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Topics: Complementarianism, The Nashville Statement, Transgenderism

JBMW 21.2 | The Clarity of Complementarity: Gender Dysphoria in Biblical Perspective

April 25, 2017

He wanted to watch wrestling; I wanted to watch the Food Network.

Seven months prior to my short-lived relationship with the guy who won the battle over the remote, I was a lesbian. My long black hair neatly tied into a ponytail. My jeans sagging just enough to show off the boxer briefs I wore faithfully. My white t-shirt covering the breasts that I worked diligently to keep flat, lest I look too much like the woman God made me. And beneath it all lay a soul that God died to save.

Born with an inherent disposition to sin mixed with fatherlessness, molestation, and limited-to-no examples of trustworthy men led me into a lifestyle of homosexuality. It was a way of life I willingly embraced. My style of dress and behavior was somewhat indicative of my personality. A girly-girl could never be used to describe Jackie. An aggressive tom-boy was more like it. Therefore, the girls I attracted were typically everything that allowed me to become what I thought I wanted to secretly be: a man.

So wrote artist Jackie Hill-Perry in a 9Marks essay about her experience of gender dysphoria and later conversion to Christ.[1] Hill-Perry’s testimony sheds helpful light on a tough issue facing the church today: how do we approach gender dysphoria? When people feel like they have the “gender identity” of the opposite sex but not the body, what kind of counsel do we provide them?[2]

Or, to sharpen the question: does the church of Jesus Christ have anything unique, anything distinctive, anything worth saying, in the modern conversation over gender dysphoria? Are we to sit quietly in the corner as this conversation transpires, offering little but affirmation?

For my part, I believe that the church has something to say on this matter. More than this, we have the wisdom our world desperately needs but utterly lacks. We are staked upon Scripture, the very power of God unto salvation, and Scripture norms our understanding of all of life. The Bible does not merely give us the discrete spiritual formula by which we may be saved. The Bible sets humanity in proper light. It tells us who made us, what we were made for, and how we are to live as enchanted but fallen creatures under the rule of God. This has great import for the conversation surrounding gender dysphoria, gender identity, and transgenderism. My view is not merely that the church has some helpful words on these convulsive matters, but that the church has the fundamental and most important testimony to offer here.[3]

In what follows, I will be addressing one specific question: is embracing the identity of the opposite sex an amoral or moral act? It has been my observation for some time now that the discussion of gender dysphoria, gender identity, and transgenderism among evangelicals has belonged more to a psychological framework rather than a moral-theological outlook. This is not to say that all who engage this matter do so from a purely or merely psychological cast; it is to say, however, that transgenderism—and related issues like cross-dressing and gender dysphoria—are sometimes approached as a subject that Holy Scripture either does not address or does not authoritatively address. To put a point on it: Scripture is not sufficient for these matters.

In this article, I will respectfully counter this view, and show that in order to minister grace and compassion to sinners like us who experience gender dysphoria, we must fundamentally and foundationally view it in light of a comprehensive moral-theological perspective. This perspective, of course, in no way denies the psychological dimensions of gender dysphoria, but it sees such dimensions as the outworking of a moral-theological choice that fallen human beings make.

My primary conversation partner here is professor Mark Yarhouse, whose book Understanding Gender Dysphoria (InterVarsity, 2015) offers much food for thought.[4] Yarhouse is ahead of his movement in addressing his subject; I am thankful for his pioneering efforts as a Christian leader. The counseling experience that Yarhouse possesses, and the compassion that he clearly exudes in his text, are commendable. I do, however, have some concerns with Yarhouse’s model. In this article, I will not attempt an exhaustive analysis of his important book, though I will summarize it. Further, I am not able in this piece to attempt a thoroughgoing overview of the causes, effects, and phenomena of transgenderism, gender dysphoria, and cross-dressing. Instead, my purpose here is to zero in like a laser on the one specific question mentioned above: does the Bible present the personal expression of gender dysphoria as a neutral matter? My answer is that it does not.

With those words in mind, we turn first to a consideration of the viewpoint advanced by Yarhouse. Following that, we shape a collegial response to Yarhouse with reference to several crucial biblical texts. We then conclude with a few brief reflections for those ministering grace to people who experience gender dysphoria. In sum, it is my hope that this brief and necessarily non-exhaustive interaction will yield a strengthening of the church’s witness and work among people who experience gender dysphoria.



Before we cover Yarhouse’s handling of gender dysphoria, we note his biblical-theological moorings. This is of great import, as we shall see. Yarhouse quotes Millard Erickson on the relevance of Scripture in his second chapter. He affirms that Scripture is “fully truthful in all its teachings” and is a “sure source of guidance” on matters of faith and life. (29) He goes on to cite Genesis 2:21-24 and note that “Christians have historically understood there to be two biological sexes, and gender sexuality is a reflection of that distinction and complementarity seen in the creation narrative.” (36) This is a sound statement.

