Compelling and Credible Witness: The Church and Gender Identity

TGI Resource List

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These resources were consulted by The Gospel Initiative while exploring this issue.

(n.d.) Denver Seminary Statement on Human Sexuality. Accessed by permission on August 23, 2021. 

Arayasirikul, S., Turner, C., Trujillo, D., Sicro, S. L., Scheer, S., McFarland, W., & Wilson, E. C. (2022). A global cautionary tale: discrimination and violence against trans women worsen despite investments in public resources and improvements in health insurance access and utilization of health care. International Journal for Equity in Health, 21(1). DOI: 10.1186/s12939-022-01632-5

• Despite significant increases in public health resources and community-based initiatives for trans women in San Francisco between 2010 and 2016, housing discrimination and physical violence due to gender presentation both significantly increased. Adverse social determinants of health also significantly increased: homelessness, living below the poverty limit, methamphetamine use, depression, PTSD, and anxiety. The improvement recommendations were for research and interventions to shift the focus and burden from trans people to cisgender people who are the perpetuators of anti-trans sentiment, stigma, discrimination, and victimization.

French, D. (March 2022). What do we do when people are equal but not alike? The Dispatch. https://frenchpress.thedispatch.com/p/what-do-we-do-when-people-are-equal?s=r

• Arguing from a legal and moral perspective, French nuances the position regarding equality for trans women. Although there are many situations where women and trans-women should be considered equal, such as in the workforce, women’s sports are an exception. In this case, he argues that failure to make distinctions violates the fairness of women’s sports. He explains why this case is not analogous to race-based distinctions. He mentions examples of where we need to protect the civil liberties of those with whom we disagree and concludes with a measured assessment of the harm done when we do not. He was interviewed about his piece by Skye Jethani on The Holy Post podcast on March 25, 2022, available here: https://podcasts.apple.com/us/podcast/the-holy-post/id591157388?i=1000555218740

Gandy, M.E., Kidd, K. M., Weiss, J., Leitch., J., & Hersom, X., Kattari, S.K., & Atteberry-Ash, B. (2021). Trans*forming access and care in rural areas: a community-engaged approach. International Journal of Environmental Research and Public Health, 18(12700), 12700–12700. DOI: 10.3390/ijerph182312700

• A mixed-methods, community-engaged research approach toward transgender and gender-diverse people in rural West Virginia. Results indicated transportation-related, cost-related, and discrimination-related barriers to receiving and seeking health services. Participants disclosed issues regarding fear of disclosing a gender identity and having gender dysphoria triggered in healthcare settings. The hope is that additional research would bring increased understanding that informs the trainings of healthcare professionals in working with this population.

Hershner, S., Jansen, E. C., Gavidia, R., Matlen, L., Hoban, M., & Dunietz, G. L. (2021). Associations between transgender identity, sleep, mental health, and suicidality among a North American cohort of college students. Nature and Science of Sleep, 13, 383–398

• While focusing on sleep issues and contrasting trans students from North America with Canada, the real import of this study is what it confirms about college student mental health. For trans students in the U.S., there was a twofold increase in depression and anxiety and nearly a fourfold increase in suicide attempts. Implications for student resources at college campuses are discussed.

Kallitsounaki, A., Williams, D. M., & Lind, S. E. (2021). Links between autistic traits, feelings of gender dysphoria, and mentalizing ability: replication and extension of previous findings from the general population. Journal of Autism and Developmental Disorders, 51(5), 1458–1465. DOI: 10.1007/s10803-020-04626-w

• Authors note the high prevalence of gender-nonconformity among those with autism spectrum disorder (ASD). This is the replication study of the original work done by authors Kallitsounaki and Williams. They confirmed their original findings of a “significant association between mentalizing ability and current gender-dysphoric feelings.” Unlike in their first study, this one showed that one’s mentalizing ability mediated the link between autistic traits and gender-dysphoric feelings. Mentalizing is the ability to represent mental states, which was operationalized with an instrument known as the RMIE, a series of thirty six photographs of the eye region where participants must match each photo to the correct mental representation in a series of four options. The authors conclude: “the main implication of these findings is that mentalizing ability could be one of the underlying neurocognitive mechanisms that explain the increased prevalence of gender nonconformity in people with a diagnosis of ASD.”

Keller, T., Nicholas, P., Coomar, T., & O’Brien, B. (November 2021). How to reach the west again. Episode 2: A Christian high theory. Apple Podcasts. https://podcasts.apple.com/ca/podcast/episode-2-a-christian-high-theory/id1593641985?i=1000541484548

• This six series podcast is on having a “fresh, missionary encounter with western culture.” This episode is not on the topic of gender identity per se, but it comes up in the context of personal identities and how we can think through individualism in western culture. It is less helpful in terms of understanding clinical gender dysphoria and more helpful regarding diagnosis of cultural trends as it relates to finding gospel-intervention points.

