Responding to the Transgender Revolution


Editors’ note: The source version of this article (and a downloadable PDF) can be found at Christ on Campus Initiative. Check out CCI’s website for more excellent articles. You can also listen to Rob and Claire Smith lecture on transgenderism in the podcast “Is This the End of Gender?

On January 30, 2017, a landmark decision was announced by the Boy Scouts of America (BSA). The decision was that the BSA would now “accept and register youth in the Cub and Boy Scout programs based on the gender identity indicated on the application.” This is a revolutionary change. For the last century, the BSA, like single-sex schools, colleges, and other gender-specific organizations, has determined eligibility for its programs based on an applicant’s birth certificate. Needless to say, it only admitted biological males. But no longer. “Trans-boys” (that is, biological females who identify as boys) can now join the BSA. The change, however, is far from isolated. It is simply one of numerous similar developments taking place across the Western world as part of, what many are rightly calling, “The Transgender Revolution.”

The phenomenon of transgenderism not only provokes reactions, but inevitably raises questions—questions about what is real and questions about what is moral. The reality question boils down to this: Is it really the case that a person can be born with “the wrong body,” or is the person who feels this way simply confused at the level of their mind? The morality question follows on from this, but has numerous faces to it, as well as various legal implications. For example, should children with gender identity issues be given puberty blockers? Should a person be allowed to use the bathroom that corresponds to their subjective gender identity? Should Medicaid pay for sex reassignment surgery? How should we regard the marriage of a man to a trans-woman or vice versa?1

Perhaps understandably, differing answers to these questions tend to polarize people. But it’s important to realize that behind the surface polarization lie two very different understandings of what gender is and how it is determined. The older understanding (which we might label biological essentialism) claims that a person’s gender is determined by the objective fact of their biological sex. Where there is a felt “mismatch,” subjectivity should be helped to yield to objectivity. The newer understanding (which we might label psychological existentialism) claims that the objective facts of biology do not determine gender identity. In fact, all objectivity should give way to a person’s own subjective perception of their gender.

In light of such a divide, and the social, medical, political, and legislative changes being wrought by the widespread acceptance of transgender claims, Christians have an urgent need to search the Scriptures carefully and prayerfully to see how God would have us think about and respond to such revolutionary developments. The main purpose of this essay is to begin such a search and to outline such a response. However, before we embark on this task, it will help us, firstly, to clarify a number of key terms that are a basic part of the current discussion and, secondly, to probe a little more deeply into contemporary gender theory and where it is taking us as a culture.

1. Key Terms and Their Meanings

a) Biological sex, birth sex, or natal sex: These terms all refer to the physical or physiological characteristics that help us differentiate between what is male and what is female: chromosomes, hormones, gonads, genitals, and secondary sex characteristics—e.g., body shape, voice pitch, and hair distribution. Biological sex is often simply referred to as “sex.”

b) Gender: Historically, the terms “sex” and “gender” have often been used interchangeably. Even today drawing a distinction between them is not universal. Where a distinction is made, however, “gender” is “often intended to emphasize the social and cultural, as opposed to the biological, distinctions between the sexes.”2 As such, the term usually encompasses three aspects: gender identity, gender expression, and gender roles.

c) Gender identity: This refers to the way individuals perceive themselves and wish to name themselves. When a person’s subjective gender identity aligns with their objective biological sex, which is the case for most people, they are sometimes referred to as cisgender (cis = on this side of).3 When there is a clash, however, then they are commonly referred to as transgender (trans = on the other side of). See further below.

d) Gender expression: This refers to the psychological and social aspects of how masculinity and femininity are presented in things like dress and demeanor, social roles and conventions, and other cultural gender norms. These vary from culture to culture, if not from person to person.

e) Gender roles: This refers to the commonly accepted expectations of maleness or femaleness, including social and behavioral expectations. While some roles (for example, who cooks the meals or irons the clothes) vary from person to person, household to household, or culture to culture, and often change over time, others are biologically determined (most obviously, pregnancy and breastfeeding).

f) Gender bending: This refers to the intentional crossing or bending or blending of accepted gender norms in a given culture. This is done either by adopting the dress, mannerisms, roles, or behaviors of the opposite gender (sometimes referred to as transvestitism), or through the attempt to obscure one’s gender and to appear as either asexual, agender, pansexual, omnigender, or androgynous.

g) Gender dysphoria: This is the latest diagnostic term (c/-DSM-V, 2013) for the distress experienced by those whose psychological or emotional gender identity differs from their biological sex. It replaces the previous term, Gender Identity Disorder (c/-DSM IV, 1994), which saw the mismatch itself as a psychiatric disorder. Now, however, it’s only the distress that is (normally) caused by gender incongruence that is regarded as a problem, not the incongruence itself.4 For this reason, I will use the term “gender dysphoria” only occasionally in this essay and, for the most part, prefer the language of “gender incongruence,” which I deem to be a more helpful descriptor of the condition.

h) Intersex: This is a term that covers a range of disorders of sex development (DSDs) where there is some biological ambiguity in a person’s genitalia or gonads, or more rarely still, their chromosomes. Except in very rare instances, a person’s biological sex can be known from their DNA. Because intersex conditions are medically identifiable deviations from the binary sexual norm they are not regarded as constituting a third sex.5 Because they are biologically (rather than psychologically) based, some intersex people do not wish to be associated with the LGBTQ+ movement.6

i) Transgender: This is an umbrella term for people who are born either male or female, but whose gender identity differs from their birth sex (to varying degrees), and who want to express the gender with which they identify through cross-dressing, if not also cross-sex hormone therapy (CHT), if not also sex reassignment surgery (SRS). The term transsexual is sometimes used interchangeably with transgender, and sometimes used only of those who seek medical assistance to transition. Because of its breadth, the transgender umbrella also includes those who identify as bigender, pangender, omnigender, gender fluid, gender diverse, or agender.

j) Heteronormativity: This is the view that biological sex is either male or female (gender binarism), that sex and gender are meant to match up (cisnormativitiy), and that only sexual orientation toward and sexual relations with a member of the opposite sex is normal and natural. As we will see, the ideas conveyed by the term heteronormativity are central to the biblical view of sex and gender. However, because these ideas are increasingly regarded as bigoted, oppressive, homophobic, and transphobic (especially by LGBTQ+ activists and allies), heteronormativity is a somewhat tainted term.

With these terms and definitions understood, we now turn to look more closely at contemporary gender theory and the revolutionary changes it is introducing.

2. The Brave New Worldview of Gender Plasticity

A. A Question of Identity

The question—“Who am I?”—is by no means new. It is part of King David’s question: “[W]hat is man that you are mindful of him, and the son of man that you care for him?” (Ps. 8:4).7 Nevertheless, as the rapid development of new terminology testifies, it is being asked today with a new force and in a new form. The old form assumes there is an objective “I” that already exists and is simply waiting to be discovered. But this, according to current gender theory, is a false assumption. So the new form of the question is this: “What do I identify as?” This way of putting things emphasizes chosenness (as opposed to giveness) and changeability (as opposed to stability).8

This takes us directly into the heart of the “brave new worldview” of gender plasticity. The word “plasticity” is important, for at the heart of this worldview lie the twin notions of “gender diversity” and “gender fluidity.” Gender diversity conveys the idea that gender is not binary (male or female) but exists on a broad spectrum with many points lying in between male and female. Tumblr, for example, currently lists 114 different gender options. ( )Gender fluidity conveys the idea that people can move back and forth along the gender spectrum. This idea is so acceptable to many millennials (Gen Y) and post-millennials (Gen Z)—that is, those born after 1984—that they have been dubbed “the gender-fluid generation.”

It is also important to understand how these two notions—“gender diversity” and “gender fluidity”—are connected. For even if biological sex is understood to be binary (male and female)—which is still the understanding of most people (notwithstanding the acknowledgement of intersex deviations)—once gender is severed from sex, then not only does gender not have to correspond to sex, but there is no reason for gender to share the binary character of sex. Here’s how one biologically female advocate, who describes herself as “gender fluid but also non-binary and trans,” puts it:

My gender is an evolving thing, like my sexuality, the more I explore it the more it changes. The only reason why I feel I should put a label on it is just to make it easier for other people.

However, not all who place themselves under the “T” umbrella are quite so ready to embrace the prospect of perpetual fluidity, nor to dispense with the sex/gender binary. In fact, many who identify as transgender have a very strong sense of the gender binary, at least in regard to their own experience. For example, those who experience gender incongruence are often convinced they are in “the wrong body” and therefore want their body to be (or be changed to appear to be) that of the opposite sex. In other words, they don’t believe in gender diversity, nor are they interested in gender fluidity or gender neutrality. This is one of many tensions within the LGBTQ+ movement.

Nevertheless, the slender but common thread that seeks to hold the “T,” “Q,” and “A” letters in the ever-expanding acronym together is the idea that subjective feelings of identity override the objective facts of biology. So, for example, Mount Holyoke College in Massachusetts, which (according to its website) “remains committed to its historic mission as a women’s college,” now admits the following array of academically qualified persons:

  • Biologically born female; identifies as a woman
  • Biologically born female; identifies as a man
  • Biologically born female; identifies as other/they/ze
  • Biologically born female; does not identify as either woman or man
  • Biologically born male; identifies as woman
  • Biologically born male; identifies as other/they/ze and when “other/they” identity includes woman
  • Biologically born with both male and female anatomy (Intersex); identifies as a woman

Such developments beg the questions: Where did this revolution come from? And how has it come upon us so suddenly?

