In Search of Better Stories

Understanding Gender Dysphoria


Navigating Transgender Issues in a Changing Culture.

Regarding the cultural milieu out of which this book comes Yarhouse writes:

“A culture at war politically and over morality and epistemology contributes to reducing complexity to simplicity, from thoughtful reflection to media sound bites. Perhaps it is a miracle anyone is actually helped or ministered to in that context.”

Yarhouse should be applauded for his attempt to avoid the culture war and get into the conversation so as to actually help people.  He acknowledges that research is very difficult in this field, because there is hostility for any findings that don’t agree with what people already want to believe in. Yarhouse’s call for humility from every perspective is needed.

What is Gender Dysphoria? 

Gender dysphoria means being uneasy about or generally dissatisfied with ones psychological and emotional identity as either male or female. The psychological and emotional uneasiness comes when ones identity does not correspond to ones biological or birth sex. This perceived incongruity can be the source of deep and ongoing discomfort.

How do people understand Gender Dysphoria? 

To help us understand the various lenses through which humanity attempts to navigate gender dysphoria, Yarhouse offers the following 4 frame works.

Integrity Framework Disability Framework Diversity Framework Integrated Framework
Identifies gender incongruence as confusing the sacredness of maleness and femaleness and specific resolutions as violations of that integrity. Identifies gender incongruence as a reflection of a fallen world in which the condition is a disability, a nonmoral reality to be addressed with compassion. Strong form: Deconstruction of sex/gender

Weak form: Highlights transgender issues as reflecting an identity and culture to be celebrated as an expression of diversity.

Seeks to integrate all three frameworks by keeping the integrity of sex differences, while at the same time having a compassionate management of gender dysphoria while at the same time leaving space for transgendered persons to make meaning, identity and community
It’s Wrong Its Unnatural It’s Beautiful It’s Complicated
Change your ways, gender incongruence must be resolved with ones birth sex. It’s a moral issue. It’s not your fault, you didn’t go looking for this. Dysphoria is not a moral issue, it’s a psychological problem.  Lets help you manage your dysphoria in a variety of ways. Celebrate it, publicize it, normalize it, flaunt it, shame anyone who doesn’t joyfully affirm it. Biological sex matters, however dysphoria exists and will need to be managed in the least invasive ways possible. It’s ok in our society to have diversity like this, but not as a means to deconstruct sex & gender.



Yarhouse promotes the integrated framework, as the way forward for Christian people, however, any specific details on what that might look like are sparse.

How do people with gender dysphoria cope? The paths that are before them include (1) resolving their Gender Dysphoria in accordance with their biological sex; (2) engaging in cross-dressing behaviour intermittently to manage dysphoria; or (3) adopt the cross-gender role, which may or may not include hormonal treatment and sex-reassignment surgery

What about the children? In particular Yarhouse is wary of the diversity frameworks experimentation with children. A small percentage of children experience some form of gender dysphoria growing up, for most it is resolved with their birth sex by adulthood. Studies are showing that efforts to use puberty suppressing hormones, or aggressive pro-transgender political ideology to push a child in a direction away from their birth sex are creating more suffering, not less. Indeed both the statistics and the stories that Yarhouse shared are troubling. It seems like, loving a child well, without forcing inflexible gender roles on them is probably the best way to navigate gender dysphoria in children.  I am sure Yarhouse, would approve  Lindsay Leigh Bentley’s story: I am Ryland – the story of a male identifying little girl who didn’t transition, particularly the role her father played in her development. The American College of Paediatricians recent release on the subject of gender ideology and children further bolsters what Yarhouse’s lifetime of research seems to be indicating. (note: the ACP is a relatively small organization of paediatricians that has splintered off of the larger, AAP)

Does biology even matter? —  a movement away from biology as a way of knowing or identifying is certainly underway. The international Gay and Lesbian Commission puts it this way: We make trans and intersex issues our priority because their presence, activism and theoretical contributions show us the path to a new paradigm that will allow as many bodies, sexualities and identities to exist as those living in this world might wish to have, with each one of them respected, desired, celebrated. While Yarhouse certainly recognizes the increasing complexities surrounding understanding human sexuality he is a lot more hesitant to jump into this new paradigm for knowing. To him it smacks of individual preference and cultural pressure not science. Is who we are, really a matter of what ever we might imagine ourselves to be? Yarhouse is unconvinced. But it would seem that the cultural air of the day might be putting him in a minority position. Click Here to watch a very interesting video that reveals our societies growing desire to dispense with traditional ways of knowing.

What about sex reassignment surgery? 

Yarhouse, quotes  Paul R. McHugh’s article “Psychiatric Misadventures”, in American Scholar magazine. In the article McHugh  likens sex-reassignment surgery to liposuction for anorexics:

“Is it not obvious how this patient’s feeling that he is a woman trapped in a man’s body is similar from the feeling of a patient with anorexia nervosa that she is obese despite her emaciated, cachectic state. We don’t do liposuction on anorexics. Why amputate the genitals of these poor men? Surely, the fault is in the mind not the member. Sex is a biological reality, and it is not subordinate to subjective impressions, no matter how intense those impressions are, how sincerely they are held, or how painful they make facing the biological facts of life. No hormone injection or surgical mutilation is sufficient to change that.”

Reassignment surgery does, Yarhouse admits, resolve the problem of gender dysphoria in approximately 75% of people who go through with it. However, in a recent study out of Sweden, that same demographic were found to be 20x more likely to commit suicide, have way higher mortality rates and are likely to need long term psychiatric and somatic follow up. It would seem that creating the body one would want to fit with what one imagines themselves to be does not correlate to health and well being.

What about brain sex theory? — This interesting theory posits that persons, could be female in their brain, but a male in their body, or vice versa. This is said to be a neuro-developmental condition of the brain.  The sex part of the brain, and it’s anatomical counterpart didn’t actually match up while developing in the womb.  There is no solid data on this theory to date and research is producing mixed results at best, at this point, science has no idea what causes gender dysphoria.

What is the role of Christian people? 

  1. There is high value in encouraging individuals who experience gender identity conflicts to resolve the conflicts in keeping with their birth sex if possible. Where those strategies prove unsuccessful, there is potential value in managing the gender identity conflict or concern through the least invasive means.
  2. Avoid adherence to rigid stereotypes of what it means to be male or female; recognize a range of experiences of our gender and ways of relating as gendered selves through various norms and roles that can be described along a continuum.
  3. Churches often operate with the following progression:
  • Behave — Believe — Belong. This won’t work.
  • Rather :Belong — Believe — Become

This book doesn’t have answers to complex pastoral questions, but it’s helpful in giving all a clear view of the horizon in front of us.

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