A bit further, Yarhouse argues that while we “affirm two different sexes,” we must also recognize that “our gender identity and gender roles are often shaped by our current cultural context” such that we need to work “to avoid adherence to rigid stereotypes of what it means to be male and female.” (38) In discussing how Christians address gender dysphoria through our knowledge of the fall, he calls for believers to “retain convictions” while offering “a thoughtful response rather than a knee-jerk reaction.” (43) He goes on to say that our doctrine of redemption leads us to seek “to restore one another” and to see that “God is at work redeeming these experiences,” which includes gender dysphoria.

Yarhouse considers the conservative evangelical approach to transgenderism to be situated in an “integrity framework” that calls struggling people back to the sure coherence of God’s design. (46) He introduces the “disability framework,” which sees “gender incongruence as a reflection of a fallen world in which the condition is a disability, a nonmoral reality to be addressed with compassion,” and then the “diversity framework” and takes care to note how Christians will struggle to see either of these two systems as the overarching structure of their engagement with gender dysphoria. (see 52) He says that he sees “value in a disability framework” that views dysphoria as “a nonmoral reality.” (53) The church should “reject” the view that “gender incongruence is the result of willful disobedience,” for this places “the blame on the person navigating gender identity concerns.” (54)

The matter of shame is a controlling concern; Yarhouse indicates that people who experience dysphoria struggle greatly with shame due to the church’s expectations. In later chapters (ch. 3), Yarhouse will share that he does not believe that counselees choose gender dysphoria—they have just experienced it, though the ultimate “cause is still unknown.” (61) He encourages those dealing with dysphoria to consider a range of responses, noting that

Different behaviors or dress may not be ideal, but the person identifies the least invasive way to manage their dysphoria so that it does not become too distressing or impairing. This places such management on a continuum from least to most invasive and recognizes that hormonal treatment and sex reassignment could be the most invasive. (123-24)

Elsewhere, he calls for the Christian community to “recognize the conflict and try to work with the person and with those who have expertise in this area to find the least invasive ways to manage the dysphoria.” (144)

In framing a response for churches, he points to the need to help people belong, for this process is “messy and much more complicated” than many believers know. (148) Accordingly, the church must be careful: “Even the message of belonging can be lost when a person wants to serve—let’s say as a greeter—but is transgender and others in the church raise concerns about what message is being sent to the community.” (148) After all, “many people who know and love Christ have besetting conditions that have simply not resolved as a result of their belief in Christ as their Savior.” (148) Yarhouse holds out three basic possibilities for people who experience gender dysphoria: 1) resolving it in accordance with their biological sex, 2) engaging in cross-dressing behavior intermittently to manage dysphoria, and 3) adopting the cross-gender role through possible hormonal treatment or sex-reassignment surgery (153).  This threefold response grid should have our full attention.

According to Yarhouse, the church should avoid “rigid stereotypes” that reflect “cultural concerns” more than “biblical concerns.” (155) Such congregations risk “not being hospitable” due to their focus on “conveying biblical truths to those on the inside.” (156) Indeed, the stakes are high. If the church does not warm to an “integrated framework,” Yarhouse believes that “speaking solely with reference to the integrity framework will increasingly isolate evangelicals from a cultural context in which the diversity framework is emerging as most salient.” (160) In the end, “Christians can benefit from valuing and speaking into the sacredness found in the integrity framework, the compassion we witness in the disability framework, and the identity and community considerations we see in the diversity frame- work.” (161)

We will leave off our engagement of Yarhouse’s material here. By this point, several things are clear. First, Yarhouse believes that gender dysphoria necessitates compassionate Christian treatment. Second, he recognizes that the Scripture teaches, at least to some degree, that manhood and womanhood are God-designed realities, and that redemption is needed for broken sinners. Third, he believes that individuals experiencing gender dysphoria may choose various means of navigating their personal experience. This includes cross-dressing and even gender-reassignment surgery. Fourth, he views the actual experience—and resultant choices—of gender dysphoria as non-moral; it is not the result of “willful disobedience.”

Yarhouse has given us much to respond to, and his substantive material requires a biblical-theological answer. What follows is an attempt at such a Scripture-shaped response. We will look at five key biblical sections.



1. God makes “male and female” in Genesis 1 and 2.

Genesis 1 is not merely informative for understanding God’s plan and expectations for humanity. It is formative. The Lord creates two sexes on the sixth day. The apex of his creation is the man and the woman:

[27] So God created man in his own image,
in the image of God he created him;
male and female he created them.