Kirchner, S., Benedikt, T., Ploderl, M., & Niederkrotenthaler, T. (2020). Perceptions of LGBQ+ youth and experts of suicide prevention video messages targeting LGBQ+ youth: qualitative study. BMC Public Health, 20(1845), 1-11. DOI: 10.1186/s12889-020-09853-5 

• The main import of this piece is its recent affirmation of the prevalence of suicide ideation among the LGBTQ+ community. The It Gets Better Project created videos that were intended to reduce population suicides, and this study found that they were perceived as helpful by the LGBTQ+ community although they were a bit lacking in representing diversity of sexual expression.

Martin, T. K., & Coolhart, D. (2022). “Because your dysphoria gets in the way of you…it affects everything.” the mental, physical, and relational aspects of navigating body dysphoria and sex for trans masculine people. Sexual and Relationship Therapy, 37(1), 82–99. DOI: 10.1080/14681994.2019.1696459

• A qualitative study on the impact of gender dysphoria on sexual experiences. Three findings emerged. First, mental negotiation of dysphoria, which included negative mental health outcomes. Second, physical negotiation, which involved hormone treatment, surgery, prosthetics, and self-pleasing. Third, relational negotiation, which involved sharing needs, experiencing connections, communication, and receiving support.

McRay, B.W., Yarhouse, M.A., Butman, R.E. (2016). Modern Psychopathologies: A comprehensive Christian appraisal. IVP Academic.

• Chapter 12, Problems of Sexuality and Gender, addresses gender dysphoria in relation to broad cultural trends, orthodox evangelical theology, the 5^th edition of the Diagnostic and Statistical Manual of Mental Disorders, and sexual dysfunctions, while taking age and state of development into account. Trends and controversies related to classifications and treatment are covered. Looking through a pastoral care lens, the authors give guidance regarding the conceptualization of and differences between psychopathology, evolutionary psychology, sin, and the Christian worldview. Though their work predates many of the current cultural trends in gender identity, their frameworks can be fruitfully applied to many of these phenomena, especially by Christian counselors and pastors.

Pearcey, N. (2018). Love thy body: Answering hard questions about life and sexuality. Baker Books.

• Chapter 6, Transgender, Transreality, deals explicitly with the issue of gender identity. As with the other chapters, Pearcey deals with the dichotomy between the body and the “authentic” self. She explores modern SOGI laws and the history of the transgender movement back to David Reimer in 1965. Mainly writing to debunk the philosophy behind transgender activists, she advances the intelligent design behind a teleological view of nature that affirms the sexual binary and the morality of heterosexuality. She shows that once “men” and “women” become politically redefined, the state would hold unprecedented power over families, as concepts like “father” and “mother” would also be adjusted as natural rights would be increasingly folded into legal rights. She highlights the political pressure on the medical community to encourage children with gender dysphoria to transition with hormones and surgery, while sharing counter-narratives of others suffering with gender dysphoria. She argues that the Christian worldview affords dignity and value to the human body like nothing else can, and that the church should be leading the efforts of creative compassion in this arena.

Schulke, B. (August 15, 2019). “The Broken Cistern of Gender Dysphoria: One Pastor’s Story.” Retrieved May 1, 2022, from https://www.centerforfaith.com/blog/the-broken-cistern-of-gender-dysphoria-one-pastor-s-story

• A short article written by a pastor who experiences gender dysphoria. Schulke concludes his piece, “perhaps, if we slow down to hear each other’s stories, we might just remember that the gospel is indeed good news.”

Smith, G.A. (November 27, 2017). Views of transgender issues divide along religious lines. Pew Research Center. https://www.pewresearch.org/fact-tank/2017/11/27/views-of-transgender-issues-divide-along-religious-lines/

• Among Christians, white evangelical protestants (84 percent) were the most likely to say that gender is determined by sex at birth. This was followed by black protestants (59 percent) and white mainline protestants (55 percent). This was compared with religious “nones” of whom 62 percent said gender is not necessarily determined by sex at birth. Of self-identified protestants 61 percent said society has “gone too far” when it comes to accepting transgender people, compared with 57 percent of religious “nones” who said society has “not gone far enough.”

Strachan, O., Yarhouse M.A., Sadusky J., DeFranza, M.K., & Sabia-Tanis, J. (2019). Understanding Transgender Identities (James K. Beilby and Paul Rhodes Eddy, Eds.). Baker Academic; Grand Rapids, MI. 

