“Understanding Gender Incongruence & Caring for Trans* People” is a 4-session course that (1) helps Christian leaders and parents think empathetically and theologically about gender incongruence and (2) equips Christian leaders and parents to offer God’s love and wisdom to trans* people. Learn more and get access at equipyourcommunity.org/gendercourse.
During the second session of Equip’s Gender Incongruence Course, we survey thirteen different biblical passages and themes often cited in conversation about gender ethics. After weighing each passage’s relevance to a Christian’s search for God’s wisdom around gender incongruence, we arrive at the following summary:
- God first intended for each of us to either be male-bodied men or female-bodied women (Genesis 1-3).
- The Bible forbids genital mutilation (Deuteronomy 22:5 and Deuteronomy 23:1), cross-dressing as part of cult practices (1 Corinthians 11:2-16), and the elimination of gender difference (1 Corinthians 11:2-16).
- The authors of Scripture were aware of trans* people.
- The Bible affirms the sex and gender binary.
- The Bible makes clear that genital mutilation does not prevent people from being able to image God and be part of His family (Isaiah 56:1-5, Acts 8:25-39).
- The Bible affirms dozens of times when men and women in the Bible break what we would consider to be contemporary gender stereotypes (Psalm 51:10-11, Micah 6:8, I Samuel 18:1-3, Proverbs 31, Judges 4:4, Acts 16:14, Luke 7:47,50).
(Note, this summary is arrived at after careful examination of each passage. To understand how Equip arrived at this summary, get access to Equip’s Gender Incongruence Course at equipyourcommunity.org/gendercourse.)
In light of this foundation of biblical evidence, what were God’s intentions for biological sex and gender? To what extent did God prescribe biological sex and gender? How is gender broken biologically and culturally? And how might our answers to those questions inform a theology of gender incongruence?
What were God’s intentions for biological sex and gender?
We see in the Scriptures that God is a being-in-relation in the Trinity, delighting in communion with the other members of the Trinity (John 1). There is diversity and complementarity in the Trinity. Then God created humankind in His image to also be beings-in-relation to each other, to desire communion with God and others, and to be diverse and complementary (Genesis 1 & 2; 2 Corinthians 13:14). There are many ways in which humans interact as beings-in-relation, and there are many sources of diversity and complementarity in the Body of Christ (1 Corinthians 12).
One source of diversity and complementarity is biological sex and gender, and one way that humans interact as male and female beings-in-relation is marriage. Eve was made from Adam in such a way that Adam and Eve complemented each other (however, in more ways than just their sexuality), for God saw that it was not good for a human to be alone (Genesis 2:18).
However, marriage is not the only way males and females can find connection and community with one another. John lays out a level of familial bonds that exceeds biological relationship when, at the cross as John 19:26 says, “Jesus saw his mother and the disciple whom he loved standing nearby, he said to his mother, ‘Woman, behold, your son!’” We also see in Jesus’s ministry the love that He has for The Twelve as well as the connections and relationships He has with the women who follow His ministry, such as Mary and Martha.
Additionally, biological sex and gender are not the only ways that humans image the diversity and complementarity in the Trinity and between Christ and the Church. As we’ll explore later, there is actually more diversity among males and separately among females than between the average male and the average female. We don’t mean to suggest that biological sex and gender don’t matter, but merely to recognize that the diversity from other sources is collectively greater.
To what extent did God prescribe biological sex and gender?
At the very least, sex and gender are important. Theologians have consistently and narrowly defined faithfulness to our biological maleness or femaleness as:
- Accepting our biological maleness or femaleness philosophically. That means recognizing in our mind (and later with our words and actions) that we are indeed biologically male or biologically female.
- Recognizing our potential for friendship and marriage as biologically sexed people and following God’s wisdom as we engage those capacities.1
This also highlights the ways that a person can reject his or her biological sex:
- By rejecting their biological maleness or femaleness outright. Rejection could be in our mind, through our words, or with our actions.
- Christians can reject our biological sex by engaging in sex outside of Christian marriage.