Genesis 2 fills out our understanding of this divine work, as it portrays the Lord making the man from the dust of the ground and the woman from the rib of the man (Gen 2:7, 21). There is much to unpack here, but for our purposes, the Lord is showing us that manhood and womanhood are the product of his super-intelligence, and his desire to be glorified by unity (one human race) in diversity (two sexes).  The Trinity itself is the ultimate ground of this concept (Gen 1:26).  The human race is an intentional reflection of the divine symbiosis. We cannot thus see manhood and womanhood are evolutionary outcomes, but rather as the very intention of God from the beginning of our world. Commenting on this material in Genesis, Ray Ortlund says it well: “It is God who wants men to be men and women to be women; and He can teach us the meaning of each, if we want to be taught.”[5]

This passage shows us that manhood and womanhood are essential properties. We do not see them as fluid, but in fundamental terms as fixed. There is a substance, a God-made reality, called manhood, but it is not abstract, but rather embodied by men. Likewise, there is a substance, a God-made reality, called womanhood, and it is lived out by women. The fact that Genesis 2 reveals God as the maker of the sexes leaves us with the unmistakable conclusion that they are called to own their God-given identity as a matter of obedience. They cannot, for example, fulfill the dominion mandate of Genesis 1:26-28 without living in marital union. They must act as a man and a woman in their God-created marriage; they have the joyful duty of being “naked and not ashamed” in one-flesh union (Gen 2:24).[6] The man and woman have no way to fulfill this mission without full-fledged recognition of their distinctive design, their complementary physiology. Manhood and womanhood as essential realities are the ground for the survival and growth of humanity, the enactment and sustenance of marriage, and the faithful pursuit of the missio dei in its early form: populating and ruling the earth coram deo.

The significance of this material for understanding gender dysphoria is difficult to overstate. If we deny or only distantly affirm Genesis 1–2 in our handling of this challenge, we surely will have precious little guidance to offer people who experience it. If, however, we locate Genesis 1–2 as vital to our understanding of God’s purposes for humanity, we are queued up to offer real and substantial help to people who need it.


2.  The fall of Genesis 3 represents an attack—a successful one—on God’s plan for the sexes.

All sin is rooted in the real historical fall of Adam and Eve as recorded in Genesis 3:1-13. We will not interrogate this passage at length, but can note one major truth of this passage: Satan, acting as the serpent, seeks nothing less than the overturning of the created order that the Lord has established. He, a creeping thing, takes dominion over the woman, whom God made from the man’s body. The Lord had signaled to Adam by making the woman from his own flesh that he had the responsibility to protect and lead his wife, even as the Lord had made his leadership role in the marriage plain by having Adam name Eve (Gen 2:23). Yet Adam, in the moment of testing, failed to step in and crush the serpent’s head. He passively received the forbidden fruit from his wife, and then, when called to account for his double failure—the failure to obey and the failure to lead—by God, he blamed both God (who made the woman) and the woman (Gen 3:12). So it was that the fall was a successful attack on the sexes, and God’s design for them, by Satan.[7]

Here in this terrible text is the ground of all sin. Here is the ground of all manly abuse, womanly insubordination, and every other form of sin (Gen 3:16-19). Here is the ground of all disobedience and creaturely rejection of the Creator and his intentions for creation. All the sin and brokenness that we taste in this cursed world is a result of the fall. All gender dysphoria, transgender instincts, and cross-dressing impulses stem from the fall. Because of this historical testimony, Christians, and Christians alone, know why people go through confusion, pain, and rejection regarding their gender. All such broken behavior and thinking begins here, in a darkened Eden. Take away this terrible scene, and you can describe and diagnose gender dysphoria, but never truly understand and redress it.


3. God forbids cross-dressing in the old covenant law.

The point at which the Scripture most addresses the matters covered by Yarhouse comes in the Deuteronomic discussion of various non-Israelite practices.[8] The people of God, we see in Deuteronomy 22, are called to be a set-apart people in big and small ways. One of the markers of God-fearing Israelites is that they will wear clothes appropriate to their sex:

A woman shall not wear a man’s garment, nor shall a man put on a woman’s cloak, for whoever does these things is an abomination to the LORD your God. (Deut 22:5)

Yarhouse recognizes that this verse has import—of some kind—for the discussion surrounding gender dysphoria. He comments here: “The passages from Deuteronomy are certainly important, and we can see different ways in which we might understand them.” He continues by both softening and backing up this observation: “We can also see that even where we might demonstrate some restraint and caution, we see a reaffirmation of gendered distinctiveness that Christians would want to understand and support.” (31-2)

I do not know all that Yarhouse might mean by sounding out “different ways” in which this prohibition could be understood. It is true, in my view, that we are not bound by the old covenant law. That aside, the will of God regarding ancient cross-dressing could not be clearer.[9] To embrace such a practice is to commit an “abomination” against God.[10] The reason why this behavior is immoral is due to the biblical testimony referenced earlier. Because in Genesis 1–2 God created the sexes and gave them a plan for glorifying his name and subduing the earth—a mission that can only proceed by the sexes living according to God’s design—it is wrong for the sexes to blur lines that God has himself drawn.[11] Separating Deuteronomy from Genesis 1–2 leaves Deuteronomy without meaning. Connecting the two texts, however, brings fresh light. God created men to present themselves as men and women to present themselves as women. The Israelites glorified their Maker by their personal presentation. Jason DeRouchie says it well: “Those born boys are to live and thrive as boys, and those born girls are to live and thrive as girls. When corrupt desires want to alter this course, one must choose with God’s help the path that magnifies the majesty of God best, and that path is defined in Deuteronomy 22:5.”[12] So is the teaching of Deuteronomy, teaching that endures and instructs even today.


