Responding To Gender Dysphoria

How should society respond to those suffering from gender dysphoria? For example, when a man claims that he is really a woman trapped inside a man’s body, how should we respond? I want to suggest that there are two responses that are equally inappropriate. The first is to effectively say, “Don’t be ridiculous! Snap out of it!”. Such a response does not acknowledge the depth of suffering and confusion that these people are dealing with. Those with gender dysphoria who eventually decide to transition to the opposite gender have generally suffered with the condition for many years. Their suffering is real and their pain and confusion is deep. Condemning them or glibly dismissing their condition and expecting them to somehow “snap out of it” demonstrates a complete lack of understanding of the depth of the condition and the desperation of those who suffer from it.

The other inappropriate response lies at the opposite end of the spectrum; to agree with their delusion and facilitate their transition to the new gender. I use the word delusion quite deliberately. I want you to think about this issue logically. Let us be clear about what the person suffering from gender dysphoria is claiming. For example, take the case of the man who thinks he is really a woman trapped inside a man’s body. He is saying that the male body in which he finds himself is not the real “him” (I will continue to use the male pronoun for this person). The real him is actually a woman, and the male body within which he resides is the wrong body – an outer shell that he inhabits; a body that is a mistake because it does not match the real him.

Stay with me. Let’s follow this through to its logical conclusion. If this is true, then we have to ask, what is this esoteric “real me”? Where does it reside? What is it? Is it the person’s spirit? If that is so, who was responsible for making this terrible blunder? Who put the wrong spirit into the wrong body? God? The angels on the production line? This view of the immaterial “real me”  would seem to completely contradict the stated atheism of many transgender people who do not believe in God or the existence of an incorporeal spiritual dimension at all

Most people would point to the “real me” as being the person’s mind; his personality and thoughts. But where does this mind reside? How did this person’s mind get into the wrong body? How was a male body given a female mind? Surely the mind resides in the brain. So, does this mean that a male body has been given a female brain? Is there such a thing as a male brain and a female brain?

Neuroscience studies of brain anatomy indicate slight variations between male and female brains (mainly in terms of size) when averaged across the whole population. But these differences are meaningless at the level of an individual in terms of diagnostic distinctiveness. For example, males, as a whole cohort, tend to have a slightly larger amygdala and hippocampus than females. They also have a slightly denser right frontal lobe, whereas females have a slightly denser left frontal lobe. These are general, very slight differences when the whole population is considered. But at an individual level, there is considerable variation within both genders. The size and density of male and female brains can be charted on overlapping normal distribution curves, in exactly the same way that most other physical characteristics can. A man with a smaller brain is not a woman, and a woman with a larger brain is not a man. They are simply normal variations within the normal distribution curve of their respective genders.

Furthermore, the same sex hormones and chromosomes that are responsible for determining the gender of the body are also equally formative in the creation of the brain. The developing foetus does not have two conflicting sets of hormones and chromosomes which develop two distinct components of their physiology – one set for the brain and one set for the body. Additionally, there are the documented instances of identical twins where one twin subsequently becomes transgender and the other doesn’t. Identical twins have anatomically identical brains, so, clearly, the concept of the wrong gender brain in the wrong body is completely without scientific merit.

So, where is this “real me” that sufferers of gender dysphoria speak of? Where does this “real me” reside? It resides only in their imaginations. It is a delusional construct, without definitive physiological pathology.

As soon as I say this, someone will point to extremely rare conditions such as Klinefelter Syndrome where a man is born with an extra X chromosome, and has XXY instead of the usual XY. But this affects only 1 in 1,000 boys, and interestingly, the vast majority of them consider themselves to be male and never transition to female.

Others will point to hormonal imbalances in some people. For example, I reported several weeks ago on the case of Max Blythin who transitioned to Maxine and is now literally smashing it out of the park playing women’s cricket in England. This week, in response to worldwide criticism of him being awarded Women’s Player of the Year, Max / Maxine revealed to the media that he has extremely low levels of testosterone – a condition he was born with – which precipitated him transitioning to become a woman. In other words, Max is saying, “I have low testosterone levels, therefore I am really a woman.” No, Max. You are not a woman. You are a man with low testosterone. And the treatment for that is really simple: Testosterone supplementation. The answer is NOT injecting yourself with female hormones, growing your hair long and calling yourself Maxine. Because even though you do all that, every cell in your body is still XY chromosome. You are a male.