However, God didn’t provide any further universal prescriptions for males or females. God didn’t communicate any further intentions about universal masculinity or femininity. He seems to have expected and even invited humans, with our authority and responsibility to care for and rule over Creation, to create beautiful cultures and to express our differences within those patterns of masculine and feminine expression.2
As such, man-made gender prescriptions do not have moral weight and frequently change from generation to generation and culture to culture. We can recognize the variety and differences within humans as created image bearers and celebrate the ways in which our differences can uniquely glorify God.
Unfortunately, everything about this world is broken, including each of our biological sexes and each of our genders.
How is gender biologically and culturally broken?
When God first imagined each of us, He created us to be perfect in every way, including our biological sex and gender (Genesis 2; Psalm 139). But even as we were knit in the womb, we developed imperfectly and were corrupted physically at a genetic level, and then we were born into a world of sin (Psalm 51; Romans 5). Nothing about who we are today is unmarred by the Fall, including our biological sex and gender.
We should not be surprised, then, when we find that our bodies, minds, and spirits experience and express our sex and gender in broken ways. As in the case of the thorn in Paul’s side, being faithful a Christian doesn’t mean that God resolves all our brokenness in this lifetime (2 Corinthians 12).
This highlights another reason why the Scriptures provide limited wisdom for universal maleness/femaleness and masculinity/femininity: When we search the Bible for prescriptions about perfect maleness and femaleness, we are only provided with perfect examples in the Garden of Eden before the Fall, in prophecy about the New Heaven and the New Earth, and in Jesus. Beyond that, we are provided with examples in the context of a broken world.
Because most examples we have of what it means to be male or female are imperfect, it is difficult to prescribe what correct gender experience and expression is beyond those previously described: to accept one’s biological maleness or femaleness, to follow God’s wisdom when we engage our capacity for relationship, and to refrain from rejecting biological maleness or femaleness.3
Furthermore, if everything in this world is broken, then our cultural understanding of gender is also broken.
Is pink a girl color? Is blue a boy color? One hundred years ago, pink was considered the more masculine color because of its resemblance to red, a “stronger” color, and blue was considered dainty. By the 1970s, children wore mostly gender-neutral clothing, and there was no sense of colors being associated with one gender or another.
But once science allowed parents to learn a child’s sex long before birth, retailers sought to increase sales by marketing higher-priced, gender-differentiated clothes, blankets, and toys so that parents would spend more money preparing a baby’s room, including differentiating these items by color.4 Now, our society attributes some colors to one gender or another despite color preferences being unrelated to gender.
Yet the impact of these arbitrary gender prescriptions can be much worse than inflated prices. What happens when we ascribe something to gender that has nothing to do with gender? Say a boy prefers the color pink: pink toys, pink clothing, pink blankets. Parents often respond with a forced choice for the child: either reject your preference for pink and choose to be a boy, or continue to prefer pink and experience shame. How much distress and confusion is caused by ascribing gender to preferences that have nothing to do with gender at all? How much shame and rejection do these forced choices create in children? Could these feelings lead a child to question whether they’re really a boy or really a girl?
All in this world must be redeemed, including our cultural concepts of gender. We would do well to resist opportunities to assign preferences to one gender or another. To be clear, we’re not trying to deconstruct gender. Instead, we hope to purify our understanding of God’s intentions for gender, removing aspects that have nothing to do with gender so that the true nature of gender may be appreciated.
In summary, God made us male or female. We’re called to honor God’s gift of our maleness and femaleness. Yet God chose not to define gender much further. Instead, He left humans to create beautiful cultures and to express our differentness in lots of ways, including through cultural patterns of gender expression. But, the Fall has impacted everything, including our biological sexes, our genders, and our cultural definitions of gender.
How, then, should Christians think wisely about the particular expression of broken gender that is gender incongruence?
How can we conceptualize gender incongruence?
We need a way to appreciate the complexity of gender incongruence. Christian psychologist Mark Yarhouse has suggested that there are three lenses through which Christian can view and seek to understand gender incongruence: the integrity lens, the disability lens, and the diversity lens.