4.  Jesus affirms the goodness of man and woman in Matthew 19.

In a discussion of divorce, Jesus reinforces the ancient view of the sexes in Matthew 19. In his divine logic, to understand divorce, one must understand marriage; to understand marriage, one must understand the sexes. So we see in this text:

[3] And Pharisees came up to him and tested him by asking, “Is it lawful to divorce one’s wife for any cause?” [4] He answered, “Have you not read that he who created them from the beginning made them male and female, [5] and said, ‘Therefore a man shall leave his father and his mother and hold fast to his wife, and the two shall become one flesh’? [6] So they are no longer two but one flesh. What therefore God has joined together, let not man separate.” (Matt  19:3-6 ESV)

Too often, Genesis 1–2 matter little for evangelicals when it comes to sorting out our practical anthropology. But these chapters matter greatly for Jesus, the Lord of the church. The creational design for the sexes is marriage (a lifelong covenant most believers will enter). Marriage, however, depends on men being men, and living out God’s plan for them, and women being women, and living out God’s plan for them. If we wanted to use modern terms here, Christ—not shockingly—held an “essentialist” or “integrity” perspective on the sexes. Marriage is not whatever we make of it, just as the sexes are not whatever we perceive them to be. The sexes and marriage are fixed and formed by God.[13]

This passage has great import for understanding gender dysphoria. We are not free to remake marriage, as Jesus teaches; we are not free to remake the sexes, for marriage depends upon the essentialist foundation of two sexes. This text does not speak directly against the inborn instinct to cross gender boundaries, but it does help to build a foundation, a backdrop, by which to reason our way to a biblical perspective on “gender identity” and gender dysphoria. Those looking to the teaching of Christ himself for a softening of old covenant theology find none; instead, Jesus not merely underlines the ancient witness, but adds the fullness of his doctrine-norming authority to it.

Here we should add that the apostle Paul will build off of Christ’s testimony in Ephesians 5:22-23. The imaging of the Christ-church relationship in earthly covenantal union depends upon a fixed understanding of manhood and womanhood. Only one man and one woman are able to fulfill God’s ultimate intention for marriage, namely, the portrayal of the divine salvific drama. You cannot support Ephesians 5, and the eschatological realization of Revelation 21, without a correspondent man-woman union. By contrast, the same-sex activity prohibited in texts like Romans 1:22-27 depends upon a blurring of the sexes. There is an indissoluble connection between owning our God-given sex and entering a God-made union.

From numerous corners of Holy Scripture, we learn that it is vital that we embrace an essentialist vision of the sexes. The very glory of God, and plan of God, rests on this sturdy and beautiful bedrock. From such an understanding, we may help sinners like us experiencing gender dysphoria to understand just how much the Lord wants us to savor the goodness of his design—and just how troubling and sinful it is to reject, to not inhabit for any reason, the vision of manhood and womanhood he unfolds in the story of his people.


5. Paul calls men and women to represent their given sex in 1 Corinthians 11.

I once heard Alistair Begg say that he feared Song of Songs like no other text. Many preachers do. Another text that modern preachers might edge away from is 1 Corinthians 11:1-16, a biblical passage filled with counter-cultural insights. In this section of Scripture, the apostle Paul affirms an order to earthly marriage that is dependent upon the order and functioning of the Godhead (1 Cor 11:3). He also teaches that men and women are to present themselves in distinct ways so that the divine plan of Genesis 1–2 may be upheld:

[7] For a man ought not to cover his head, since he is the image and glory of God, but woman is the glory of man. [8] For man was not made from woman, but woman from man. [9] Neither was man created for woman, but woman for man. [10] That is why a wife ought to have a symbol of authority on her head, because of the angels. [11] Nevertheless, in the Lord woman is not independent of man nor man of woman; [12] for as woman was made from man, so man is now born of woman. And all things are from God. [13] Judge for yourselves: is it proper for a wife to pray to God with her head uncovered? [14] Does not nature itself teach you that if a man wears long hair it is a disgrace for him, [15] but if a woman has long hair, it is her glory? For her hair is given to her for a covering. (1 Cor 11:7-15  ESV)

This passage has sparked much discussion, and rightfully so. It is material to our purposes, for it shows us that the new covenant vision of the sexes is precisely the same as the old covenant vision, in that it accords with essentialism. Men and women are not the same. They are united as God’s creation but distinct from one another. Men are called to be the head of their wife even as God is the head of Christ in verse 3. They are to honor the Lord by showing the distinctive glory of their God-given sex. The glory of a woman is her “long hair” in a way that is not true for a man.