B. The Transgender “Tipping Point” 

Social commentators are generally agreed that sometime toward the end of 2013, and triggered, in part, by the success of the TV series Orange is the New Black,9 a transgender “tipping point” was reached in Western society.10 Sociologically speaking, a “tipping point” refers to that moment in time when a minority is able to change the attitude of the majority—a change that presupposes the weakening, if not the collapse, of long-held understanding.

But despite the appearance of “suddenness,” the larger change didn’t, in fact, take place overnight. It has been happening incrementally for the last half-century or more. Indeed, it is simply one part of a much broader social and sexual revolution that has engulfed Western culture—a revolution that includes the advent of the contraceptive pill, the various waves of feminism, pre-marital sexual experimentation, de facto marriage, no-fault divorce, abortion on demand, the lowering of film and television standards, the repeal of blasphemy laws, the repeal of sodomy laws, and the legalization of same-sex adoption and same-sex marriage.

What’s more, ever since the late 1960s, the transgender revolution—both politically and ideologically—has been intertwined with both the feminist and homosexual revolutions. Yet because it has been tucked in behind them (sometimes quite deliberately so, due to the gay lobby’s uneasiness with their transgender compatriots) most Westerners hadn’t felt its force, recognized its significance, or seen its implications. For at the heart of the transgender revolution, as we’ve already noted, is a new way of thinking about gender.

Central to this new way of thinking is the idea that gender itself (and not simply gender roles or gender expression) is entirely a social construct and not in any way biologically determined. The seeds of this idea came out of feminism (e.g., Simone de Beauvoir’s famous statement: “One is not born, but becomes a woman”), but then got refracted through homosexual ideology into queer ideology or gender theory. How so? The logic is as follows: if being born a female and becoming a woman are two different things (feminist ideology), and if there is no necessary correlation between your biological sex and your sexual orientation (homosexual ideology), then why should there be any necessary correlation between your biological sex and your gender identity (queer ideology)?11

In other words, this new way of thinking not only draws a sharp distinction between sex and gender but severs the connection. Sex is still generally seen as an objective biological reality, but it is not determinative of gender. What then determines gender? Answers vary. For some, gender is determined by one’s own choice (gender voluntarism); for others, by social forces (gender constructivism); for yet others, by independent neurological factors12 (gender determinism); and for others still, by some combination of factors. Either way, there is no necessary connection between any person’s biological sex and their gender identity. Consequently, more and more people are choosing to identify as transgender, pangender, bigender, trigender, multigender, omnigender, agender, gender fluid, gender diverse, gender queer, etc. As one teenager recently remarked to a psychiatrist: “I want to be transgender, it’s the new black.”

C. Queer Theory and the End of Gender

If this were not revolutionary enough, some want to take things even further. For example, the ultimate goal of some queer theorists is freedom from gender itself! In other words, they not only want to eliminate “heteronormativity” and banish binary categories, but jettison completely the very concept of gender. As one advocate has put it: “At the heart of Queer culture is revolution. The truest rebellion against a world built on categories, labels and binaries is coming from the emergence of identities that refuse to conform.”

Queer theorist Judith Butler states it this way:

The prospect of being anything, even for pay, has always produced in me a certain anxiety, “to be” gay, “to be” lesbian seems to be more than a simple injunction to become who or what I already am . . . I am not at ease with lesbian theories, gay theories, for identity categories tend to be instruments of regulatory regimes.13

Butler, therefore, believes that gender is not something a person has but something a person does. It is “reiterated” rather than “received,” “performed” rather than “possessed.” For this reason, any notion of gender norms necessarily “operates as a preemptive and violent circumscription of reality” (Gender Trouble xxiv). In fact, she even puts forward the idea that biological sex “is as culturally constructed as gender; indeed, perhaps it was always already gender, with the consequence that the distinction between sex and gender turns out to be no distinction at all” (9–10). 

Only slightly less extreme ideas are being propounded by queer theologians. Virginia Ramey Mollenkott, for example, suggests that:

All of us are therefore called to confront the binary gender construct for our own good and the good of those who are transgender. Because gender roles are by no means equitable, binary gender assumptions and roles are devastating to all of us—“masculine” men, “feminine” women, and those somewhere in the middle.

Mollenkott, therefore, anticipates and champions an omnigender future in which everyone “would have their own unique sexuality, falling in love with another person because of their emotional response to the person’s entire being, not the person’s genitals” (167). In such a future, birth certificates and driver licenses would not record a person’s sex or gender, individuals would be free to change their bodies by any means available, and all bathrooms, sports, and even prisons would be unisex. Those who fear such a prospect, Mollenkott claims, are reacting “out of loyalty to the idea that there really is an essential feminine and masculine binary that is either God’s will or nature’s perpetual norm or both” (8). 

D. The Shape of the Future

This is the future that LGBTQ+ ideologues and activists are seeking to realize and, to some extent, have already achieved. In 2014, for example, the Vancouver School Board instructed teachers to replace he/she with xe, him/her with xem, and his/hers with xyr. In a slight variation on this, the University of Iowa has more recently opted for ze, zem, and zir. (13) Numerous other schools and colleges are fast following suit with various alternative sets of pronouns.14

Going a step further, in January 2015, City University in New York (CUNY) announced the introduction of a policy not only banning all gendered titles and salutations but banning all pronouns completely. Students and staff are all to be referred to only by their first and last names. In fact, according to Dominique Nisperos, co-chair of the Doctoral Students’ Council at CUNY, “eliminating the use of pronouns . . . is a necessary step toward protecting the rights, privacy, and safety of students.”

Going further still, in 2015, at Washington State University, students who enrolled in a class called “Women & Popular Culture” were threatened with “failure for the semester” for using offensive language, such as “referring to women/men as females or males.” In this case, the university authorities were forced to step in and reassure students that no one “will have points docked merely as a result of using terms that may be deemed offensive to some.” Nevertheless, such is the momentum of the sex and gender revolution, that the making good of such a threat may not be too far off.

As a final indication of where things are heading, on March 10, 2017, The Multnomah County Court in Oregon granted a 27-year-old video game designer named Patch a “General Judgment of Name and Sex Change,” so that he might only be registered as mononymous—that is, as only having one name instead of a given name and a surname—but also registered as genderless. In defense of her decision, Judge Helen Hehn told an NBC reporter: “I made these decisions, like all decisions, because they were supported by facts and law, and out of respect for the dignity of the people who came before me.”

But while Judge Hehn and those of like mind believe that their decisions and advocacy reflect “respect for the dignity of the people,” others cannot help but conclude that the deconstruction of sex and the undoing of gender is a recipe for psychological confusion, sexual anarchy, social disintegration, and moral chaos. In any case, this is where many Western societies are fast heading. As The New York Times columnist Frank Bruni wrote in a 2016 Op-Ed piece, there is “a clear movement in our society toward L.G.B.T. equality, a trajectory with only one shape and only one direction.” This is confident, triumphalistic language, to be sure, but it is not without a basis. Indeed, despite President Trump’s recent ban on transgender people serving in the military, evidence of such “a clear movement” is all around us and growing daily.15

E. How Should Christians Respond? 

The first and fundamental responsibility of every Christian is to live by every word that comes from the mouth of God, irrespective of whether our culture makes this easy or hard. This means we need to listen carefully to what the Bible teaches us about human sexuality and gender identity, and then to work out how we live, love, and minister in a very confused and sometimes hostile culture, and to the many confused individuals within it (if not within our churches also).

This, in turn, means that we have both a pastoral task and a political task. Both are important, although some of God’s people will be better able to engage in one more than the other. As we now turn to examine the Scriptures, my primary interest is in the pastoral implications of the Bible’s teaching. To help us, I want to flag up front the key pastoral questions we need to answer so we can be alert to how the Bible’s teaching speaks to them:

  • How do we teach and encourage those who are conflicted and confused by the social changes going on around us?
  • How do we counsel and care for those who, through no obvious fault of their own, experience a profound sense of gender incongruence?
  • How do we effectively evangelize gender non-conforming people?
  • What does repentance mean for someone who has transitioned gender?
  • What does Christian discipleship look like for someone who battles ongoing gender dysphoria?

3. Biblical and Theological Exploration

It has taken us a little while to get here, but we now come to the most important of our tasks: engaging with the Word of God in Scripture. My aim is to explore some of the chief ways in which the Bible’s teaching speaks to the issues raised by the transgender revolution and the phenomenon of gender incongruence. In terms of method, I will be combining a biblical theological approach (which seeks to be sensitive to the unfolding nature of the Bible’s teaching) with a systematic theological approach (which is concerned to synthesize the Bible’s overall teaching), while keeping an eye on the pastoral questions raised above and addressing them at appropriate points along the way.

