Recent conceptualizations of the fluidity of sex and gender have increased the prevalence of associated bioethical decisions such as sex‐reassignment surgery for adults, hormone therapy for adolescence, and sperm and embryo preservation in transsexual men and women. While there are some Christian writings on the topic of transsexual/transgender ethics, there is little foundational work that attempts to clarify possible positions within the scope of the Judeo‐Christian worldview. In our paper, we will draw on Christian writings as well as the larger religious and secular corpus to distill the major perspectives on at least four important concepts underlying ethical questions surrounding ambiguous sex/gender. First, we will discuss various perspectives of sex. Does each person have an “essential” sex, and is sex revealed by the body or does it arise from the body? Second, we will discuss perspectives on gender. Is gender a continuum or a dichotomy? What defines masculine and feminine characteristics? Third, are sex and gender necessarily linked or are they independent of each other? Does sex or gender have ontological priority over the other? Fourth, what is the significance of uncovering a biological basis for gender dysphoria? More generally, what are views on the morality of actions precipitated by “naturally occurring” variation in the human body and mind? For each of the four concepts, we will explore the implications of each perspective on bioethical decisions regarding ambiguous sex/gender. Our goal in this paper is to simplify rather than add complexity to the topic. In that light, our characterizations will be broad, and we will defer to other sources for more nuanced discussions of individual positions. We aim to provide a “toolbox” rather than a treatise. By bringing clarity to the playing field, we hope to increase substantive ethical discussion in the Christian community on issues related to ambiguous sex/gender.