towards the various issues involved.

© Ray Fowler

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Click here for more messages from the Hot Button Topics series.
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Recommended Resources on Transgender Issues:

Books: (* = highly recommended)
*God and the Transgender Debate by Andrew Walker
   – good general level discussion of the various issues
*The Gospel and Gender Identity: Gender as Calling
   – biblical and theological response to gender identity issues
Love Thy Body by Nancy R. Pearcey
   – chapters on abortion, homosexuality and transgenderism
Talking Points: Transgender by Vaughan Roberts
   – another good general level discussion of the issues
*Understanding Gender Dysphoria by Mark A. Yarhouse
   – technical presentation of the clinical issues involved
When Harry Became Sally by Ryan T. Anderson
   – research on current medical, social and political issues

Resources: (CMF File 59 – Gender Dysphoria) (Healing from Cross Dressing)

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