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Eternity on transgender and transitioning

OPINION  |  Patricia and Kamal Weerakoon

Thursday 19 May 2016

This is a response to an article published by Eternity both in our May edition of the newspaper, and online this week. The original article writer, Tess Holgate and Eternity’s editor, John Sandeman, have written a further response to many of the comments we’ve received this week, including this one, here.

Transgender is a complex issue. The one title ‘transgender’ seeks to capture a variety of conditions and personal situations – some biological, some personal-psychological-identificative, some sexual – all of them usually interconnected in complicated ways which depend on the person’s particular situation and history. It is therefore probably not helpful to celebrate one response to transgender issues as being the ‘solution’ to the difficulties that a transgender person experiences. Helping a transgender person live as best as possible is a complicated question, with as many answers as there are transgendered people.

Eternity News recently published an article describing how a transgendered person, “Joan”, found peace and wholeness, with the support of her church, by socially transitioning so as to present in public as a woman, not a man.[1] The article quotes one of us (Patricia) at length.

The article shows how the disjunction between Joan’s body and her own conviction of her identity caused her significant psychological pain. We have no doubt that her church was convinced that supporting Joan through her divorce and transitioning was the best option for her in her particular situation.

However – we are concerned about the overall tone of the article. It too simplistically celebrates transitioning as the solution to issues of transgender identity.

On the one hand, this is the nature of the article. It’s a news report, not an academic journal article – or even a blog post like this one. News reports, by their nature, focus on one point, and communicate that one point through narrating a personal story which everyone can relate to.

However, that focus on transitioning has kicked off a debate on Eternity’s Facebook site, which I (Patricia) got drawn into because the article quotes her. We write this post with two objectives: (1) we want to make clear where I (Patricia) stand with regard issues of gender, transgender, and transitioning, and (2) we hope to ‘depolarize’ the debate by showing how surgical transitioning[2] is one – but only one, and the most extreme – possible response to transgender identity.

The nature and prevalence of ‘transgender’ and ‘transsexuality’

Transgender is an umbrella term for persons whose gender identity, gender expression, or behaviour does not conform to that typically associated with the sex to which they were assigned at birth.[3]

Notice how broad the term is, and the different aspects of life it encompasses – identity, expression, and/or behaviour. It includes a wide range of people who use a variety of titles to describe themselves – transsexual, cross dresser, she-males, queer, questioning, third sex, two-spirits, drag queen, transvestite… and many more. It is really only useful as a contrast to cisgender – which refers to experiencing a congruence between your body and your subjective sense of who you are.

Transgender identity also varies in significance from person to person. For some, it’s a relatively minor thing which they just ignore – like an old injury might occasionally hurt enough to make you wince, but most of the time you forget about it. Some people express it only occasionally, or in private. For a few, the internal conflict is genuinely so great as to make them want to end their life – like Joan says in the Eternity article.

At this broadest level, something like 1 in 300 to 1 in 500 people experience some kind of transgendered sense of themselves.[4] This was the figure I (Patricia) was quoted as saying in the article. But Joan belongs to the much narrower group of people who experiencegender dysphoria, who are sometimes called transsexuals – people who are convinced that they really are the opposite gender to the body they were born into. About 1 in 10,000 to 1 in 30,000 people experience this.[5]

Gender dysphoria used to be considered a version of body dysmorphia – a mental condition where people are convinced that their body is injured or deformed in some way, while their body is observably healthy.[6] While we don’t rule this out, we think it’s too simplistic to say that all occurrences of gender dysphoria – or transgender identity more broadly – is alwaysan instance of body dysmorphia. Some recent brain studies have suggested that transgendered people’s brains may develop differently from cisgendered people.[7] The research is new, the evidence is tentative. But it means we have to leave open the possibility that transgender identity might have some as-yet-undiscovered neuro-biological cause.

Created male and female, yet fractured by (unchosen) sin

But regardless of the cause, transgender identity is, we think, always a decline from God’s creational intention. In Matt 19:4-5, Jesus uses Gen 1:27 to explain Gen 2:24. That means Jesus thought God created humanity as two genders, and that these two genders ‘complement’ one another[8] – they are different, but in such a way that the union of the differences does not cause conflict, but joyful harmony. And if Jesus came, as God incarnate, not to abolish the law and prophets but fulfil them (Matt 5:17), then his interpretation of Genesis holds a final authority which circumscribes orthodox Christianity.

But, in a world fractured by sin, none of us live up to God’s created purposes. None of us obey God with all our heart, soul, mind and strength, nor do we love our neighbour as ourselves. None of us, that is, except Jesus. He is the only fulfilled human being who ever lived.

We all suffer, in various ways, some effects of sin which we are not personally responsible for. The book of Job is the classic example. Job was a righteous man, but God permitted Satan to put him through severe, undeserved suffering – some of it physical (Job 2:7-8;30:16-17). The lack of gender clarity which transgender identity, by definition, is, represents an unchosen effect of sin deep with our ‘souls’. It is not good – but neither is it something for which we are personally culpable.

Thinking creatively about living as best as possible: three principles

So, we need to help transgendered people live the best they can, as either a man or a woman, in light of the particular transgender issues they face in their particular situation. There are therefore going to be as many responses as there are transgendered people.

But this individualised variation is not unbounded. We propose three principles to help shape the ‘best’ life for a transgendered person.

We have already discussed the first principle: the goodness of binary gender. While transgendered people are, by definition, not clear on their gender, we think it is better to encourage them to identify as a gender – either male or female – rather than letting them continue drifting in uncertainty.