A. The Binary Nature of Sex

With refreshing clarity, the basic, binary, and dimorphic nature of human sex is revealed in the creation account of Genesis 1 and then repeated in Genesis 5:

Then God said, “Let us make man (Heb. ’adam) in our image . . .” So God created man (Heb. ’adam) in his own image, in the image of God he created him; male (Heb. zakhar) and female (Heb. neqevah) he created them. (Gen. 1:26–27)

When God created man (Heb. ’adam), he made him in the likeness of God. Male (Heb. zakhar) and female (Heb. neqevah) he created them, and he blessed them and named them Man (Heb. ’adam) when they were created. (Gen. 5:1b–2)

The implication of these texts is plain: God has created no third sex! This was not only the case before humanity’s fall into sin (hereafter “the Fall”), as we see in Genesis 1, but remains the case after the Fall, as we see in Genesis 5. Lest we be in any doubt, this point is underlined by none other than Jesus himself. In answering a question about divorce posed by the Pharisees, he references Genesis 1:27 (and 1:1 also), interpolating the word “from” (Gk. apo) to indicate that the binary nature of human sex is not only an ongoing fact but one with ongoing implications:

“Have you not read that he who created them from (Gk. apo) the beginning made them male and female. . . .” (Matt. 19:4; cf. Mark 10:6)

While we will say a little more about the reality of intersex conditions shortly, it is important to realize that all such DSDs, like every other kind of disorder, disease, or disability, are an “after the Fall” phenomenon, not part of the “very good” creation (Gen. 1:31). Moreover, far from contradicting the teaching of either Genesis or Jesus, such conditions are normally, and rightly, classified as “medically identifiable deviations from the human binary sexual norm” (American College of Pediatricians). In other words, male and female are not two extremes at either end of a broad continuum and, as we’ve already noted, the intersexed are not a third sex. From the beginning of creation, God made human beings male and female and either male or female, despite the difficulty we may have (on extremely rare occasions) of determining a person’s sex.16

B. The Relationship Between Sex and Gender

The binary reality of human sexuality revealed in Genesis 1 is both emphasized and developed in Genesis 2. Here we move from humanity being described in terms of the adjectives “male” (zakhar) and “female” (neqevah)—which are not unique to humans but also apply to animals (e.g., Gen. 6:19)—to the nouns “man” (’ish) and “woman” (’ishshah), as these are applied to Adam and Eve:

Therefore a man (’ish) shall leave his father (’av) and his mother (’em) and hold fast to his wife (’ishshah), and they shall become one flesh. And the man (’adam) and his wife (’ishshah) were both naked and were not ashamed. (Gen. 2:24–25)17

The clear implication of this move from “male” and “female” (in Genesis 1) to “man” and “woman” (in Genesis 2), an implication everywhere confirmed as the biblical narrative unfolds, is that a person’s biological sex reveals and determines both their objective gender (what gender they, in fact, are) and certain key gender roles (should they be taken up). That is, human males grow into men (and potentially husbands and fathers) and human females grow into women (and potentially wives and mothers).18 Indeed it is this set of binary connections that makes human marriage possible. As Jesus again confirms, bringing Genesis 1 and 2 into the closest possible connection:

But from the beginning of creation, “God made them male and female.” “Therefore a man shall leave his father and mother and hold fast to his wife, and the two shall become one flesh.” (Mark 10:6–8a)

Furthermore, in fulfilment of God’s purpose that human beings should “be fruitful and multiply and fill the earth” (Gen. 1:28), it is out of the “one flesh” union of husband and wife that children are (normally) conceived and brought into the world—children who perpetuate not only the sex and gender binary but the sex and gender connection. The Hebrew language of the Old Testament expresses this dual reality at every stage of personal development and in every station of life. For example:

  • son (ben) and daughter (bat)
  • boy (yeled) and girl (yalda)
  • brother (’ach) and sister (’achot)
  • young man (na‘ar) and young woman (na‘arah)
  • bridegroom (chatan) and bride (kalla)
  • father (’av) and mother (’em)
  • father-in-law (cham) and mother-in-law (chamot)
  • uncle (dod) and aunt (dodah)
  • manservant (‘eved) and maidservant (’amah)
  • prophet (navi’) and prophetess (nevi’ah)
  • prince (sar) and princess (sarah)
  • king (melek) and queen (malka)

In summary: a person’s biological sex reveals and determines their actual gender and certain potential gender roles.19 For example, only a male can truly be a son and truly become a father. Only a female can truly be a daughter and truly become a mother.20 Furthermore, man and woman are not two poles at either end of a gender spectrum. Indeed, as we’ll see further shortly, there is simply no space in biblical anthropology—either before or after the Fall—for additional sexes and/or additional genders.

C. The Impact of the Fall

This is not to say that the Bible presents human sex and gender, outside the garden of Eden, as straightforward. To the contrary, it plainly teaches that the entrance of sin has had a catastrophic effect on every part of our humanity. Not only have our hearts and minds become corrupt, but our bodies, like the rest of the created order, have been “subjected to frustration” and are “in bondage to decay” (Rom 8:20–21, cf. v. 23 NIV). In other words, because sin and death have permeated both ourselves and our world, all kinds of things go wrong with us, both psychologically (at the level of the mind) and physiologically (at the level of the body).

One of the many ways the Bible acknowledges this latter fact is by introducing us to the category of the eunuch.21 In fact, in Matthew 19, following his discussion of the nature of marriage and the possible grounds for divorce and remarriage, Jesus distinguishes between three types of eunuchs: two literal and one metaphorical:

For there are eunuchs who have been so from birth, and there are eunuchs who have been made eunuchs by men, and there are eunuchs who have made themselves eunuchs for the sake of the kingdom of heaven. Let the one who is able to receive this receive it. (Matt. 19:12)

Leaving aside Jesus’s third category (which refers to those who have denied themselves marriage in order to serve God’s kingdom),22 his first two categories were, almost certainly, informed by the common Jewish distinction between “eunuchs of the sun” (Heb. saris hamma)—that is, those who have been eunuchs from the moment they first saw the sun (i.e., from birth)—and “eunuchs of man” (Heb. saris ’adam)—that is, man-made eunuchs, either by accident or deliberately. The first of these categories would, most likely, have included the various conditions that today are included under the “intersex” umbrella.23

Whatever might be said of the status of eunuchs in later Christian reflection,24 it is important to repeat the point made earlier: Scripture does not present eunuchs as either a “third sex” or a “third gender.”25 In fact, every eunuch we meet in Scripture is presented as male (as indicated by the use of masculine verbs and male pronouns); simply a male who is unable to function sexually or procreatively (Isa. 56:3)—either because of a birth defect or due to human intervention. Otherwise put, Scripture resists diluting the sex/gender binary, even though some do not fit neatly into it.

D. Dualistic Holism or Holistic Duality

But what about those whose biological sex is unproblematic, but who claim to have been born in the wrong body? For example, how do we make sense of a biological male who sincerely believes he is a woman? Can a female soul end up in a male body or vice versa? Is this a genuine possibility outside the Garden of Eden? To answer this question, we need to consider the Bible’s teaching on the relationship between the physical (or corporeal) and nonphysical (or incorporeal) aspects of human beings.

The biblical authors display a variety of different ways of speaking about these two anthropological aspects.26 What is consistently taught in both Testaments, however, is a dichotomous or bipartite view.27That is, human beings consist of two distinct elements: body (Gk. sōma) and soul (Gk. psychē).28 Furthermore, while the body perishes at death, and so can be separated from the soul, God’s intention is for it to be reunited with the soul in resurrection at the last judgment. This, for example, is what enables Jesus to speak in the following way:

And do not be afraid of those who kill the body (sōma) but cannot kill the soul (psychēn). Rather be afraid of the One who can destroy both soul and body (kai psychēn kai sōma) in hell. (Matt. 10:28)

At the same time, the biblical authors view the human person as an integrated whole. As John Cooper writes: “Biological processes are not just functions of the body as distinct from the soul or spirit, and mental and spiritual capacities are not seated exclusively in the soul or spirit. All capacities and functions belong to the human being as a whole, a fleshly-spiritual totality” (78). In other words, Scripture understands “human beings holistically as single entities which are psychosomatic unities” (78). We are dealing, then, with a both-and: an ontological duality (a distinct body and soul) within a functional holism (an integrated person).

Otherwise put, and without wanting to minimize the reality of the psychological distress experienced by sufferers of gender incongruence, there is simply no space within biblical anthropology for the kind of ontological mismatch that is sometimes claimed. The soul is the soul of the body, as the body is the body of the soul. As 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.
Wonderful are your works; my soul knows it very well.
My frame was not hidden from you, when I was being made in secret,
intricately woven together in the depths of the earth.
Your eyes saw my unformed substance;
in your book were written, every one of them, the days that
were formed for me when as yet there was none of them. (Ps. 139:13–16)

There is, then, no person or soul or spirit that has been created independently of the body and then placed in the body (or perhaps in the wrong body). As the Lord knit my body together in my mother’s womb, “was made in the secret place.” The sex of the body, then, reveals the gender of the person.

This understanding has profound and far-reaching implications, which Oliver O’Donovan expresses both clearly and compassionately:

The sex into which we have been born (assuming that it is physiologically unambiguous) is given to us to be welcomed as a gift of God. The task of psychological maturity—for it is a moral task, and not merely an event which may or may not transpire—involves accepting this gift and learning to love it, even though we may have to acknowledge that it does not come to us without problems. Our task is to discern the possibilities for personal relationship which are given to us with this biological sex, and to seek to develop them in accordance with our individual vocations . . . Responsibility in sexual development implies a responsibility to nature—to the ordered good of the bodily form which we have been given. And that implies that we must make the necessary distinction between the good of the bodily form as such and the various problems that it poses to us personally in our individual experience. This is a comment that applies not only to this very striking and unusually distressing problem, but to a whole range of other sexual problems too. (28–29)

So, while all kinds of things can and do go wrong with us—both physiologically and psychologically—the Bible offers no support to the idea that one can actually be a man trapped in a woman’s body or a woman trapped in a man’s body. That may well be a person’s subjective feeling, but it is not an objective fact.

