Book Review

“Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture” by Mark A. Yarhouse

Matthew J. Tuininga
Mark A. Yarhouse
Wednesday, March 1st 2017
Mar/Apr 2017

The politics of transgenderism is removing the veil that has long obscured gender dysphoria and intersexuality from the serious thoughts of most Christians. Very few Christians have any real understanding of what gender dysphoria and intersexuality even are, let alone their cause or the trauma and isolation endured by individuals experiencing them. The church’s temptation is simply to reject anything that seems new or different. If that is all we do, however, then we will be withholding the compassionate ministry of the church from those under our care and throwing up barriers against those outside of the church—in the harshest possible way.

This is why Mark A. Yarhouse’s book Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture is a must-read. Yarhouse is a mental health practitioner with long and rich experience counseling individuals struggling with gender dysphoria. What makes this book particularly helpful is that he carefully interprets his expertise through the lens of a gospel-centered biblical theology. He does not answer every pertinent question—this is a book permeated with humility—but he does leave his reader with a better understanding of gender dysphoria and solid pastoral direction for those seeking to minister to gender dysphoric individuals in loving, Christ-like ways.

Yarhouse urges Christians not to approach the issue of gender dysphoria through the lens of the culture wars. Most people who experience gender dysphoria are not gender activists, he points out, nor have they chosen their dysphoria as an act of rebellion against God or society. Rather, they are simply children, young people, or adults who struggle in varying degrees with deep uneasiness or dissatisfaction with their biological sex. (Gender dysphoric individuals must be distinguished from individuals who are born with ambiguous genitalia or with both male and female biological characteristics, a phenomenon known as intersexuality.) Yarhouse devotes an entire chapter to demonstrating that no one really understands why this occurs; the scientific scholarship is extremely thin and complicated here. The book stresses that we should understand gender dysphoria and transgenderism as umbrella terms that encompass a seemingly infinite variety of experiences and struggles. As Yarhouse puts it, the saying goes that if you’ve met one transgender person, you’ve met one transgender person.

Beyond walking his readers through the complexity of gender dysphoria and transgenderism, he stresses the importance of being conscious about the mental framework through which we try to understand these phenomena. He points out that, while it is true that God created human beings as male and female, the curse of the fall reaches to our bodies and minds in innumerable ways that are not reducible to willful sin. While God grants us redemption, he does not offer us complete sanctification in this life. Christlikeness for a gender dysphoric Christian may not involve the overcoming of gender dysphoria in this life, but God will use a person’s dysphoric struggles to bring them to greater maturity in Christ.

Perhaps the most helpful paradigm Yarhouse offers is his distinction between the three most prominent frameworks for thinking about gender identity concerns. The first is the “integrity framework.” This views God’s creation of each human being as male and female as sacred, “an immutable and essential aspect of one’s personhood” (47). It tends to emphasize that there is one morally sound option for those who struggle with gender dysphoria, and one option alone: conformity to one’s biological sex.

The second framework is the “disability framework.” This framework recognizes that gender dysphoria runs counter to a healthy and ordinary human experience of gender but considers it to be a non-moral condition that may or may not be under some measure of a person’s control. It emphasizes that a person who struggles with gender dysphoria is not necessarily any more morally culpable than is a person with depression, autism, or Down syndrome. It calls for caring for gender dysphoric individuals with compassion and empathy.

The third framework is the “diversity framework,” which Yarhouse describes as having both a weak and a strong form. In its weak form, it celebrates transgenderism and intersexuality as phenomena to be celebrated. It encourages individuals to embrace a transgender identity in the spirit of diversity. In its strong form, it calls for the deconstruction of norms of sex and gender altogether.

Yarhouse argues that a healthy Christian perspective on gender dysphoria and transgenderism must include the strengths of all three frameworks, while avoiding their weaknesses. It must affirm the biblical teaching that God created human beings as male and female and that we are being redeemed as such. Yet it must also recognize that due to the fall, human beings struggle with all manner of dysfunction that is not reducible to sin, including mental dysphoria of various kinds. Christians need to work compassionately with dysphoric individuals, bearing their burdens without undue moral judgment. Finally, a Christian perspective must take seriously the need to affirm gender dysphoric individuals and provide meaning for them as gender dysphoric Christians while upholding biblical teaching regarding gender.

Yarhouse concludes the book with two chapters on how Christians and churches should respond to gender dysphoria and transgenderism. Because of his recognition of complexity and his pastoral sensitivity, his advice is humble and restrained. It is also sobering. Yarhouse offers numerous anecdotes that show just how ignorant and reactionary many Christians have been in this area, dismissing gender dysphoria as rebellion, responding with rejection or fear, and ultimately driving many gender dysphoric individuals out of the church altogether (and into the more welcoming and compassionate arms of the LGBT community). He centers on the need for Christians to be humble and welcoming to those who are suffering, even as they seek faithfully to witness to the truths of the gospel for human beings created as male and female in the image of God. The Christian witness cannot be driven by the reactionary impulses of the culture war. We need to struggle alongside our dysphoric brothers and sisters, bearing their burdens with them, and so fulfilling the law of Christ (Gal. 6:2).

Some readers will be troubled by Yarhouse’s reluctance to offer more specific, universal principles, or to condemn certain interventions outright, but I think that would be to miss what really drives Yarhouse’s restraint: his humility. Yarhouse warns Christians not to confuse rigid cultural or traditional assumptions about gender with God’s created order. Far too often, he argues, such assumptions have led Christians to be arrogant and judgmental against those individuals who simply cannot—for physical, psychological, or other reasons outside of their control—conform to such rigid expectations.

If anything, I wish Yarhouse had explored the biblical resources on gender and sexuality further in this respect. A reflection on the significance of Jesus’ comments about those who are eunuchs for the sake of the kingdom (Matt. 19) or Paul’s declaration that in Christ there is neither male nor female (Gal. 3:28) may have helped to sharpen a theological paradigm for how Christians should respond to gender dysphoria. Still, what Yarhouse gets right far outweighs such shortcomings. He has given the church a resource of inestimable value as it seeks to proclaim and embody the good news of Christ to the gender dysphoric.

Matthew J. Tuininga is assistant professor of moral theology at Calvin Theological Seminary in Grand Rapids, Michigan. He blogs at

Wednesday, March 1st 2017

“Modern Reformation has championed confessional Reformation theology in an anti-confessional and anti-theological age.”

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