The integrity lens is primarily concerned with moral dimensions of gender incongruence and how Christians respond. Generally, when Christians use the integrity lens to evaluate any phenomena, they ask, “What actions are sins? What actions are seemingly morally neutral? Which actions clearly glorify God?” If Christians seek to understand gender incongruence exclusively through the integrity lens, they would primarily explore whether different steps of social, hormonal, and surgical transition are sins or not.
The disability lens focuses on recognizing a particular phenomena as an unchosen, enduring bodily brokenness that must be faithfully stewarded by the Christian and demands the Church respond by providing metaphorical wheelchair access ramps to ensure that the believer managing enduring brokenness can fully enjoy God’s love and belonging with His people. When Christians view gender incongruence through the disability lens, they recognize that gender incongruence is a brokenness as a result of living in a fallen world, but those navigating gender incongruence do not choose to experience incongruence nor is there a reliable method for eliminating gender incongruence. Christians seeking to understand gender incongruence through the disability lens then recognize the responsibility of churches to care for trans* people with God’s love and wisdom as those trans people faithfully submit their enduring brokenness to Jesus.
The diversity lens focuses on the ways a particular phenomena contributes to the beautiful complexity of the body of Christ. When Christians who hold a progressive gender ethic view gender incongruence through the diversity lens, they see the trans* experience as a variation intended by God to contribute to the ways the body of Christ collectively images God. However, when Christians anchored by historic interpretations of Scripture seek to understand gender incongruence through the diversity lens, they ask how a Christian faithfully navigating gender incongruence may develop unique testimony, gifts, and strengths to offer the body of Christ particularly from stewarding their brokenness (while recognizing that God did not intend for anyone to experience gender incongruence or for gender incongruence to image God).
As Mark Yarhouse suggests, seeking to understand gender incongruence through any one of these lenses alone is inadequate. Like a kaleidoscope, we appreciate the complexity of gender incongruence when we stack all three lenses on top of each other and seek to understand gender incongruence through them simultaneously. There are simultaneously moral questions, an invitation to the Church to provide Christians faithfully navigating gender incongruence with the support they need to thrive, and an opportunity to recognize and appreciate the spiritual gifts trans* Christians have developed from faithfully submitting their brokenness to Jesus.
If, however, Christians wonder in what order they should stack these lenses, we might suggest Christians foreground the disability lens slightly over the other two lenses, with the other two lenses prominently in frame just beyond the disability lens. This arrangement properly balances God’s love and wisdom while appropriately challenging churches around how they will come around Christians navigating gender incongruence to do so faithfully.
With this understanding of gender incongruence, here are some key theological questions that still need answers:
- How does gender incongruence develop?
- Was it God’s intention? Can it change?
- Is merely experiencing gender incongruence a brokenness? A sin?
- If someone experiences gender incongruence, who are they in God’s eye?
- What steps can faithful trans* Christian take to reduce their distress?
How does gender incongruence develop? Was it God’s intention? Can it change?
Like many things in life, gender incongruence develops from a combination of genetic and biological factors (nature) as well as cultural and familial influences (nurture). No study points conclusively to the reasons or sources of gender incongruence. For most people, it is a combination of multiple factors that are typically experienced from an early age.
Second, God did not intend for anyone to experience gender incongruence. When God first imagined each of us being born into a perfect world, He intended for each of us to be either a male who feels fully like a man or a female who feels fully like a woman.
When God created humans in Genesis 1 and 2, He created them mind, body, and spirit as male-bodied men and female-bodied women. We can assume that pre-Fall, there was complete congruence between mind, body, and spirit, and therefore, between biological sex and felt gender.
That being said, it’s true that Scripture never states explicitly that God intended every person pre-Fall to be a male-bodied man or a female-bodied woman. Similar to much of orthodoxy in historic Christianity, the Church has discerned with the Holy Spirit and through dialogue in the body of Christ further clarity needed for day-to-day life.
But because everything in this world is broken, one of the ways some people were impacted by that brokenness is that they developed gender incongruence.
But we want to be clear: no one chose to experience enduring, robust gender incongruence.
And while some may experience relief from gender incongruence over time, there’s no formula for “healing” gender incongruence.