This is not to deny that there are social or cultural elements to gender expression and gender roles. Nor is it to deny that a person’s gender identity may be at odds with their biological sex. The point is, contrary to the prevailing view of our culture, the true gender of the inner person is revealed by the sex of their outer body. Sam Allberry puts it this way:

Our culture says: Your psychology is your sexual identity—let your body be conformed to it. The Bible says: Your body is your sexual identity—let your mind be conformed to it. (Cited in Transgender 43).

E. Prohibitions against Gender Bending

Such an understanding also helps us to see the rationale behind the Bible’s condemnation of a number of behaviors that fall under the banner of “gender bending.”

(i) The first of these behaviors is cross-dressing. This is addressed directly and unequivocally in Deuteronomy 22:5:

A woman (Heb. ’ishshah) shall not wear a man’s (Heb. gever) garment, nor shall a man (Heb. gever) put on a woman’s (Heb. ’ishshah) cloak, for whoever does these things is an abomination (Heb. to‘evah) to the LORD your God.

There can be little doubt that this text condemns cross-dressing in the strongest possible terms. This is clear from the use of the Hebrew word to‘evah, which means “detestable, repulsive, or loathsome” and is applied to any act that is “excluded by its very nature” or is regarded as “dangerous or sinister.”29 It is thus the word applied to various idolatrous practices (Deut. 7:513:14), homosexual intercourse (Lev. 18:2220:13), and other violations of the created order (Davidson 171).

But why should cross-dressing be seen in such terms? Many commentators have assumed a link with either homosexuality or pagan religion. This is possible, but there is nothing in the immediate context to suggest such a connection. It is more likely, then, that “the wording of the legislation goes beyond a cult setting to include any and all circumstances of men dressing like women and vice versa” (Davidson 171).30 Therefore, the nineteenth-century German commentators, Carl Keil and Franz Delitzsch, were right to conclude:

The immediate design of this prohibition was not to prevent licentiousness, or to oppose idolatrous practices . . . but to maintain the sanctity of that distinction of the sexes which was established by the creation of man and woman, and in relation to which Israel was not to sin. (1.945)

Consequently, as Peter Harland explains: “To dress after the manner of the opposite sex was to infringe the natural order of creation which divided humanity into male and female. That distinction was fundamental to human existence and could not be blurred in any way” (76). This is why the Lord regarded such blurring as an “abomination.”

But what is the relevance of this text to new covenant Christians living in the twenty-first century? While care is needed in applying old covenant commands to later situations, the abiding ethical principles behind them can be readily discerned. It is not, then, as some have claimed, “doing a disservice to reasonable hermeneutics” to apply this verse to contemporary forms of transvestitism, certainly not to those who claim to be Christians.31

Now as then, “this injunction seeks to preserve the order built into creation, specifically the fundamental distinction between male and female. For a person to wear anything associated with the opposite gender confuses one’s sexual identity and blurs established boundaries.”32

This does not mean that all men (or all women) must dress alike, or that “unisex” items of clothing (like T-shirts or jeans) are inherently problematic. But it does warn against intentional cross-dressing, particularly for the purpose of bending or disguising one’s true gender.

(ii) The second of the behaviors that Scripture censures is sexual effeminacy; that is, a man playing the part of a woman (by being the “receiver”) in homosexual intercourse. Those who engage in such a practice, and are finally unrepentant, are listed among those who will be excluded from the kingdom of God:

Or do you not know that the unrighteous will not inherit the kingdom of God? Do not be deceived; neither fornicators, nor idolaters, nor adulterers, nor effeminate (malakoi), nor homosexuals (arsenokoitai), nor thieves, nor the covetous, nor drunkards, nor revilers, nor swindlers, will inherit the kingdom of God. (1 Cor. 6:9–10, NASB)

Like his sexual ethics generally, the apostle Paul’s assessment of homosexual behavior derives from the absolute prohibitions found in Leviticus 18:22 and 20:13, and so (like Deut. 22:5) is ultimately grounded in the creation theology of Genesis 1–3.33 His use of the two distinct terms highlighted above reveals that he is censuring all who participate in homosexual acts—whether actively or passively (Ciampa and Rosner 241). His reference to the malokos (“soft man”), therefore, is not aimed at victims of exploitative relationships or homosexual rape (as some have suggested), but at any man who actively feminizes himself by being sodomized (Gagnon 311). 

Self-feminization for the purposes of homosexual sex is thus unambiguously condemned by Paul. However, it is also likely that he would be equally troubled by “those who engage in a process of feminization to erase further their masculine appearance and manner” (Gagnon 312). So if the practice of cross-dressing remains problematic (as Deuteronomy 22:5 indicates), how much more serious is surgical transitioning? Furthermore, even if done without homosexual intent, such feminization often has a way of leading to homosexual activity—particularly as many transsexuals, tragically, are driven to “sex work” in order to pay for SRS and continued CHT.34

(iii) The third behavior the Bible opposes is gender ambiguity; that is, the attempt to blur the lines between male and female by one’s gender expression. This is Paul’s chief concern in 1 Corinthians 11:2–16 and why he says:

Every man who prays or prophesies with his head covered dishonors his head. But every woman who prays or prophesies with her head uncovered dishonors her head—it is the same as having her head shaved . . . . Judge for yourselves: Is it proper for a woman to pray to God with her head uncovered? Does not the very nature of things teach you that if a man has long hair, it is a disgrace to him, but that if a woman has long hair, it is her glory? For long hair is given to her as a covering. (1 Cor. 11:4–513–15, NIV)

Although there are a number of difficulties and obscurities in the passage in which these verses appear,35what is clear is that Paul desires both men and women in general, and husbands and wives in particular, to wholeheartedly embrace and unambiguously express the gender distinctions with which we have been created, rather than to deny, diminish, or disguise them (Ciampa and Rosner 503). This explains why he “expresses no less disquiet (probably indeed more) about men whose style is effeminate with possible hints of a quasihomsexual blurring of male gender than about women who likewise reject the use of signals of respectable and respected gender distinctiveness” (Thiselton 805). 

The other dimension of Paul’s concern with the gender blurring, if not gender exchanging, behavior of the Corinthians, was their implicit rejection of the God-given order between husbands and wives and the consequent dishonoring of one’s head occasioned by their behavior—that is, the husband’s dishonoring of Christ and the wife’s dishonoring of her husband (vv. 4–5) (Schreiner 138–139). While, in contemporary Western cultures, “there is no piece of clothing that functions as a cultural equivalent to the first-century Graeco-Roman head covering,” this does not mean that there are no cultural symbols that send a similar message (Smith 78). 

Taking the teaching of this passage seriously, then, will necessarily impact the way Christian men and women “do gender”; that is, the way we present ourselves in terms of hair style, clothing choices, and general demeanor. Although cultures differ, “in every culture there are certain kinds of adornment which become culturally acceptable norms of dress for men and women” (Schreiner 138). Therefore, our aim is not to replicate first-century church practice, but to operate within the norms of our culture and to do so in such a way that we signal our recognition of both the God-given differences between men and woman and our grateful embrace of our own biologically-given gender.

(iv) As we reflect further on the implications of the above passages, it is important to recognize that none of them suggests that those with genuine gender incongruence are culpable for their condition. There is a biblical category of “affliction” (Gk. malakia) that is, most certainly, a consequence of humanity’s sin but not necessarily, and certainly not always, a consequence of the afflicted person’s own sin (e.g., John 9:1–3). Therefore, unlike willful, rebellious gender bending or deliberate and destructive gender erasing (which are certainly prohibited by such texts), the experience of gender incongruence would appear to be largely a non-volitional, and to that extent a non-moral, illness.36 It is also a deeply distressing illness. Consequently, our first response to those who suffer from it ought to be compassion and care, not condemnation or censure.

However, the Bible’s teaching certainly has implications for how we should respond to gender identity problems—whether our own or another’s. There are right and wrong ways to address or manage all of life’s challenges, including mental health issues like gender incongruence. It therefore needs to be said that, as far as the Bible’s teaching is concerned, trying to obliterate, disguise, or live at odds with one’s God-given gender is contrary to God’s will and against human good. Consequently, any attempt to do so is not only sinful but will not ultimately bring the relief that sufferers are seeking and may well bring them even greater distress in the longer term.37

F. The Saving and Sanctifying Power of Jesus Christ

What then, according to Scripture, is the way forward? Here we need to understand the saving and sanctifying power of our Lord Jesus Christ and how it is applied by the Spirit to believers in the present age.

(i) The first and fundamental thing to appreciate is that all those who confess Jesus as Lord and believe in their hearts that God raised him from the dead are justified from sin, brought to new birth by the Holy Spirit, and given a new identity as sons and daughters of the living God. “Therefore,” writes Paul, “if anyone is in Christ, he is a new creation. The old has passed away; behold, the new has come” (2 Cor. 5:17). This vital, spiritual union is necessarily determinative of a whole new self-understanding. We are no longer defined by our failures or our feelings.