• Editors Dr. Beilby and Dr. Rhodes offer an excellent introduction to the topic, including recent history, published research, and consultation with experts in related fields. This includes relevant theological questions. Their remarks do not take any positions, but they set a groundwork for the four views of the contributors, who then interact with each other. Dr. Strachan offers a very conservative view, while Dr. DeFranza and Dr. Sabia-Tanis offer views that would be considered unorthodox by many evangelicals and that do not fall in line with the Denver Seminary statement on human sexuality. Dr. Yarhouse and Dr. Sadusky are past presenters with The Gospel Initiative in this conference series and both have taught at Denver Seminary. The book was endorsed by another conference presenter, Dr. Preston Sprinkle.

Trueman, C. (2020). The Rise and Triumph of the Modern Self: Cultural Amnesia, Expressive Individualism, and the Road to Sexual Revolution.” Crossway Publishers.  

• Though his tone varies in winsome degrees, and he sometimes writes about cultural realities in a way that lacks compassion for individuals, Dr. Trueman presents an acute and provocative work about our cultural understanding of the self. He focuses on issues of sexuality and politics through the lenses of Charles Taylor and Philip Rieff.

Teena, D. M., Jamie, D. F., Nicco, R., Jonathan, V., Mats, H., Amirhossein, M., Behzad, S. K., & Ivanka, S. (n.d.). Predicting outcomes of cross-sex hormone therapy in transgender individuals with gender incongruence based on pre-therapy resting-state brain connectivity. Neuroimage: Clinical, 29, 102517–102517

• Confronting the challenge of predicting the success of hormone therapy for trans people, researchers used MRIs, computer generated body-morph images, and self-report data from twenty five men and women with gender incongruence. Researchers admitted that clinical variables alone were not able to explain body congruence, yet they claimed that the model significantly predicted post-therapy body congruence. While participants were excluded from the study if they had or were undergoing hormone therapy, none of the participants were followed up with after hormone therapy. Instead, the body morph task was used as a proxy for hormone therapy. The study had many stated limitations, and it overlooked the impact of hormone therapy on the brain as it relates to one’s experience of gender congruence post-therapy.

Walker, A.T. (2017). God and the Transgender Debate: What does the Bible actually say about gender identity? The Good Book Company.

• Writing to both cis-gender and transgender people, Andrew Walker stresses the need for compassion. He offers an interpretation of Genesis 1 that confirms a gender binary, and he advocates for a body-conformity approach to transgendered people who are Christians. He does not endorse hormone therapy or surgery as treatment options. He suggests that transgendered people cannot also find their identity in Christ. He offers guidance for pronoun usage, bathroom issues, and other topics.

Yarhouse, M., & Sadusky, J. (2022). Gender Identity and Faith: Clinical Postures, Tools, and Case Studies for Client-Centered Care. IVP Academic.

• Both past presenters at conferences with The Gospel Initiative, Dr. Yarhouse and Dr. Sadusky are leading Christian researchers and counselors in this field. This work identifies a congruence orientated clinical approach to gender identity issues that Christian counselors should appreciate.

Yarhouse, M., & Sadusky, J. (2020). Emerging Gender Identities: Understanding the Diverse Experiences of Today’s Youth. Brazos Press; Baker Publishing; Grand Rapids, MI. 

• Authors look at the challenges of gender identity issues for both youth who suffer and for caretakers of youth, especially where such cases may not always fit a diagnosable category of gender dysphoria. They probe language puzzles, including whether and how far those who name gender identity struggles are using language to describe something that has always been. Similarly, they probe whether and how far we are allowing for or even creating unique gender identities by the process of naming them. They focus strongly on seeing the person and not confusing the surrounding issues with a youth in need. They consider levels of engagement on the issue and apply classic Christ-modeling responses in fresh ways. They take a wider lens on the needs of youth in general and attempt to locate gender identity struggles inside this wider lens so that Christian caretakers do not lose sight of the many influences operating on today’s youth.

Zaliznyak, M., Yuan, N., Bresee., C., Freedman, A., & Garcia, M. M. (2021). How early in life do transgender adults begin to experience gender dysphoria? Why this matters for patients, providers, and for our healthcare system. Sexual Medicine, 9(6), 100448–100448. Retrieved April 4, 2022, from https://doaj.org/article/49a80d90ab8d48cd8721f68bbeb3be01

• Researchers asked one hundred fifty five transgender women and fifty five transgender men, all of whom were seeking genital gender-affirming surgery, when they first experienced gender dysphoria and the length of time between this experience and gender transition. They found the medium age of onset of gender dysphoria was between ages six and seven for all people. Transgender men on average went 22.9 years before starting their transition while transgender women went 27.1 years. Researchers stress that diagnosis earlier in life would mitigate rates of anxiety, depression, and suicidal ideation that persist in the gap between when gender dysphoria presents as persistent and when first treatment occurs.