Let me explain.
Interestingly, 80% of people who experience gender incongruence as a child experience relief from their gender incongruence by the time they reach adulthood. Not because the child or their parents did anything in particular, but without explanation, once they get to and through puberty, their gender incongruence resolves on its own. However in about 20% of cases, gender incongruence persists.5
To be clear: There’s no proven combination of counseling or pastoral care strategies or spiritual exercises to increase the likelihood of a person’s gender incongruence resolving. If an individual sees gender incongruence persisting beyond adolescence and into adulthood, it is likely going to be a lifelong experience. Also note that resolved incongruence does not mean that the child’s gender incongruence was ingenuine or that the child was merely confused. It’s important to recognize that there is also no way to know whether gender incongruence will resolve, and as such, the experience should not be dismissed regardless of the age of the person experiencing incongruence.
Next, if God didn’t intend for anyone to experience gender incongruence, then what is it?
Is merely experiencing gender incongruence a brokenness? A sin?
Gender incongruence is a brokenness and one of many manifestations of the brokenness of all of creation as a result of the Fall. Merely experiencing gender incongruence is not a sin.
Gender incongruence, just like other forms of pain and brokenness, may tempt a person to soothe their discomfort in sinful ways or attempt to sinfully remake God’s gift of their biological sex, but a person does not sin until they say “yes” to temptation in thought, word, or deed. Still, we should be quick to remember that even when we sin intentionally or unintentionally, grace abounds more through Jesus Christ (Romans 5:20-21).
Every person experiences brokenness in one way or another, and because we all experience the hurt and pain that are byproducts of this brokenness, we as believers should be driven to show love and compassion.
Certainly, in an ideal world people would not experience gender incongruence. Yet the beauty of God and His power is that our brokenness does not keep us from His love and grace because of His son, Jesus Christ. He can take what is broken and make it something greater, something more beautiful, something that points to His glory and power.
So, based on relevant passages of Scripture and the theological understanding we explored so far, if someone experiences gender incongruence, how does God see them?
If someone experiences gender incongruence, how does God see them?
When a Christian asks, “Who am I, fundamentally? Who did God create me to be? How does God see me?” the individual is asking a question of ontology. Then, the Christian’s appreciation for God’s intentions should guide how they faithfully respond to the broken world they experience. As we’ve already stated, when God first imagined each of us born unblemished into a perfect world, He imagined each of us as either a male-bodied man or a female-bodied woman. But we live in a broken world, and some experience a distressing incongruence between their biological sex and felt gender.
Which reflects God’s intentions? Which is broken? And how then should the trans* Christian faithfully manage that brokenness?
If an individual is not intersex and their chromosomes, gonads, sexual anatomy, and secondary sex characteristics all indicate the same biological sex, then we can see God’s intentions for the individual’s biological sex.
Plus, when God’s intentions for an individual’s biological sex are evident, we can also see His intentions for their experience of their gender. So when a person is not intersex but they experience gender incongruence, we believe that their biological sex is as God intended but their experience of their gender is broken. We know that God intended to gift them with a particular biological sex and gender, and we believe that their experience of their gender has been negatively impacted by the Fall.
For example, if a person is biologically male, then God intended for that person to be biologically male and feel mentally/psychologically like a man. If this male experiences gender incongruence and, as such, does not feel robustly like a man and instead feels more like a woman or somewhere in between a man and a woman, we can recognize that their experience of gender has been negatively impacted by the brokenness of Creation caused by sin.
We know that God intended to offer this male his maleness and a sense of being a man as a sacred gift, but unfortunately the downstream effects of the Fall have disrupted God’s intentions for the male’s gender.
Some might push back on the previous claim by asserting that most people actually experience a brain-sex/body-sex difference, and as such should be treated as intersex people.
Let’s explore that.
What about brain-sex / body-sex difference?
In recent years, queer theorists have suggested that the brains of males and females are categorically different in ways that determine their experience of their gender. The brain develops much earlier in the mother’s womb than the rest of the body, and male brains are exposed to a hormone bath of testosterone that female brains are not.