For as Paul writes elsewhere: “It is no longer I who live, but Christ who lives in me” (Gal. 2:20a). In short, no Christian is what they once were (1 Cor. 6:11). Christ has taken from us all that shamed and defiled us, all that crushed and condemned us, and made us “sharers with him in the gifts with which he has been endowed” (Calvin 1.737). Due to the indwelling of his Spirit, Christ is in every believer and every believer is “in Christ” (John 14:16–20). Christians have truly been given new life (eternal life!) that we might be and become our true selves.

(ii) Second, new life means a new lifestyle. Those in Christ are called to “no longer live for themselves but for him who for their sake died and was raised” (2 Cor. 5:15). This does not, of course, mean that Christians experience the removal of all temptations and afflictions—not, at least, in this age. Rather, because there is a new power at work in us (that of the Holy Spirit), there are new possibilities open to us (choosing righteousness over sin). “Let not sin therefore reign in your mortal body, to make you obey its passions” (Rom. 6:12), writes Paul.

The reason such resistance is now possible is because “our old self was crucified with him in order that the body of sin might be brought to nothing, so that we would no longer be enslaved to sin” (Rom. 6:6). This call to walk in “newness of life” (Rom. 6:4) has profound implications for every dimension of our existence, including what we do with and to our bodies. For the Christian’s body is now a temple of the Holy Spirit. “You are not your own,” says Paul, “for you were bought with a price. So glorify God in your body” (1 Cor. 6:19–20). A further implication is that all forms of bodily self-harm are nothing less than a defacing of that temple.

(iii) Third, among the vices of the old self that all believers are called to discard are covetousness and deception. I draw attention to these two particular sins because of their relevance to transgenderism. As to the first, many who struggle with gender incongruence are sorely tempted to desire a body other than the one they have been given. That desire, to be frank, is a form of covetousness. Paul’s advice is blunt: “Put to death, therefore, whatever belongs to your earthly nature: sexual immorality, impurity, lust, evil desires and covetousness, which is idolatry” (Col. 3:5). As to the second, the aim of those who seek to transition genders is to “pass” as being the opposite sex to what they, in fact, are. This is deception. Again, the apostle pulls no punches: “Do not lie to each other, since you have taken off your old self with its practices and have put on the new self, which is being renewed in knowledge in the image of its Creator” (Col. 3:9–10). In short, faithfulness to Christ cannot be separated from how a person manages their gender identity challenges (Yarhouse). 

No Christian is at liberty to attempt to change their gender. Robert Gagnon puts the point strongly but helpfully: “[W]hile redemption is unmerited, an active pursuit of a ‘transgender’ life would be at odds with minimal standards for repentance, faith, transformation, and a claim to ‘faithfulness’ to Christ.”

(iv) Fourth, just as there are vices that believers are called to “put off,” so there are virtues that we are called to “put on.” Four are of especial relevance to our subject: endurance, patience, joy, and thanksgiving. Development of such Christ-like characteristics is repeatedly encouraged in Scripture, but these four are brought together by the apostle Paul in his prayer for the Colossian Christians:

May you be strengthened with all power, according to his glorious might, for all endurance and patience with joy, giving thanks to the Father, who has qualified you to share in the inheritance of the saints in light. (Col. 1:11–12)

Endurance and patience are vital for sufferers of gender dysphoria, particularly for those whose cross-gender identification is strong and persistent over time. No one is helped by underplaying either the distress of such a condition or the force of the temptation to alleviate it in disobedient and self-destructive ways. The battle to be faithful can be painful and exhausting, and the desire to end the struggle by ending one’s own life can be acute for some. However, resistance and obedience are possible, although much prayer is needed that strength be given to this end.

Here is where a healthy perspective on the nature of the Christian life is vital, for it is “through many tribulations we must enter the kingdom of God” (Acts 14:22). Here also is where the importance of the biblical practice of lament is highlighted, for Scripture encourages us to pour out our sorrows and complaints before the Lord (e.g., Ps. 102). On the positive side, joy and thanksgiving are also possible—if not for the affliction itself, for the sufficiency of God’s grace (2 Cor. 12:9) and the fruit that perseverance bears under the sovereign hand of God (James 1:2–4). It is in this way that God’s children are able to rejoice in their sufferings (Rom. 5:3–5).

At this point, someone might ask, “But shouldn’t we try to alleviate suffering wherever possible? And, if so, is there not an argument for relieving a gender dysphoric person’s distress by bringing their body into alignment with their mind?” Traditional medical ethics would suggest not. The canons of sound medical practice have typically “ruled against surgical intervention into a living human body except to protect the functional integrity of that body when it was endangered by disease or injury” (O’Donovan 151). 

For Christians, the biblical doctrines of creation, incarnation, and resurrection all support the view that “the physical structure of our human bodies is not something we are free to change without very careful thought” (Wyatt 98). What this means, as Dr. John Wyatt points out, is that we should only use medical and surgical technology “in a way which is appropriate to preserve and protect the original design, to maintain and preserve the creation order embodied in the structure of the human body” (100).38

In the case of gender incongruence, it is the mind that is disordered, not the body. “SRS, therefore, is a ‘category mistake’—it offers a surgical solution for psychological problems” (Fitzgibbons, Sutton, O’Leary 97).  Furthermore, “SRS is a ‘permanent,’ effectively unchangeable, and often unsatisfying surgical attempt to change what may be only a temporary (i.e., psychotherapeutically changeable) psychological/psychiatric condition” (Fitzgibbons, Sutton, O’Leary 98). In other words, because the problem is in the mind and not the body, it should be treated with psychotherapy and not surgery. Consequently, any treatment of gender incongruence that seeks to relieve mental suffering by inflicting harm on an otherwise healthy body cannot be deemed ethical.39

(v) Fifth, battles with gender incongruence, whether long term or short, should never be fought alone. Like all who suffer from a crippling disability, those who are afflicted by gender dysphoria are in great need of compassionate and practical support from others. This is one of the reasons why the risen Christ has given his followers the gift of brothers and sisters—not only to keep us accountable but that we might bear one another’s burdens. So Paul writes:

Brothers and sisters, if someone is caught in a sin, you who live by the Spirit should restore that person gently. But watch yourselves, or you also may be tempted. Carry each other’s burdens, and in this way you will fulfill the law of Christ. (Gal. 6:1–2, NIV)

This text raises the important question: What counts as “sin” and what counts as a “burden”? In my view, the experience of gender incongruence falls most naturally in the latter category (burden). Mark Yarhouse is, therefore, right to point out that “there is a need for the church to be able to cope with the disclosure of gender dysphoria among those who experience it and have the courage to share what they are going through” (151). And not just cope, but embrace, love, and protect. These precious brothers and sisters require our special care and must be surrounded by much love, prayer, and emotional, spiritual, and practical support.

At the same time, and as we’ve already noted, there are ways of managing gender incongruence that, from a biblical standpoint, fall into the category of “sin.” What, then, will gentle restoration look like when such sin takes place? To answer this question responsibly in any given case, a range of factors need to be taken into account: e.g., whether the person is Christian or non-Christian, whether they are spiritually mature or spiritually immature, their level of intellectual and moral capacity, the severity and complexity of the dysphoria, and whether they have other physical and mental health issues.

Nevertheless, in light of Scripture’s clear direction and boundaries, Yarhouse’s advice—that some believers “may benefit from space to find ways to identify with aspects of the opposite sex, as a way to manage extreme discomfort”—ought not be followed. All forms of intentional cross-gender identification are inappropriate for those in Christ. The fact that some of God’s people desire such “space” does not mean it is beneficial for them. Repentance, then, will mean seeking to live consistently with one’s God-given sex.

Furthermore, the good of the church community must also be considered. What message is being sent by a church that effectively condones behavior that Scripture condemns? What effect will this have on other members of Christ’s body—particularly those who are vulnerable and impressionable? Paul’s concern—that “a little leaven leavens the whole lump of dough” (1 Cor. 5:6)—clearly has some application here. Having said that, and as we’ve already seen, needlessly imposing rigid gender stereotypes (e.g., that all men must have crew cuts or all women must wear skirts) is not helpful either. Provided that believers are operating and presenting themselves within accepted norms and cultural expectations for gender roles and gender expression, not all men and women need to look and dress the same way.

G. Bodily Resurrection and Life to Come 

The final piece of scriptural teaching relevant to our subject has to do with what is revealed about the nature of our resurrection bodies. Admittedly, there are all kinds of things we cannot know on this score (1 Cor. 15:35–36). Nevertheless, in broad terms, the Bible affirms a principle of both continuity and transformation (1 Cor. 15:42–44). That is, following the pattern of Jesus’s own resurrection, it is these earthly bodies that will be raised (continuity), but with different qualities and capacities (transformation). As Paul says, Christ “will transform our lowly body to be like his glorious body” (Phil. 3:21).

Curiously, the prospect of transformation has led some to speculate about the possibility of our being raised as either androgynous or monosexual or asexual beings. Given that our bodies are sexed in this world, and that the risen Jesus remains a man, it would require a very clear statement of Scripture to create the expectation that we will be raised as something other than eternally sexed (and therefore gendered) beings. But no such statement exists.

Certainly, when read in their contexts, neither 1 Corinthians 6:13–15 nor Galatians 3:28 teaches any such thing. The point of the first passage is that Christians ought not to engage in sexually immoral behavior because our bodies belong to Christ (1 Cor. 6:13), are “members of Christ” (v. 15), and God intends to raise them (v. 14). The point of the second passage (in particular, the statement that “there is no male and female, for you are all one in Christ Jesus”) is that both male and female believers in Christ are equally God’s children (Gal. 3:26), have equally “put on Christ” (v. 27), and are equally Abraham’s offspring and inheritors of all that God has promised them (v. 29).40 In short, neither passage implies the elimination of sex/gender distinctions, either in this age or in the one to come.

