A Sweeping Revolution
The transgender revolution is sweeping. Deeper understanding of it requires us to consider three core beliefs that underly it and make it possible. Though often unarticulated, these beliefs are like the framing of a house, giving the transgender movement its present shape and stability.
Belief 1: My Identity Is Self-Determined
We can’t understand the transgender movement if we don’t grasp how it relates to our culture’s obsession over the question Who am I? Traditionally, our identity was something we received, and it was therefore relatively stable. Who we are was understood as determined by family of origin, nationality, biological sex, religion, and perhaps occupation. These matters were largely “givens,” arising not from feelings or decisions but from realities outside a person’s control. Things have changed. Today, identity is a do-it-yourself project based on self-discovery and self-expression.1 This gives personal feelings and decisions pride of place, and it resists external constraint. “[Here is] a view of personhood,” Carl Truman explains, “that has almost completely dispensed with the idea of any authority beyond that of personal, psychological conviction, an oddly Cartesian notion: I think I’m a woman, therefore I am a woman.”2
Belief 2: My Feelings, Not My Body, Determine My Gender
When I was in graduate school, a classmate named Taylor shared with me about his experience of gender dysphoria. Taylor was a biological male but, since early childhood, felt like a girl. Taylor was on a hormone treatment, experimenting with cross-dressing, and hoped to undergo transition surgery. One day Taylor asked me, “Do you feel like a man?” I answered, “Yes.” Taylor fired back: “What does that mean? And don’t tell me it means you like girls and sports. What does it mean to feel like a man?”
For years, that exchange troubled me. How do you describe the feeling of being a man—or a woman—and do so without reaching for cultural stereotypes about gender? In a culture obsessed with gender identity, I was shocked at how hard it was simply to describe what being a man feels like.
Finally, it dawned on me. Taylor’s question contained a significant assumption. Taylor didn’t ask me if I was a man. He asked me if I felt like a man. Subtle but seismic, this shift in verbiage reflects a core belief of the transgender movement: your feelings, not your biology, determine your identity. It’s a mind-over-matter view of people, and we may be tempted to think there’s nothing wrong with this way of thinking. But try applying this logic to age or race. What if a sixteen-year-old trying to buy a six-pack of beer blurts out to the vigilant clerk, “But I feel twentyone”? What if a fifty-year-old man pursuing a sixteenyear-old girl says to her father, “But I feel sixteen”? What if a White male applying for a scholarship designated for African Americans responds to the university examiner, “But I feel Black”?
Our society agrees—at least for now—that age and ethnic identity are determined by cold, hard facts, not feelings. You may have feelings about your age or ethnicity, but those feelings don’t determine your age or ethnic background. Why the difference in the case of gender?
Sadly, the shift toward feeling-based identity has affected the way we care for people with mental health struggles. Skylarr told me, “My therapist is on my side.” Her therapist practiced affirmative therapy, confirming Skylarr’s psychological sense of gender and encouraging Skylarr to find ways to explore and express it.
Historically, therapists practiced watchful waiting, seeking to patiently understand the feelings of those who suffer from gender dysphoria while helping them become more comfortable with their biological sex. Studies indicate that most kids—roughly 70 percent— who experience childhood gender dysphoria and are not socially transitioned outgrow it.3 Nevertheless, clinicians are under pressure to be gender affirming.4 What does this mean for patient care? This question leads us to the third core belief of the transgender movement.
Belief 3: We Find Wholeness through External, Not Internal, Change
People have long recognized their need for inner healing and change. Humans suffer from bad thinking, broken hearts, and any number of internal psychological disorders. But the transgender revolution’s path toward healing and wholeness assumes that the deep change a person with gender dysphoria needs must happen mainly on the outside. Those who suffer are told they need to change their external appearance, not their perspective.
We can’t understand the transgender movement if we don’t grasp how it relates to our culture’s obsession over the question “Who am I?”
Increasingly, gender dysphoria is treated not through counseling but through transitioning, a process that involves puberty blockers, hormone treatments, and surgeries. There’s debate within the medical community as to the age and speed at which to start a young person on this treatment pathway. Some see a quick transition as inappropriate and unsafe, but Dr. Colt St. Amand of the Mayo Clinic suggests that a long assessment period before transitioning “reeks of some old kind of conversiontherapy.” The doctor goes on:
I am less concerned with certainty around identity, and more concerned with hearing the person’s embodiment goals. Do you want to have a deep voice? Do you want to have breasts? You know, what do you want for your body?5
Even when there’s debate about the timing and pace of treatment, doctors are increasingly agreed on this trajectory: change the body to heal the mind.
Some Concerns about Transitioning
Even if one were to grant that feelings determine gender, three major concerns arise about affirmative therapy’s push for hormone and surgical transitioning.