Writing in the Calvin Theological Journal, Branson Parler comments on the latter part of this section:

1 Corinthians 11:14-15 can and should be understood as stemming from the same moral logic that undergirds the biblical prohibition of same-sex sexual activity, namely, the creational difference of male and female. When Paul names same-sex sexual activity as a sin, he does so because God created humans as male and female, when Paul argues that hair length ought to properly differentiate male and female, he does so because God created humans as male and female.[14]

This is quite right. It matters for handling gender dysphoria rightly. Paul clearly taught that men and women are called to own their God-given sex in order to glorify their maker by the power of Christ in them. We do not know,  of course, the specific hair length that the apostle desires in his teaching on differentiation between the sexes. We feel some cultural tension here. But we must be careful not to press too quickly the “First-Century Teaching Only” button here.[15] An apostle of the new covenant cut in Christ’s blood reinforces the kind of sex distinctions found in the formation of humanity and the teaching of the old covenant.[16] It is to the glory of God that men and women display the distinctiveness of their sex.[17] This is a matter of obedience; it is also a matter of joyful, satisfied, God-blessed Christian living.

All through the Bible, we are confronted with an essentialist vision of the sexes. From the first pages of the Scripture, to the witness of the old covenant law, to the words of Christ, to apostolic counsel from the apostle Paul, we learn that God cares about his people owning their God-given sex. In no era do the people of God have freedom to blur the sexes; at no point in holy writ does God soften or modify his anthropological design due to overwhelming neo-pagan cultural pressure.

From the beginning of God’s creation until its consummation, the Lord has one design for the sexes, and one desire: for them to receive their body, and thus their sex, as a gift. He wants men and women to treasure their body, their bodily identity, and to honor God by owning it in a spirit of thankfulness, modesty, and joy. Being a man or a woman is not incidental to God’s plan; it is essential to it. This is true for single men and women. This is surely true for those who enter into marriage and consciously display together the theistic aesthetics of the Christ-church covenantal union. Living according to the wisdom of biblical complementarity is not an option for God’s people; it is a matter of doxological obedience.

It always will be, even unto to the end of the age, and beyond.



In the foregoing, I have attempted to build out the beginnings of a biblical-theological framework by which to understand gender dysphoria, gender identity, and transgenderism. More than this, I am trying to help believers confused by a pansexual, gender-neutral age recover a meaningful doctrine of humanity. There is no area of modern public life that more exposes the lack of theistic thinking, or even simple common-sense living, than our handling of the sexes. This is true in the secular public square; this is, regrettably, all too true even in the church. Too many Christians either take the sexes for granted, assuming they are only of the merest biological importance (the procreation and feeding of children, for example), or are of no real importance at all.

As a result, when challenging public and personal realities like gender dysphoria become a national conversation, evangelicals in particular may have precious little to say. They may have learned, however unwittingly, a hermeneutic of silence regarding such inquiries. The Bible, they may think, has no real perspective or guidance to offer in this realm. Only psychologists, therapists, and doctors can speak to anthropological issues.

Yarhouse himself voices a version of this view in Understanding Gender Dysphoria:

There is a need to balance between two hazards when we turn to the Bible to inform our discussion about gender dysphoria. The one hazard is to look to Scripture for answers it is not prepared to provide. The other hazard is to fail to critically reflect on the sociocultural context in which we live and make decisions about gender identity and dysphoria. (30)

While Yarhouse does engage Scripture in places in his book, he does not do so exhaustively or even substantially. Scripture, he implies above, “is not prepared to provide” answers to a good portion of the material dealt with in counseling those who experience gender dysphoria. Further, the implication of his words is that we are far more socioculturally influenced that we know, and thus face the frightful “hazard” of counseling people to embrace a model of the sexes that owes to cultural archetypes, not what is best for them personally.

Let us be clear: we should be aware of the potential pitfalls Yarhouse mentions. The Bible does not directly answer every tough question we face on this or any subject. Further, we do need to take care that our vision of humanity is shaped by what Francis Schaeffer called “true truth” and no other source. With these points noted, however, we need to point out that Yarhouse has not put the mark where it needs to be. Walking with people through gender dysphoria will take great care and compassion, it is true. But we have to go well beyond Yarhouse’s troubling rendering of biblical sufficiency (or lack thereof). His characterization of the Scripture’s role in handling gender dysphoria treads close to what we might call “biblical insufficiency,” in fact.

We have to take a different stance here. Those who know the Lord have no greater authority than the Bible. We must affirm with fullness of confidence the sufficiency of Scripture for all of life and godliness. 2 Peter 1:3 tells us that it is through knowledge that we possess all we need to honor Christ. 2 Timothy 3:16 reminds us that all Scripture is God-breathed and useful for teaching, training, rebuking, and instruction in righteousness. Because of this, the Christian pastor is equipped to deal with all matters that bear on life and godliness, and the Scripture is what equips him to do so. R. Albert Mohler, Jr.  speaks to our role in this tumultuous time:

We are called to be the people of the truth, even when the truth is not popular and even when the truth is denied by the culture around us. Christians have found themselves in this position before, and we will again. God’s truth has not changed. The holy Scriptures have not changed. The gospel of Jesus Christ has not changed. The church’s mission has not changed. Jesus Christ is the same, yesterday, today and tomorrow.[18]