Gender dysphoria – the belief that you are actually the opposite gender to your body – is completely delusional thinking. In that sense, it is a form of mental unwellness. The Diagnostic and Statistical Manual of Mental Disorders (DSMMD), which is the internationally recognised gold standard diagnostic tool for the identification and treatment of mental illness, published in conjunction with the American Psychiatric Society, categorises gender dysphoria as a treatable mental disorder. (Although the transgender movement is currently applying pressure to have this classification altered).

Gender dysphoria is a product of mental unwellness, not some kind of cosmic mismatch between mind and body.

How are we to respond to all this?

We need to understand that people who believe they are one gender trapped inside the body of the opposite gender are profoundly unwell. They are as disturbed as the sighted woman who believes she is really blind, or the able-bodied man who believes he is really disabled. In saying this, there is no judgmentalism, no condemnation. Transgenderism is a sickness, not a sin. On the whole, these people have not deliberately chosen to spurn their physiological gender, in some kind of recalcitrant rebellion against God or society. No. They are profoundly disturbed individuals whose “unwellness” creates significant internal turmoil and distress. As a Christian, my response towards transgender people ought to be one of compassion, not judgment. To condemn someone because they suffer from gender dysphoria makes as little sense as condemning someone because they suffer from depression or schizophrenia. They are sick, not bad.

At a deeper theological level, we need to view Transgenderism through the lens of the opening chapters of Genesis. Gender dysphoria and transgenderism are another reminder to us of the ubiquitous and profound consequences of The Fall.  The world in general, and people in particular, no longer function perfectly as we once might have. Each one of us is inherently flawed. We have inherited an intrinsic unwellness that manifests itself in all sorts of ways; insecurity, paranoia, various anxieties, depression, narcissism, dishonesty, arrogance, pride, selfishness, … etc. Some of us are fortunate, because our flaws are less obvious and more socially acceptable than others.  It is this paradigm of The Fall and its consequences that lead me towards compassion rather than judgmentalism. For I am a fallen creature too, who will struggle with elements of my own unwellness all the days off my life.

On the other hand, my compassion arising from this Biblical paradigm does not mean that I condone the current societal push to accept transgenderism as a normal and healthy expression of the diversity of human sexuality. The early chapters of Genesis describe the creation of two clear genders. In the beginning God created us male and female. He did not create a mixed category of half and half. The Bible gives no indication that God might, on occasion, intentionally create a person of contradictory or confused gender, or that one of the angels working on the baby production line might periodically lose focus and put the wrong spirit in the wrong body. Gender fluidity or gender confusion cannot be substantiated from the Bible as part of God’s perfectly created world. To promote transgenderism as a normative variation of healthy sexuality would be to deny its inherent sickness – a sickness that is both mental and spiritual.

Sadly, the current push to portray transgenderism as normative, healthy and even desirable, is gaining almost exponential momentum. This is seen in the proliferation of gender-neutral toilets in public facilities, the growing number of people transitioning to the opposite gender and even a growing movement of new parents refusing to identify the gender of their babies on birth certificates and giving them gender-neutral names in order to allow them to one day choose their own gender.

All these politically correct trends deny the inherent unwellness of transgenderism, and seek to normalise it within society. The condoning of gender reassignment (either behavioural or surgical) fails to recognise gender dysphoria as the mental illness that it is. Gender reassignment makes as little sense as setting up voluntary amputation clinics for people who would like to transition from able-bodied to disabled.

When we condone gender transitioning, we reinforce and legitimise a mental illness.

Just this week, 61-year-old Debbie Karemer, of Hemel Hemptstead, England, admitted that her 17-year attempt to live as a male was a terrible mistake. She had her breasts removed, received male hormones and had a fake penis surgically attached to her body, but is now “de-transitioning”, saying:

“I’m a woman. I’m not meant to be a bloke. I’m trapped. I feel completely mutilated. It’s a complete mess ― where do you even start? I just regret the decision.”

If only someone had counselled Debbie and helped her through her mental unwellness all those years ago, instead of assisting her in her delusion, she would have been spared the anguish she now faces.

Mental illness needs to be treated, not legitimised.

Of course, treating any kind of mental illness requires, firstly, the recognition that the illness exists. People who deny that they are sick, cannot be treated. In that case, all we can do as Christians is love them and ask God to draw them to the Saviour. Because, ultimately, that is what is needed. Jesus came to seek and save those who are lost. And He is still seeking them today. All of us are equally in need of His mercy. In the end, it is not a person’s gender or sexuality that will determine their salvation, it is whether they have come to know their Creator God, through the grace and mercy of Jesus Christ His Son. Let’s not lose sight of this as we seek to engage in informed dialogue on this complex ethical issue.

In my next post, I will evaluate the genetic and hormonal arguments often used to justify the normalisation of transgenderism.