But if uncertainty is a key aspect of transgender identity, how can they discover a stable binary gender? This is where our second principle comes in: the goodness of our existingfamilies. The command to “honour our father and mother” is consistent between both Old and New Testaments (Exodus 20:12; Eph 6:2). God uses (heterosexual) marriage as a metaphor for himself and his people (Hos 1-3; John 3:29; 2 Cor 11:2-3; Eph 5:22-33), therefore “marriage should be honoured by all” (Heb 13:4). We are, to a significant degree, who other people say we are. Our personal identity does not simply flow out from within ourselves; it is given to us, from outside ourselves, by those who love us. Our parents bring us up as a boy or girl. Our siblings relate to us as brother or sister. To our extended family, we are nephew or niece, uncle or aunt. We are mother or father to our children. If we are Christian, then our most significant identity – ‘in Christ’ – is given to us, from outside ourselves, by the God who loves us.

This means that in ministering to transgender people, we should try to honour the relationships they are in, and their identity within those relationships, as much as possible. We propose this as an attitude, not an unbreakable law. Those who love the transgendered person would presumably, precisely because they love them, want to help them live well. This kind of positive attitude towards the transgendered person’s relationships should encourage their family and friends to continue to provide a deep, supportive network of love. And this kind of loving, communal support should help the transgendered person find the best way to live, not hinder them from it.

The Eternity article recounts how Joan and her (then) wife tried to retain their relationship, but it didn’t work and they ended up divorcing. We believe they did their best; we are confident their church helped them as best they could; but in this particular case they couldn’t stay together.

However, we do not think this is a good model for how we respond to all cases of transgender or transsexuality. We need to think creatively about how the transgendered person can minimise the dysphoria – the psychological pain caused by the conflict between their bodies and their subjective sense of self – without necessarily changing their identity– who they are in relation to other people who love them.

And this takes us to the third principle: our bodies. The Bible is positive towards embodied existence. The whole book of Song of Songs is a highly erotic celebration of bodily beauty and sexuality. Jesus became incarnate, healed bodily diseases, and was raised bodily. That means we should, as much as possible, strive to be content with our bodies, and not hastily change them.

One way we can manage dysphoria without necessarily changing our body is to think creatively about gender expression – how we live out and enact being the man or woman that we are. This means thinking beyond the taken-for-granted stereotypes of masculinity and femininity which we inherit from our culture. Even if these stereotypes happen to be consistent with the Bible, they cannot limit healthy gender expression, because they are only human cultural constructs. This is what I (Patricia) meant by “accepting some level of cross-gender behaviour or dress”, as quoted in Eternity. As we try to find a way of living which best caters to the well-being of transgendered people and their families, the way of life we come up with may involve breaking cultural behaviour stereotypes – not just to be rebellious, but to try and help everyone be as happy and healthy, in body and mind, as possible.

We need to attend to a transgendered person’s mental health before seeking to change their body. While not all transgender merely an occurrence of body dysmorphia, we need to consider it as a possibility. Many transgender people suffer other mental health issues – depression, anxiety, etc. – which need to be addressed anyway, so that they’re in a sufficiently healthy state of mind to make decisions about their body.

Even if a transgendered person’s well-being requires modifying their body, full transitioning is only one option among many – and the most extreme one at that. We can manage the dysphoria through staged intervention, beginning with hormonal treatment – which is minimally invasive and maximally reversible – through partially reversible partial transitioning – e.g. “mak[ing] some bodily adjustments (for example a hysterectomy and mastectomy)”, as I (Patricia) was quoted in Eternity – and only finally, as an absolute last resort, ending in full transitioning.

Conclusion: the transgender spectrum

None of this is meant to disparage Joan, or her church, as reported in Eternity. We believe that in Joan’s particular case, the best option may have been for Joan’s marriage to end and for her to undergo social transitioning.[9]

But we do not think this should be taken as a model response to transgender identity. Transgender identity is as varied as the people who experience it. We hope the three principles reviewed above – binary gender; family relationships; and contentment with our body – will help transgendered people, their families, and their churches, find a way of living that is genuinely good for everyone, and, in that goodness, honours God.

References

1, 9. EDITED 19 MAY. These sentences previously asserted that Joan SURGICALLY transitioned from manhood to womanhood. It has been drawn to our attention that her transitioning was SOCIAL, not surgical.
2. Now called “gender affirmation surgery”.
3. American Psychological Association, ‘Answers to your questions about transgender people, gender identity, and gender expression’ (2011), online athttp://www.apa.org/topics/lgbt/transgender.aspx.
4. Ibid.
5. K. J. Zucker, A. A. Lawrence and B. P. C. Kreukels, ‘Gender Dysphoria in Adults’,Annual Review of Clinical Psychology, 12 (2016), 20.1–20.31.
6. A. Garcia-Falgueras, ‘Gender Dysphoria and Body Integrity Identity Disorder: Similarities and Differences’, Psychology, 5.2 (2014), 160-165.
7. E. Hoekzemaa, S. S. E. Schagenc, B. P. C. Kreukels et.al. ‘Regional Volumes and Spatial Volumetric Distribution of Gray Matter in the Gender Dysphoric Brain’,Psychoneuroendocrinology, 55 (2015), 59–71.
8. While we are ‘complementarian’ in terms of male headship of churches and families, we use the term here in a broader way to refer to harmony between difference, without drawing implications for roles within the home or church. We hope our perspective will be acceptable to ‘egalitarians’ who hold to a ‘complementarity without hierarchy’.

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