Surely we exercise compassion in tone and demeanor and conversation when we counsel people experiencing gender dysphoria. Yarhouse calls for such a posture, and he is right to do so. But we mark this as well: truth and compassion are not distinct, but one. As we have seen, the Bible speaks to gender dysphoria, to the duty to own our God-given sex, and thus by extension to the fallen reality of the person who suffers from gender dysphoria. While making clear that such individuals require deft pastoral care, we must set our mark by this: the church of the Lord Jesus Christ has the means of helping people through these matters. It is the gospel of grace. We undertake what the Puritans used to call “the cure of souls” by the Word and the gospel. The good news of Christ is “the power of God unto salvation” and thus the means by which sinners of every kind, bearing every burden a cursed world lays upon their backs, may taste wholeness, forgiveness, and redemption to the uttermost (Rom 1:16). The church does not merely have a place in the discussion over gender dysphoria. Because we stand upon Scripture and believe it, we of all people know most of all why people experience gender dysphoria. The fall has disordered every person. We all fell in Adam; our hearts in him are “desperately wicked” (Jer 17:9). In truth, we are both the victim of sin and the willing conspiratorial partner of sin. Wickedness is done to us, a sobering and horrifying truth. We do not choose that which is acted upon us. But no human being responds to unasked-for by living in perfection. In other words, we who are victimized by sin go on to produce wickedness ourselves. If we live in a home wracked by confusion and turmoil, we may become anxious, not finding our security in God. If we are bullied, we may become angry, lashing out at others. If we are sexually abused, we may become warped, acting out ungodly behaviors.

This is the terrible chain of original sin. This is what Adam’s fall begets: the generational inheritance of a sinful and God-denying nature. No one, tragically, can avoid this linkage. No one can opt out of a depraved heart. We all die in Adam, and we may only rise in Christ.

These words bear on counseling of struggling individuals. In many situations, including the problem of gender dysphoria, it may be hard to find the precise cause and origin of our feeling that we do not fit in our body.  Skilled pastors and counselors will work hard and graciously to identify the roots of our suffering, but they will also help people see that there is a wildness that runs in our hearts, a desperate wickedness that extends not merely to behavior but to “corrupt desires” (2 Pet 2:10). As fallen beings, we may not even know we are sinning against God and dishonoring his design, but if we are missing the mark he has set for us, we are sinning nonetheless.[19]

Gender dysphoria may be the result of unasked-for events and acts. We may desire to own the body and bodily identity God has given us. But for reasons deeper than we can fathom, we may also want to cross-dress, to identify with the opposite sex in some unbiblical and unnatural way. From the smallest such inclination (a fleeting desire contained to our mind) to the greatest (undergoing a medical “transition” to take on an opposite-sex identity), we must know and preach and counsel that all such expressions run counter to the plan and wisdom of God, and demand all the repentance we can offer. We are not free by Scripture to encourage and allow individuals experiencing gender dysphoria to cross dress, to take on an opposite-sex identity, and to surgically “transition” out of our natural body. Here I must break, and break strongly, with Yarhouse.[20]

I come to this position not because of censoriousness, but because of hope. To repent of all our ungodly inclinations and desires is not to bury hope in the ground. To repent in the manner I have just outlined is the very genesis of hope. It is the beginning of newness. It is the first step in a long walk of obedience powered by the grace of Christ. It is essential material for those who experience gender dysphoria. As with all sinners, the world, the flesh, and the devil tell people who know this struggle that they cannot change, that there is no goodness in them, and that they are trapped. The journey of every man or woman to the celestial city will vary, and we all must navigate our own ups and downs on the way to the new Canaan, to lasting and permanent wholeness. But we must unmask the cultural wisdom that tells us we cannot change as no wisdom at all. To tell people that they cannot change and cannot overcome their flesh by Christ’s power is to feed them a lie, a damning and destructive lie.

Gender dysphoria may proceed from a range of fallen experiences and behaviors. Though we should carefully and compassionately probe the background and narratives of those who face it, we should also recognize that finding the root may prove difficult in some cases. Wherever we can, we unspool what people are experiencing. We ask good and searching questions; we listen well; we show empathy; we help our friends see that we are fallen just as they are. But our counsel to people who struggle with gender dysphoria is not merely psychological or emotional. It is preeminently biblical, moral, and theological. To resist God’s good design, to move out of step with God’s gift of our sex, is to dishonor and disobey God. It is only when sinners like us hear this that they can begin to heal, for they may step out of the darkness of sin and walk in the light of Christ.

Again, this flies in the face of modern secular wisdom. We are told that transgender individuals cannot help themselves, but this is not true. Transgenderism, after all, is nothing other than a belief in change. Ironically, it still holds to gender essentialism, for it is premised upon the idea that some individuals must change to a different fixed sex to become who they truly are. One way or another, it seems, humanity cannot escape a fixed vision of the sexes. The question before us all is this: will we embrace the fixed sexual reality God has given us, however little we may feel we identify with that reality, or will we adopt a different fixed sexual reality? Even a kind of neutral “genderqueer” identity—a third possibility in a world of multiplying options—is itself fixed in a way.