The only passage that could possibly be thought to suggest such a possibility is Matthew 22:30 (and parallels), where Jesus says: “For in the resurrection neither do they marry nor are they given in marriage, but are like the angels.” But while this passage clearly affirms that marriage belongs to this age only, it says nothing about the elimination of human sexual distinctions. In fact, Jesus’s choice of words implies quite the opposite: as Augustine saw, “neither do they marry” can only refer to males and “nor are they given in marriage” can only refer to females (19.22.17). In other words, “[f]ar from saying that there will be no distinctions of gender in the new creation, Jesus said in essence that those who are male in heaven will not take a wife, nor will those who are female be given in marriage” (Walton 19). 

Scripture, then, gives us no reason to doubt and every reason to believe that we will be resurrected not simply as embodied beings, but as sexed (and therefore gendered) beings. We will certainly be changed (1 Cor. 15:51–52), but not changed from men or women into something else. Rather we will be changed from mortal to immortal, perishable to imperishable men and women (1 Cor. 15:53–54).41 While the eternal purpose of our sex distinctions is yet to be fully disclosed, the suggestion that it has to do with the way in which humanity as male and female images the unity and distinction within the Trinity is likely (Barth195). Whatever the case, “men and women will always be beings-in-relation, even when the business of marrying and procreating has been fulfilled” (Roberts 165–166).

The glorious prospect of bodily resurrection has two implications.

(i) First, whatever disappointments, dysphorias, and disabilities we may have to deal with in this life, it matters what we do with and to the bodies God has given us (as we have seen). In fact, while we should be willing to spend and be spent in the cause of our Master, we are nonetheless to love our bodies. As Paul says, “No one ever hated his own flesh, but nourishes and cherishes it, just as Christ does the church” (Eph. 5:29). Consequently, self-rejection and self-mutilation are not only tragic but also sinful. Those in Christ must, therefore, resist such temptations and instead fly to the throne of grace, where we can find “mercy and find grace to help in time of need” (Heb. 4:16).

(ii) Second, in the resurrection every form of disease and disorder, sickness and sadness will be healed and banished once and for all. Little wonder that “we wait eagerly for our adoption to sonship, the redemption of our bodies” (Rom. 8:23). Indeed, says Paul, “in this hope we have been saved (Rom. 8:24). What’s more, so wonderful will be the glory revealed both to us and in us that the sufferings of this present time will not be worth comparing to it (Rom. 8:18). This is good news for all of God’s people, but particularly for those whose gender incongruence proves irresolvable in this life. Christians have a real hope that will not disappoint us. This is why we are called to wait for it with patience (Rom. 8:25) and to fix our eyes not on what is seen and transient but on what is unseen and eternal (2 Cor. 4:18).

4. Concluding Thoughts

How should we think about gender incongruence and the distress it produces? In light of the Bible’s teaching, and in the absence of any compelling evidence for regarding it as a type of intersex condition, genuine gender dysphoria is best regarded as a psychological disorder.42 In other words, despite what is sometimes claimed, there is no reason (either biblical or scientific) to believe that a person can have either the brain or soul of one sex and the body of the other. It may be a person’s strong feeling or deeply held conviction, but it is not an objective fact. As one of the tragic effects of the Fall, the gender dysphoric person is suffering from a pathology of the mind.

In and of itself, such a conclusion does little to remove the distress of those who suffer from a profound sense of gender incongruence. It does, however, lay some important foundations upon which to build a biblically informed, pastorally responsible, and medically coherent therapeutic approach. It likewise provides a helpful interpretive grid through which we can make sense of the various social, political, and ideological changes going on around us. For not only is the basic assumption of transgender ideology unsustainable, but the goal of transitioning is unrealizable. “Transgendered men do not become women, nor do transgendered women become men” (McHugh). As Dr. Paul McHugh writes, the best they can ever hope to become is “counterfeits or impersonators of the sex with which they ‘identify.’”

What, then, is our message to those who have sought to transition—socially, hormonally, or surgically? First, they are to come to Jesus as they are. This means that in our evangelism we must not let the temporary overshadow the eternal. The greatest need of those who experience gender dysphoria or identify as transgender or have undergone SRS is not for their identity issues to be resolved (as wonderful as that would be), or their attempts at transitioning to be reversed (which may not be entirely possible), but to be reconciled to God and adopted as his children. In other words, like the rest of us, transsexuals, the transgendered, and the gender confused need the gospel of Jesus Christ. Every human being has been created through and for Jesus Christ (Col. 1:16), and will therefore be restless unless and until they find their rest in him (Augustine). But rest is precisely what Jesus promises to all who come to him in faith (Matt. 11:28)—irrespective of their past sins or present burdens. This is the hope of the gospel: that true life, lasting peace, and eternal comfort can be found in Jesus Christ.

Second, while we are invited to come to Jesus as we are, he is not content to leave us as we are. His goal is to restore us into his image and teach us to discern and do the will of God (Rom. 12:2). For the reasons we’ve seen, this will necessarily entail living, as far as is possible, in conformity with our God-given sex. For those who have gone down the path of transitioning, this will mean ceasing CHT, cross-dressing, and other forms of cross-gender identification. Some surgical steps may, of course, be irreversible. If so, as Russell Moore argues, the person may need to see themselves akin to a biblical eunuch; that is, as one wounded physically by past sin, but awaiting wholeness in the resurrection. Whatever the case, sensitive pastoral care and strong congregational support will be essential for anyone who, in obedience to Christ, is seeking to de-transition.

Finally, how should Christians respond to the transgender revolution that is currently sweeping the Western world? If we truly love our neighbors, we will not withdraw from the public square, particularly if we understand the way in which “today’s uncontested nonsense becomes tomorrow’s accepted wisdom” (Cater). Therefore we must not only pray fervently for our world but, as part of our prophetic task, take up our apologetic responsibility to expose the vacuous foundations and corrosive effects of contemporary gender ideology.

In addition to that, and where possible, we will work politically for ways of treating gender incongruence that don’t normalize a psychiatric disorder or incentivize self-harm, for public policies that don’t perpetuate gender confusion and facilitate social contagion, and for truly “safer” school programs that protect the dignity and interests of all children. As in our evangelism, engaging at this level will not always make us popular, indeed, it may see some of us persecuted, prosecuted, and even imprisoned. But as Albert Mohler reminds us, we cannot be silent. As has often been said, our calling as Christ’s followers is to present the truth with compassion but without compromise. May the Spirit of God enable us for this, for the love of God demands no less from us.

Select Annotated Bibliography

Gagnon, Robert J. The Bible and Homosexual Practice: Texts and Hermeneutics. Nashville: Abingdon Press, 2002.

Although over a decade old, the thoroughness of Robert Gagnon’s analysis of the biblical texts relating to homosexuality (and also transsexuality) has yet to be surpassed. Gagnon also addresses sexual issues discussed in the related literature of intertestamental Judaism and makes extensive reference to both biblical and extrabiblical material. Rigorously engaging scholars and historians of all persuasions, Gagnon demonstrates why attempts to classify the Bible’s rejection of same-sex intercourse as irrelevant for our contemporary context fail to do justice to the biblical texts and also to current scientific data. This work is relevant to our subject because it contains treatments of a number of the texts we’ve examined (e.g., Gen. 1–3Deut. 22:5; and the meaning of malakoi in 1 Cor. 6:9), also because it explores some possible links between homosexuality and transsexuality and, finally, because it provides a model of responsible, scholarly exegesis.

Kuby, Gabrielle. The Global Sexual Revolution: Destruction of Freedom in the Name of Freedom(Translated by James Patrick Kirchner). LifeSite, 2015. (First Published in German as Die globale sexuelle Revolution: Zerstörung der Freiheit im Namen der Freiheit. Fe-Medienverlags Gmbh, 2012).

This insightful and courageous book provides a detailed historical, philosophical, and sociological survey of the rapid advance of the LGBT agenda, the devastating effects of pornography and sex-education, the assault on freedom of speech and religious liberty, the corruption of language, and the destabilization of the family. The net (and, for many advocates, intended) effect of these revolutionary developments is the dissolution of the identity of man and woman, the deregulation of sexual norms, and the free rein of polymorphous urges that have no ultimate meaning.

From the movement’s trailblazers to the post-Obergefell landscape, Gabrielle Kuby documents in detail how successive phases of the sexual revolution are slowly gripping the world in a stranglehold. The book, however, is not without hope. “There is resistance,” writes Kuby, “and there is successful resistance. Around the world, Christian churches, NGOs, individuals and institutions are working for a culture that respects the dignity of the human person and fights for life, marriage and family” (258). What’s more, “Christians know that the story will come out well” (278).

Kuehne, Dale. Sex and the iWorld: Rethinking Relationship beyond an Age of Individualism. Grand Rapids: Baker, 2009.