As a result, theorists have suggested that a primary source of a trans* experience could be a brain-sex body-sex difference, where a biological male develops a male body but for some reason develops the brain of a female.
Because the brain and the rest of the body develop at different times in a mother’s womb, it is hypothetically possible that an atypical hormone bath during brain development could cause it to develop contrary to its genetic material.
If such a brain-sex/body-sex difference were discovered among trans* people, one could argue that those trans* people are actually intersex.
As we have already discussed, God’s intention for the sex of an intersex person is not clear, so the wisdom for how the intersex Christian should faithfully steward their gender is less clear.
Are our brains sexed, then? And could a meaningful number of trans* people have a brain-sex/body-sex difference?
Limited studies have been conducted to explore this theory. The results of some suggest that trans people have brains more similar to people of the opposite sex.6 7 8 9 10 11 Other studies show that trans* people have brains more similar to people of the same sex.12 13 And then still other studies suggest something in between.14 15 16
Moreover, the studies that found trans* people to have brains more similar to people of the opposite sex either suffered from a small sample size, surveyed participants who had already taken cross-sex hormones, studied participants with HIV/AIDS, or followed participants who had already lived for years as someone of the opposite sex. In short, the credibility of those studies is widely doubted.17 18 19
In contrast, studies of biological females who received a wash of testosterone in utero found that while they were more likely to report masculine-typical behaviors and interests, they were not more likely to identify as male or experience gender dysphoria.20 21 22 A further analysis of gender identity and prenatal hormone exposure found that prenatal androgens had “large effects on interests and engagements in gendered activities, moderate effects on spatial abilities; and relatively small or no effects on gender identity, gender cognitions, and gendered peer involvement.”23 24
In conclusion, available evidence strongly suggests that a brain-sex/body-sex difference does not exist, contribute to gender incongruence, or qualify a meaningful number of trans people as intersex (and therefore leave God’s intentions for their biological sex unclear).
In contrast, consistent research has shown that while there are physical differences on average between male and female brains, the variation among male brains and among female brains are greater than the differences between the average male and female brain. This variance is natural, but does not predict gender incongruence or make a person any more or less male or female.25 26 27 28 29
God created us each uniquely and beautifully. Our differences and our commonalities reflect God’s handiwork and His intentionality with us.
Based on all of this, we get to our final and admittedly most difficult theological question:
What steps can faithful trans* Christian take to reduce their distress? How can they find relief?
What steps can faithful trans* Christian take to reduce their distress?
First, let me describe steps that a person could take in three different ranges: social transitioning, hormonal transitioning, and surgical transitioning.
Social transitioning involves taking steps within one’s social circles to mitigate incongruence non-medically. These include name and/or pronoun changes, adjustments to one’s appearance through clothing and hairstyle changes, wrapping/taping to flatten the breasts, packing to give the appearance of having a penis, using single stall bathrooms, using the bathroom of people of the opposite sex, and voice training to raise or lower the pitch of one’s voice.
Hormonal transitioning involves the use of Hormone Replacement Therapy (HRT) that chemically alters a person’s secondary sex characteristics to align with their gender identity. There are two main approaches: Masculinizing hormone therapy for transgender men consists of androgens and antiestrogens. Feminizing hormone therapy for transgender women consists of estrogens and antiandrogens.
Surgical transitioning can include adding or removing breasts, various forms of plastic surgery to change facial features or enhance other parts of the body, vocal cord surgeries, and altering genitalia. The most common terms associated with surgical transitioning is “top” (think top half of the body) and “bottom” (refers exclusively to genital alterations) surgery.
To what extent is each of these ranges of transition morally neutral or a sin?
If (1) a person who experiences gender incongruence is not intersex, if (2) we know God’s intentions for the individual’s sex and gender, and if (3) we know that the person’s gender experience is broken whereas their sex is as God intended, then taking steps to alter one’s sex and reject God’s gift of their sex is sinful.
When a trans* Christian undergoes hormonal or surgical transition, they are at risk of responding to broken gender by breaking their biological sex, not being grateful for God’s gift of their sex, and falling short of faithfully managing their broken gender.