In truth, we have no freedom to choose from 78 different gender options, as Facebook suggests. The desire to overhaul one’s body and one’s gender expression is not a problem isolated from a lack of faith in Christ. It is sin that leads us away from Christ; it is a lack of Christ that leads us to reject all of God’s goodness, including his design for humanity; it is Christ who brings us back to God and to his creative intentions. When individuals experience the desire to act against the grain of their biological sex, they are acting out their fallenness, as each and every sinner does. They are disobeying new covenant teaching. They are, wittingly or unwittingly, moving out of step with God’s design. They are not entering a different class of human persons in doing so. They are acting out on desires from a heart that is wicked as every human heart is wicked.

In our day, the church must go back to Scripture. We must know that Scripture equips us to lend gospel aid to people who experience gender dysphoria. It is compassionate—profoundly compassionate—to do so. The cross-dresser of ancient Israel needed to hear God’s word about this behavior. The Corinthians enticed to bend their gender in Paul’s day needed to return to the clarity of God’s design. The men and women told they will find healing and wholeness in the cyclone of gender-confusion need us to speak warmly and firmly in our time. They need the clarity of complementarity; they need the gospel of transforming grace.[21]

In the end, it is not that transgenderism is a radical behavior. It is that it is not radical enough. God wishes to remake us not to a degree, but in full. This is transformation the world cannot understand, and the sinner can scarcely believe.



The story of Jackie Hill-Perry, introduced earlier, does not end with her anger and sexual confusion. It continued for a time, to be sure:

I always saw men as being something to envy. They seemed strong, powerful, in control. Femininity, or the skewed view of it that I held, seemed weak. Part of my embracing masculinity and rejecting femininity was my own way of protecting myself from pain—pain that I believed men were capable of subjecting me to. After all, that’s what my father did to me. That’s what I saw men do to my mother. That’s what I witnessed my guy friends do to the women they claimed to love. All I knew of men was that they used their manliness as a means to inflict pain. And us women—us “weak beings”—were target practice.

But then God in his mercy reached out to Jackie and saved her. As a result of her conversion, Jackie found not only her spiritual desires changing, but her anthropological desires. Here is where she finds herself today:

I haven’t been on this journey for too long, and it has definitely been a difficult one. But God is faithful. He has sent me a husband who is not a lover of wrestling but a basketball fanatic who doesn’t fight with me over the remote but humbly offers to watch Food Network with me. He leads me in humility in the small and large things of life. God has given me a gift in my daughter Eden Grace, who is slowly bringing out the gentle parts of me that I tried for so long to hide.

I am a Christian, a wife, a mother, and a woman who is being made strong in her weaknesses, and I love it.[22]

So may it be for all of us.


