In recent years, discussions concerning the relation between one’s sense of self and one’s body have become increasingly prosaic. We are in the midst of a ‘gender nonconformity’ cultural revolution that defies gender stereotypes, grounded in the belief that one’s true self is the inner person of thoughts, feelings, and desires. The very public transition of Bruce to Caitlyn, bathroom wars, boycotts, and the introduction of several controversial governmental policies attest to a crisis of identity that challenges nearly every aspect of society. While the phenomenon of Gender Dysphoria has only recently become a subject of public concern, the medical community has wrestled with this issue for decades, though not without a fair degree of controversy and consternation, especially when treatment involves surgically removing healthy organs to align one’s physiology with one’s sense of gender identity. As one psychiatrist put it, “If we are trying to ‘do no harm’ [per the Hippocratic Oath], do we harm less by operating more, or harm more by operating less?”[1]
What are we to make of the claims that a person’s gender identity conflicts with his or her body? Should someone undergo gender-reassignment surgery to match one’s sense of identity, or should it be the other way around? Answers to such questions will depend fundamentally on our understanding of what it means to be a human being, an understanding that derives its intelligibility from the larger story (or metanarrative) in which it is situated. For Christians, this metanarrative is informed by Scripture, which attests to the creative, redemptive, and restorative activity of God as revealed in Christ Jesus. While we confess that God’s good creation has been thrown into disorder by sin, disrupting our relationship with God, our neighbors, and our own selves, we also celebrate Christ’s coming to dwell among us—the incarnation—in order to demonstrate God’s love and His judgment of sin through the cross. Finally, Christ’s resurrection and ascension orient us to God’s good future, when Christ will return to His creation, making us—and indeed all things—new.
How then are Christians to respond to Gender Dysphoria and gender reassignment surgery? First, we should take the diagnosis of Gender Dysphoria seriously, and with a degree of humility. Reports of mental torment, depression, and dysphoria that often accompany this condition are well-documented, and should not be dismissed or minimized out of hand. Christian reflection on issues in medicine should seriously consider the findings of clinicians, surgeons, psychologists, and psychiatrists, and the expertise they bring to this condition, though not of course uncritically nor apart from theological resources that enable us to interpret this phenomenon from a different plane. For, at the very least, such conditions bespeak our own fallenness. Thus, when Christians belittle, mock, and misconstrue those who wrestle with this condition, we forfeit opportunities to be agents of God’s redeeming grace in the world.
Second, we should confess that our current given biological sex is good and assigned by God, for the creation accounts in Genesis give unqualified affirmation that male and female bodies as created by God are good, not just instrumentally, but in and of themselves (Gen. 1:27). But we should also note that such a claim is not available to science, but can only be confessed. Whatever the interpretation of one’s gender—and here we must admit of a variety of options—one’s current biology (excepting the ambiguities of intersex conditions) should be given epistemological priority, meaning that we ‘know’ we are male or female by considering our given biological sex as determined by God. Moreover, and related to the first point above, given that sin entered the world through an act of will, we should expect to find ‘fallen’ attitudes toward our bodies, without necessarily denying a biological component to our fallenness. In other words, sin should not be associated with embodiment per se, but in our attitudes toward our bodies. With Augustine, we can understand our fallenness in terms of disordered desire, which, in the case of Gender Dysphoria, manifests itself as a profound, debilitating, and often unwanted, unease with one’s given biology.
Third, we need not accept all interpretations of Gender Dysphoria and the surgical remedies offered by medicine, for the Christian faith relies on a revelatory account of the human condition as disclosed in Scripture which transcends any medical diagnosis. Thus, even though the latest edition of the Diagnostic and Statistical Manual on Mental Disorders has intentionally replaced the older term “Disorder” (DSM-IV) with “Dysphoria” (DSM-V) as a way of emphasizing the existential over the normative, and even though psychotherapeutic approaches promote coping with the identity-induced dysphoria rather than reorienting one’s identity, Christians need not accept such interpretations as the final, definitive word on the subject. There is a real danger in allowing a formal diagnosis to so essentialize the experience of dysphoria that any moral considerations of engaging in practices that might actually refine or change one’s identity to more closely align with one’s biology are precluded.
Finally, and related to this last point, we must remember that ultimately our identity is rooted in the crucified, resurrected, and ascended Christ. Christians who struggle with their gender identity may find some relief by finding their true identity in Christ, who, in the words of Robert Song, “did not lay claim to his identity as something to be hung on to.”[2] We should consider too how our bodies, created as male and female, can help us discipline our desires and shape our identities, especially in those practices instituted by Christ (i.e., Baptism and the Eucharist). Here, Jesus’ words, “This is my body broken for you,” might begin to mute the thought that “this is my broken body,” enabling a degree of identity transformation in this life that will be perfected in the age to come. Speaking of these Christian practices is not to deny the potential benefits of psychiatry or psychology, but to cultivate a deeper hope for the day when our identities will be fully reflected in Christ—body and soul—having seen Him face to face.
Resources
[1] George R. Brown, “Bioethical Issues in the Management of Gender Dysphoria,” Jefferson Journal of Psychiatry 6, no. 1 (1988): 41.
[2] Robert Song, “Body Integrity Identity Disorder and the Ethics of Mutilation,” Studies in Christian Ethics 26, no. 4 (2013): 498.