However, in the range of steps considered social transition, the morality of many of those actions depends on the motivation behind the action. Few of them are inherently sinful.
Each step of social transition could be taken as part of a rejection of God’s gift of one’s biological sex, or each step of social transition could be taken merely to reduce the distress of a person’s gender incongruence, while affirming internally and externally that they are ontologically the biological sex that God intended.
Some might say, “Transition saves lives. Inviting trans* Christians to consider the moral implications of transition will only lead to more suicide. The risk of suicide is reason enough to set aside God’s wisdom.” But, as we’ve already noted, available research is inconclusive about the effectiveness of hormonal and surgical transition to reduce suicide risk. If robust longitudinal studies eventually demonstrated conclusively that hormonal or surgical transition are meaningfully more effective at reducing suicide risk than a time-tested combination of talk therapy, exercise, medication, and social support—if that is shown to be the case in the future, then the moral calculus for hormonal and surgical transition would change.
Earlier, a trans* Christian seeking to faithfully steward their sex and gender was offered as the point of reference. In an ideal world, a trans* Christian would consider the moral implications of transition from a place of positive mental health, a robust relationship with Jesus, compassionate church discipleship, and robust support from friends and family. Unfortunately, this has rarely been the case.
Many have taken steps to transition in times of mental unhealth, before knowing Jesus, after leaving the Christian faith, without compassionate support, and/or amid harassment from people who call themselves Christians.
When offering discipleship to trans* people, as covered in Session Three of Equip’s Gender Incongruence Course, conversations about the morality of social/medical transition will rarely be a first or early conversation in pastoral care that imitates Christ’s love. Additionally, medical transition does not remove a person’s ability to image God and represent Him to the world. We all make sinful decisions that affect our lives in significant ways, yet we also know that God takes our sin and brokenness and redeems it for His glory and our good.
Finally, any conversation about the morality of transition and the steps trans* people take to address their distress isn’t complete without a confession of the sins of Christians over the past century. Christians have overprescribed gender roles and rules, creating (in part) gender incongruence in some instances and amplifying gender incongruence in other instances.
While conservative advocates might accuse progressive advocates of Gnosticism by falling into mind/body dualism and valuing the mind over the body, it could equally be argued that conservative advocates often fall into the reserve trap of valuing the body over the mind.
Even if we know that a trans* person’s body is as God intended and it is the mind that is broken, a person’s gender is just as central to who they are. Enduring gender incongruence is just as devastating and deserving of compassion as enduring a broken body.
If Christian leaders are going to invite trans* Christians to honor God’s gift of their biological sex by refraining from hormonal/surgical transition and instead endure the pain of persisting gender incongruence (even when that wisdom is true and will be better for those trans* Christians in the long-term), those Christian leaders are still calling trans* Christians to something profoundly difficult, made more difficult by decades of gender overprescription by Christian leaders.
Bearing that moral responsibility, what will Christian leaders do to reduce the distress of trans* Christians faithfully stewarding their broken gender?
A final note about gender ethics and caring for trans* people: we at Equip want to recognize that the topics covered in this article are complicated and consequential for those in our churches navigating gender incongruence. As I shared in another article on Equip’s Blog titled “Certainty & Consistency in Gender Ethics”, we are not 100% confident in the conclusions we have drawn, but we’ve forced ourselves to arrive at specific and detailed convictions (despite our hesitation) because it is through attempting to come up with better answers for the sake of trans* people that the Church can actually discover a consensus of compassionate orthodoxy.
As a result, we hold our conclusions about gender ethics less tightly than our convictions about sexual ethics. We are certain that we’ve gotten at least a few things wrong. We are open to correction. Churches that hope to partner with Equip do not need to fully align with our convictions on gender ethics in order to work with us. Yet, this is how the Church arrives at better answers–by workshopping first attempts and then trying again.
For the sake of trans* people, we must.
Get access to Equip’s Gender Incongruence Course today to survey relevant passages of Scripture and explore these key theological questions even more deeply at equipyourcommunity.org/gendercourse.
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