  1. [1]Jackie Hill Perry, “From Lesbianism to Complementarianism,” 9Marks, March 11, 2015, accessible at
  2. [2]I am using the terminology that has caught on in recent years in the broader culture. My use of these terms does not necessarily imply agreement either with the definition or the broader worldview(s) responsible for For one secular source’s definition of “gender identity,” see
  3. [3]This paper is a considerable expansion of a paper delivered at the 68th annual meeting of the Evangelical Theological Soci- ety in San Antonio, Texas (November 2016). In days ahead, I will publish a good bit more on these topics, first as part of a multiple views book on transgenderism (information coming soon), and more fully in a scholarly biblical anthropology that I am writing for B&H Academic entitled Reenchanting Humanity: Biblical Anthropology for the 21st-Century
  4. [4]Mark Yarhouse, Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture (Downers Grove, IL: InterVarsity, 2015). Due to the extensive nature of my interaction with this book, I have left page numbers in the text for ease of reading.
  5. [5]Raymond C. Ortlund, Jr., “Male-Female Equality and Male Headship: Genesis 1-3” in Recovering Biblical Manhood & Womanhood: A Response to Evangelical Feminism, eds. John Piper and Wayne Grudem (Wheaton, IL: Crossway, 2006 [1991]),
  6. [6]See Andreas and Margaret Köstenberger, God’s Design for Man and Woman: A Biblical-Theological Survey (Wheaton, IL: Crossway, 2014), 31. The authors helpfully note that “God delegated to humanity as male and female the power to rule and to procreate. He put humans on the earth to take care of it for him, requiring them to reproduce as male and female.”
  7. [7]Denny Burk insightfully points out that “The apostle Paul indicates that it was indeed the undoing of this order that was the basis for the fall of humanity into sin (1 Tim. 2:13-14).” Burk, What Is the Meaning of Sex? (Wheaton, IL: Crossway, 2013),
  8. [8]Jeffrey Tigay introduces a possible tie to ungodly Amorite sexuality in his discussion of this passage: “Pertinent to the suggestion that it was a pagan practice is a Babylonian adage, according to which a person who is apparently an Amorite says to his wife, ‘You be the man and I’ll be the woman,’” a fascinating possibility. Jeffrey H. Tigay, Deuteronomy, The JPS Torah Commentary (Philadelphia: Jewish Publication Society, 1996),
  9. [9]Robert Bratcher and Howard Hatton suggest that the prohibition could include “Anything that pertains to a man: this seems to include other things besides clothes, such as adornments and weapons.” Robert G. Bratcher and Howard A. Hatton, A Handbook on Deuteronomy, UBS Handbook Series (New York: United Bible Societies, 2000),
  10. [10]See the illuminating words of Jason DeRouchie here: “Idolatry gives glory to someone other than YHWH; witchcraft looks to means other than God’s word to discern his will or what will happen in the future, and dishonest gain diminishes the value of God’s image in others. We must conclude, therefore, that something about transgender expression and gender confusion directly counters the very nature of God.” Jason S. DeRouchie, “Confronting the Transgender Storm: New Covenant Reflections from Deuteronomy 22:5,” in Journal for Biblical Manhood and Womanhood 21:1 (Spring 2016): 65.
  11. [11]Eugene Merrill notes the problem of “mixtures” in this broader passage, suggesting that God wants creation to function as he intends it to function. “Another linkage between the verse and its context is the chiasm connecting vv. 5–8 with 9–12: dress (v. 5), animals (vv. 6–7), house (v. 8), field (v. 9), animals (v. 10), dress (vv. 11–12). There is thus a strong tie-in between death and mixtures, that is, between the expositions of the sixth and seventh The sin in improper mixtures is brought out in the laws of purity that follow (22:9–23:18).” Eugene H. Merrill, Deuteronomy, vol. 4 of The New American Commentary (Nashville: Broadman & Holman Publishers, 1994), 297–298.
  12. [12]DeRouchie, “Confronting the Transgender Storm,” 6
  13. [13]David P. Nelson says it well: “Jesus based his teaching on divorce and the sanctity of marriage on God’s purpose in creation and also affirmed that marriage is, by definition, the union of a man and woman.” Nelson, “The Work of God: Creation and Providence” in A Theology for the Church, ed. Daniel L. Akin (Nashville: B&H, 2007), 265.
  14. [14]Branson Parler, “Hair Length and Human Sexuality: The Underlying Moral Logic of Paul’s Appeal to Nature in 1 Corinthians 11:4,” Calvin Theological Journal 51 (2016): 135.
  15. [15]I concur with Mark Taylor on this point. He argues that “Paul’s use of the intensive construction (“nature itself”) and his prior appeal to the created order in 11:7–10 suggests that mere human convention is not Paul’s meaning here.” Mark Taylor, 1 Corinthians, ed. Ray Clendenen, vol. 28, The New American Commentary (Nashville, TN: B&H Publishing Group, 2014), 265–266.
  16. [16]See Anthony Thiselton on this point: “…gender differentiation relates to that which God wills, decrees, and expresses in creation or in the creation order.” Anthony C. Thiselton, The First Epistle to the Corinthians: A Commentary on the Greek Text, New International Greek Testament Commentary (Grand Rapids, MI: W.B. Eerdmans, 2000), 836–837.
  17. [17]Craig Blomberg asserts regarding verses 7-10 that “For a Christian man to appear gay or pagan dishonors God; for a woman to appear lesbian or unfaithful dishonors her husband. Obviously husbands also dishonor their wives and wives dishonor God when they act in these inappropriate ways, but if an authority structure is implicit in this passage, Paul’s less inclusive wording becomes understandable.” This is sound. Craig Blomberg, 1 Corinthians, The NIV Application Commentary (Grand Rapids, MI: Zondervan, 1994), 211–212.
  18. [18]Albert Mohler, Jr., We Cannot Be Silent: Speaking Truth to a Culture Redefining Sex, Marriage, and the Very Meaning of Right and Wrong (Nashville: Thomas Nelson, 2015), 183.
  19. [19]See Owen Strachan, “A Referendum on Depravity: Same-Sex Attraction as Sinful Desire,” Journal for Biblical Manhood & Womanhood 20:1 (Spring 2015): 24-34; Denny Burk and Heath Lambert, Transforming Homosexuality: What the Bible Says About Sexual Orientation and Change (Phillipsburg, NJ: P&R, 2015).
  20. [20]We should point out that some people are born with the condition called “intersex,” meaning that they possess from birth genitalia of both sexes. With others, I read this condition as a symptom of the fall, not as a normative state. For wisdom regarding care and counseling for individuals in such situations, see Burk, What Is the Meaning of Sex?, 169-76.
  21. [21]For more on the biblical vision of the sexes, see Owen Strachan and Gavin Peacock, The Grand Design: Male and Female He Made Them (Fearn, Scotland: Christian Focus, 2016).
  22. [22]Jackie Hill-Perry, “From Lesbianism to Complementarianism”; for a similarly powerful testimony, see Rosaria Champagne Butterfield, The Secret Thoughts of an Unlikely Convert, Expanded Edition: An English Professor’s Journey into Chris- tian Faith  (Pittsburgh: Crown & Covenant, 2014).
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