First, affirmative therapy moves too quickly with immature kids who are easily manipulated by social pressure. Historically, gender dysphoria affected predominately males in early childhood, with a ratio as high as five boys to one girl6—and the majority outgrew it.7 Today, roughly two-thirds of cases affect biological females, with symptoms arising suddenly during the turbulent years of adolescence.8 Such changes in prevalence suggest social pressures are at play. Moreover, studies indicate that socially transitioning a child dramatically increases the likelihood gender dysphoria will persist.9 How can we justify encouraging children during years of complex development to make permanent changes based on what may be a passing phase?
Second, the methods of transitioning are inherently traumatic to our natural bodies. One can’t help but see a disconnect between our culture’s growing concern for nature—care for the environment and our embrace of organic foods that aren’t genetically modified—and the transgender movements treatment of our natural bodies. One theologian put it poignantly in a letter to the [London] Times’s editors:
[Gender transitioning] involves denying the goodness, or even the ultimate reality, of the natural world. Nature, however, tends to strike back, with the likely victims in this case being vulnerable and impressionable youngsters who, as confused adults, will pay the price for their elders’ fashionable fantasies.10
As the number of gender clinics skyrockets in the US—from one in 2007 to more than a hundred in 202211—several European nations have tightened restrictions for youth seeking to transition.12 “The risks of hormonal interventions for gender dysphoric youth outweigh the potential benefits,” said Sweden’s National Board of Health and Welfare.13
Finally, when affirmative therapy is judged by its own stated goals, transitioning hasn’t proved effective. It’s not yet known whether the short-term relief from dysphoria teenagers can feel after transitioning will persist in adulthood.14 Neither is it clear how teens will feel in the long run about irreversible changes made to their bodies. Grace Lidinsky-Smith’s story in Newsweek is sobering: “One year [after transitioning], I would be curled in my bed, clutching my double-mastectomy scars and sobbing with regret.”15Skylarr’s mother shared with me post-transition, “Skylarr still knows she’ll never really be a man, but she’s resigned to life presenting as one.” Transitioning appears to be a high-risk and often low-reward gamble.16
- Brian Rosner, How to Find Yourself: Why Looking Inward Is Not the Answer (Wheaton, IL: Crossway, 2022), 16.
- Carl Trueman, The Rise and Triumph of the Modern Self: Cultural Amnesia, Expressive Individualism, and the Road to Sexual Revolution (Wheaton, IL: Crossway, 2020), 36.
- Abigail Shrier, Irreversible Damage: The Transgender Craze Seducing Our Daughters(Washington, DC: Regnery, 2021);119.
- The American Academy of Pediatrics describes watchful waiting as “outdated” (Yarhouse and Sadusky, Gender Identity and Faith, 54), and the American Psychological Association encourages psychologists to “adapt or modify their understanding of gender, broadening the range of variation viewed as healthy and normative” (Shrier, Irreversible Damage, 99).
- Emily Bazelon, “The Battle over Gender Therapy,” New York Times, June 24, 2022.
- Yarhouse and Sadusky, Gender Identity and Faith, 78.
- Shrier, Irreversible Damage, 119, notes, “Several studies indicate that nearly 70 percent of kids who experience childhood gender dysphoria—and are not affirmed or socially transitioned—eventually outgrow it.”
- Abigail Shrier, Irreversible Damage: The Transgender Craze Seducing Our Daughters(Washington, DC: Regnery, 2021);119 and Bazelon, “The Battle over Gender Therapy.” Bazelon notes that “two-thirds” of the current caseload involves biological females.
- Kenneth J. Zucker, “Debate: Different Strokes for Different Folks,” Child and Adolescent Mental Health 25, no. 1 (2020): 36–37.
- N. T. Wright, letter to the editor, Times (UK), August 3, 2017, https://www.thetimes.co.uk/.
- Chad Terhune, Robin Respaut, and Michelle Conlin, “As More Transgender Children Seek Medical Care, Families Confront Many Unknowns,” Reuters, October 6, 2022, https://www.reuters.com/investigates/.
- Bazelon, “The Battle over Gender Therapy,” writes, “As the United States battled over whether gender-related care should be banned or made more accessible, a few European countries that had some liberal practices concerning young people seeking medication imposed new limits recently.”
- “Summary of Key Recommendations from the Swedish National Board of Health and Welfare,” SEGM, February 27, 2022, https://segm.org/segm-summary -sweden-prioritizes-therapy-curbs-hormones-for-gender -dysphoric-youth.
- Emily Bazelon, “The Battle over Gender Therapy,” New York Times, June 24, 2022.
- Grace Lidinsky-Smith, “There’s No Standard for Care When It Comes to Trans Medicine,” Newsweek, June 25, 2021, https://www.newsweek.com/.
- In the UK, one gender clinic hid reports that showed rates of self-harm and suicide did not decrease after adolescent girls were put on puberty blockers. Shrier, Irreversible Damage, 118.
This article is adapted from Does God Care about Gender Identity? by Sam Ferguson.
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