In this highly perceptive work, Dale Kuehne surveys a range of popular conclusions about gender and human sexuality and raises the question: is the world we’re creating one that is harming us more than helping us? He examines how postmodernity has impacted social policy and our thinking about issues such as sexual orientation, the nature of the family, and gender identity. Kuehne proceeds to draw a contrast between the “tWorld” of traditional morality and the present-day “iWorld”—a world in which the immediate desires of the individual reign supreme. Both, he suggests, fail to deliver the benefits of the “rWorld,”—a world in which healthy and nourishing social relationships provide the most fulfilling context for personal, relational, and sexual wholeness. Finally, he presents the biblical story through the lens of a relational theology, highlighting its implications for marriage, family, civil partnerships, friendship, gender distinctions, and sexual boundaries. His conclusion is that our lifelong desire for fulfillment can only be met by inhabiting the “rWorld.”

Mayer, Lawrence S. and Paul R. McHugh. “Sexuality and Gender: Findings from the Biological, Psychological, and Social Sciences.” The New Atlantis 50 (Fall 2016).

This report, written by Dr. Lawrence Mayer, an epidemiologist trained in psychiatry, and Dr. Paul R. McHugh, one of the most important American psychiatrists of the last half-century, presents a careful summary and up-to-date explanation of research from the biological, psychological, and social sciences in relation to the questions of sexual orientation and gender identity. The report reveals that many of the most frequently heard claims about sexuality and gender are not supported by scientific evidence.

The report also has a special focus on the higher rates of mental health problems among LGBT populations and questions the scientific basis of trends in the treatment of children who do not identify with their biological sex. The report helpfully highlights the fact that “only a minority of children who experience cross-gender identification will continue to do so into adolescence or adulthood,” as well as arguing that there is “little scientific evidence for the therapeutic value of interventions that delay puberty or modify the secondary sex characteristics of adolescents” (9).

O’Donovan, Oliver, “Transsexualism and Christian Marriage.” Journal of Religious Ethics 11:1 (1983): 135–162.

This carefully argued account of the implications of transsexualism for marriage sets out the main theological objections to gender transitioning. Oliver O’Donovan’s foundational argument is that it is impossible to be born into the “wrong body” because there is no pre-existing male or female soul that enters the body at birth. Consequently, sex reassignment surgery goes beyond the bounds of what is legitimate for humans to do with their God-given bodies. Nonetheless, he considers two cases against this conclusion. The psychological case argues that since biological sexuality cannot be considered on its own, the transsexual should be seen as ambiguously sexed. This, however, requires an overriding of the objective reality of the body. The social case argues that public acceptance of a transsexual’s gender does not immediately depend on their “real” sex. This, however, requires the public affirmation of an illusion. As neither the psychological case nor the social case is persuasive, O’Donovan’s theological objections to gender transitioning (in general) and transsexual marriage (in particular) remain.

Roberts, Vaughan. Transgender. The Good Book Company, 2016.

This short book (74 pages) supplies readers with a masterful but accessible introduction to the transgender phenomenon, as well as providing Christians with a starting point for constructive discussions both inside and outside the church. After surveying the main ingredients of the biblical-Christian worldview, Vaughan Roberts skillfully applies the Bible’s teaching to the many complex questions surrounding the issue of gender identity. He does this not only with love and compassion for sufferers of gender dysphoria, but with an awareness that we live in a world of conflicting values that requires Christians to be clear-minded and courageous. Roberts’s book serves as a very useful primer both for individuals struggling with personal gender questions as well as for anyone confused by the current cultural trends.

Transsexuality: A Report by the Evangelical Alliance Policy Commission. London: Evangelical Alliance, 2000.

This report from the Evangelical Alliance is intended to inform the public about the subject of transsexuality and its complex consequences for the church. Despite its brevity (87 pages), it addresses both the current and historical contexts of the issue, medical and legal considerations, scriptural and ethical perspectives, and practical and pastoral considerations. It concludes by offering a series of affirmations and recommendations and includes a bibliography and suggested further reading. Its main argument is that it is the duty of every Christian to live in obedience to God and that natal gender should be seen as a clear intention of God’s will. This is because sex is an objective biological reality and so ought to determine self-perception. It therefore contends that the onus of proof should be on transsexuals and the medical establishment to demonstrate the reality of transsexualism rather than the onus of proof being on Christians to justify their position on the issue (52).

Walker, Andrew T. God and the Transgender Debate: What Does the Bible Actually Say About Gender Identity. The Good Book Company, 2017.

With gospel-minded clarity and Christ-like care, Andrew Walker deftly navigates a path between the folly of affirming transgenderism and the cruelty of dismissing the distress of those who experience gender incongruence. After a number of introductory chapters, explaining “How We Got to Where We Are” and where “here” is, Walker steps us through the Bible’s storyline and applies it along the way. In so doing, he shows why the gospel of Jesus Christ is good news for the transgendered and gender dysphoric and how Scripture equips the church for the good work of loving and bearing witness to the LGBTQ community. The book also contains an important chapter on “Speaking to Children” (chapter 11), as well as a valuable “Tough Questions” section (chapter 12)—dealing with everything from restrooms to pronouns.

Yarhouse, Mark A., Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing CultureDowners Grove: IVP, 2015.

In Understanding Gender Dysphoria, Mark Yarhouse (a professor of psychology and licensed psychologist) offers a Christian perspective on transgender issues (generally) and gender dysphoria (particularly). Addressing questions of causation, phenomenology, prevalence, prevention, and treatment, Yarhouse engages with the latest scientific research in chapters 3 to 5. The most important section of the book, however, is chapter 2, “A Christian Perspective on Gender Dysphoria.” Here Yarhouse examines “the four acts of the biblical drama: creationfallredemption and glorification” (35) and then outlines “three different frameworks for understanding gender identity concerns” (46): integrity, disability, and diversity. The first two frameworks effectively combine the doctrines of creation and fall. The third approaches things from the perspective of the current “sociocultural context” in the West, which sees transgenderism “as something to be celebrated, honored, or revered” (50). While cautious about this framework (although, in my view, not cautious enough), Yarhouse sees it as having something important to teach us because it addresses questions of identity, meaning, and acceptance, and thus highlights the need for Christians to come alongside those who are trying to resolve questions and concerns about their gender identity.

1. That is, a man who has socially, hormonally, and surgically transitioned to become (or, at least, appear to become) a woman—otherwise known as an MTF (male to female).

2. J. A. Simpson & E. S. C. Weiner (eds.), Oxford English Dictionary (Oxford: Clarendon Press, 1989). However, it is important to note that distinguishing gender from sex is not the same as disconnecting gender from sex. This has been a more recent development.

3. Cisgender, however, is something of a loaded term, for it is often employed as a way of normalizing transgender experience. In other words, it suggests that it is just as natural for a person’s gender identity to land on the other side of their sex, as it is for it to land on the same side.

4. Needless to say, this has been a highly controversial change and is regarded by some psychiatrists as an “abrogation of professional responsibility in the interest of political correctness.” Richard B. Corradi, “Psychiatry Professor: ‘Transgenderism’ Is Mass Hysteria Similar to 1980s-Era Junk Science,” The Federalist (November 17, 2016).

5. Interestingly, even the Intersex Society of North America is opposed to the idea that intersex people constitute a third gender on pragmatic grounds.

6. In deference to them, and for the reason given above (i.e., that Intersex covers a range of biologically based DSDs), I will use the LGBTQ+ acronym in this essay. As is generally understood, L stands for “lesbian,” G for “gay,” B for “bi-sexual,” and T for “transgender.” Q normally stands for “queer,” although it sometimes doubles up to cover “questioning” as well. The letter A—for “asexual”—is also becoming increasingly common. It can also double up for “ally” (i.e., for someone who is an LGBTQ ally). Further letters are sometimes added, but to keep the acronym manageable, these are often covered by “+.”

7. Unless otherwise indicated, all Bible references are taken from The Holy Bible, English Standard Version (ESV®). Permanent Text Edition® (2016). Copyright © 2001 by Crossway Bibles, a publishing ministry of Good News Publishers.

8. In philosophical terms, this speaks of the triumph of existentialism over essentialism. For in essentialism, essence precedes existence (i.e., what you are determines what you do, being determines act). But in existentialism, existence precedes essence (i.e., what you do determines what you are, act determines being). When linked with the postmodern “turn to the subject,” this shift opens the door not only to transgenderism (identifying as a gender contrary to one’s body), but to transracialism (identifying as a race contrary to one’s ethnicity), transableism (identifying as disabled contrary to one’s ability), and transspeciesism (identifying as a species contrary to one’s DNA). All such identifications take the notion that “truth is subjectivity” to a place Søren Kierkegaard (who coined the phrase) never intended or imagined. For a recent defense of the thesis that the “considerations that support transgenderism extend to transracialism,” see Rebecca Tuvel, “In Defense of Transracialism,” Hypatia 32:2 (2017): 263–278.

9. The series, which premiered on 11 July, 2013, features a black transgender character played by trans-woman (i.e., MTF) actor, Laverne Cox.

10. This was the verdict of a 2014 TIME magazine cover story.

11. For a more comprehensive account of the many connections and conflicts between feminism, gay and lesbian studies, queer theory, and trans ideology, see Patricia Elliot, Debates in Transgender, Queer, and Feminist Theory: Contested Sites (Abingdon: Routledge, 2016); also Talia M. Bettcher, “Feminist Perspectives on Trans Issues,” Stanford Encyclopedia of Philosophy (January 8, 2014).

12. Despite claims to the contrary, there is no clear or consistent evidence that gender identity is determined by microstructures in the brain. As Lawrence S. Mayer and Paul R. McHugh write, “[T]he current studies on associations between brain structure and transgender identity are small, methodologically limited inconclusive, and sometimes contradictory. Even if they were more methodologically reliable, they would be insufficient to demonstrate that brain structure is a cause, rather than an effect, of the gender-identity behavior” (104).

13. Nahema Marchal, “University of Iowa Introduces Gender Neutral Pronoun Policy,” Heatstreet (July 27, 2016).

14. Tumblr currently lists 54 different sets of alternative pronouns. See “Pronoun Master List,” Genderfluid Suppor(July 30, 2017).

15. For example, on June 11, 2017, thousands participated in a national Equality March for Unity and Pride, with a central march in Washington, D.C. According to organizers, the aim of the march was to bring together and affirm members of LGBTQ communities and their allies, to highlight discrimination, and to call for expanding LGBTQ rights. See Jenna Gray, “At Equality March, thousands rally for LGBTQ rights,” PBS NEWSHOUR (June 11, 2017).

16. There is some debate about which conditions are rightly categorized as Intersex. If the category is restricted to those conditions in which chromosomal sex is inconsistent with phenotypic (e.g., genital) sex, or in which the phenotype is not classifiable as either male or female, then the true prevalence of intersex is about 0.018%. See Leonard Sax, “How common is lntersex? A response to Anne Fausto-Sterling,” The Journal of Sex Research (39:3, 2002): 174–178.

17. As to the view that Adam was an androgyne (i.e., a mix of both male and female) prior to God bringing forth Eve from his side, two things need to be said. First, if it were true, God deemed it “not good” and, having remedied it, made it irrelevant from that point on. Second, every indicator in the text of Genesis tells against it. Adam, after Eve’s creation, remains Adam (minus a rib!) and Eve is called “woman” (’ishshah) precisely because she was taken out of “man” (’ish). In other words, Adam was a man (’ish) before and after Eve’s creation.

18. Contrary to the claims of “queer” parents. See, for example, Katherine D. M. Clover, “Please Stop Calling My Child ‘Little Man’,” Ravishly (March 18, 2016).

19. Lest I be misunderstood, I’m not suggesting that biology alone dictates how a person expresses their gender (e.g., manhood) or performs a gender role (e.g., motherhood). For the Christian, this will be determined by the Word of God and by the application of godly wisdom to our personal circumstances and to our particular cultural context.

20. I maintain this despite claims that biological men will be able to receive womb transplants and bear children within a decade. 

21. Both the Hebrew word saris and the Greek word eunouchos can refer either to a court officer (Gen. 39:1) or to a castrated male (Isa. 56:3) or to one who was both (possibly Acts 8:27).

22. See, for example, D. A. Carson, Matthew, F. E. Gaebelein, ed., The Expositor’s Bible Commentary Vol. 8 (Grand Rapids: Regency, 1984), 419; L. L. Morris, The Gospel According to Matthew (Grand Rapids: Eerdmans, 1992), 485–486; R. T. France, The Gospel According to Matthew (NICNT; Grand Rapids: Eerdmans, 2007), 725.

23. See F. P. Retief and J. F. G. Cilliers, “Congenital eunuchism and Favorinus,” SAMJ 93:1 (January, 2003), 73–76.  

24. This is a much contested question. See, for example, Shaun Tougher, The Eunuch in Byzantine History and Society (Abingdon: Routledge, 2008); Kathryn M. Ringrose, “Eunuchs in Historical Perspective,” History Compass 5:2 (March 2007): 495–506; idem, The Perfect Servant: Eunuchs and the Social Construction of Gender in Byzantium (Chicago: University of Chicago Press, 2003); Mathew Kuefler, The Manly Eunuch: Masculinity, Gender Ambiguity and Christian Ideology in Late Antiquity (Chicago: University of Chicago Press, 2001).  

25. Contrary to the suggestion of Megan K. de Franza, Sex Difference in Christian Theology: Male, Female, and Intersex in the Image of God (Grand Rapids: Eerdmans, 2015), 66.  

26. For example, “‘Inner man’, ‘spirit’, ‘soul’, ‘mind’, ‘heart’,—all do duty for the incorporeal part of man and different functions thereof. ‘Outer man’, ‘flesh’, ‘body’, ‘members’, ‘mouth’, ‘face’, and several metaphors do similar duty for the corporeal part of man.” Robert H. Gundry, Sōma in Biblical Theology: With Emphasis on Pauline Anthropology (Grand Rapids: Zondervan, 1987), 156.  

27. Admittedly, there are two texts that suggest a distinction between “soul” and “spirit” (1 Thess. 5:23Heb. 4:12), which some see as evidence for a trichotomous or tripartite view. However these texts might best be interpreted, they do not disturb the general, two-fold distinction between the inner and outer person.  

28. Some passages of Scripture (e.g., Matt. 26:411 Cor. 5:5) employ a parallel contrast between “flesh” (Gk. sarx) and “spirit” (Gk. pneuma).  

29. Ernst Jenni and Claus Westermann, Theological Lexicon of the Old Testament (Peabody: Hendrickson, 1997), 1429. See also Francis Brown, S. R. Driver, Charles A. Briggs, James Strong, and Wilhelm Gesenius, The Brown-Driver-Briggs Hebrew and English Lexicon: With an Appendix Containing the Biblical Aramaic: Coded with the Numbering System from Strong's Exhaustive Concordance of the Bible (Peabody: Hendrickson, 1996), 1072–73.  

30. See also the arguments of Peter J. Harland, “Menswear and Womenswear: A Study of Deuteronomy 22:5,” ExpTim 110 (1998): 74–75.  

31. Transsexuality: A Report by the Evangelical Alliance Policy Commission (London: Evangelical Alliance, 2000), 47. In fairness to the report, it then goes on to modify its own verdict and in a helpful footnote admits that “we need to be careful not to dilute Scripture at this point.”

32. Daniel I. Block, The NIV Application Commentary: Deuteronomy (Grand Rapids: Zondervan, 2012), 512. The issues of intention and effect also require consideration. That is, might it be possible to engage in cross-dressing for (say) the purpose of entertainment without the intention or effect of confusing either self or others or “blurring established boundaries”? Perhaps. But there are obvious risks. While intentions can be innocuous, effects are much harder to predict and impossible to control.

33. See Gordon J. Wenham, “The Old Testament Attitude to Homosexuality,” ExpTim 102 (1990-91): 359–63.

34. Consequently, transwomen are the fastest growing demographic of HIV-positive people in the US.

35. For example, commentators debate whether Paul is talking about head coverings, veils, or hairstyles and what he means by “because of the angels” in v. 10. For a clear, scholarly, and accessible exposition of both the meaning and implications of this chapter, see Claire Smith, God’s Good Design: What the Bible Says About Men and Women (Sydney: Matthias Media, 2012), 53–80.

36. I say “largely” because it is impossible to disentangle the “complex interplay of nature, nurture, environment, and choices. Incremental choices made in response to impulses may strengthen the same impulses.” See R. J. Gagnon, “How Should Christians Respond to the Transgender Phenomenon,” First Things (October 16, 2015).

37. Not surprisingly, the instance of “sex-change regret” is disturbingly high (and little publicized) and, tragically, the experience of undergoing “gender transition” seems to do little to address the high attempted-suicide rate of transgender people (over 40 percent). In fact, one longitudinal Swedish study (published in 2011) found the attempted-suicide rate following transition was some 20 times that of comparable peers. See Cecilia Dhejne, Paul Lichtenstein, Marcus Boman, Anna L. V. Johansson, Niklas Långström, and Mikael Landén, “Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden,” PLoS One 6:2 (22 February, 2011).

38. Furthermore, as O’Donovan argues, “Whatever the surgeon may be able to do, and whatever he may yet learn to do, he cannot make self out of not-self. He cannot turn an artifact into a human being’s body. The transsexual can never say with justice: ‘These organs are my bodily being, and their sex is my sex’” (152). 

39. Given the alarmingly high rate of post-transition suicide attempts and the prevalence of psychiatric disorders in persons who successfully suicide, the claim that withholding treatment increases suicide risk is misleading. See J. M. Bertolote and A. Fleischmann, “Suicide and psychiatric diagnosis: a worldwide perspective,” World Psychiatry 2002;1(3):181–185; Mayer and McHugh, “Sexuality and Gender,” 106–113.

40. See Richard Hove, “Does Galatians 3:28 Negate Gender-Specific Roles?,” 105–143 and Daniel R. Heimbach, “The Unchangeable Difference: Eternally Fixed Sexual Identity for an Age of Plastic Sexuality,” 275–289. Both essays are found in Wayne Grudem, ed., Biblical Foundations for Manhood and Womanhood (Wheaton: Crossway, 2002).

41. As to the idea that the intersexed will be raised as intersexed, this would seem to fly in the face of the fact that all diseases, disorders, and disabilities will be healed in the resurrection.

42. This is why it appears, and how it is classified, in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders. However, the weakness of DSM-V, as we’ve already noted, is that it is only the dysphoria or distress that is seen as the clinical problem, not the gender incongruence itself (as was the case in DSM-IV). This leads to a focus on alleviating the consequence (distress) rather than attempt to resolve the condition (incongruence) causing the distress. However, there are stronger reasons for regarding gender incongruence itself (irrespective of the distress it may or may not cause) as a mental disorder. This was the helpfulness of the category of “Gender Identity Disorder” in DSM-IV.