Understanding Gender Dysphoria: Book Review
Last November I had the opportunity to attend a lecture given by Dr. Mark Yarhouse[1] at an event sponsored by the Center for Faith and Culture at Southeastern Baptist Theological Seminary.[2] Yarhouse is Professor of Psychology at Regent University. His topic was on how we should engage issues of gender identity with the gospel.
This topic is so important because the church must be equipped in the areas of sexual ethics. Seven months after Yarhouse’s lecture, the controversial “House Bill 2” passed by the North Carolina General Assembly. The church should be alert and ready to respond.
The rapid pace with which many of these sexual issues have progressed is alarming. This is why I am grateful for Mark Yarhouse’s book, Understanding Gender Dysphoria. In this book Yarhouse discusses questions of sexual identity, including transgenderism and gender dysphoria.
Summary
In chapter one Yarhouse notes that the present cultural context has shifted towards a more supportive attitude of gender identity labels. He shows how this change is seen in professional literature when the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) moved from the phrase “Gender Identity Disorder” to “Gender Dysphoria.”
In light of the cultural shifts that we’re seeing, what is the church doing to minister to those who feel the distress associated with gender identity, particularly within the transgender community? These are complex issues and Yarhouse carefully urges “church leaders to spend time in careful reflection as we think about the best way to engage the broader culture from more of a missional approach while simultaneously considering how to come alongside people within our own Christian communities who are navigating this terrain.”[3]
In chapter two Yarhouse examines what a Christian response to those experiencing gender dysphoria should be. One helpful way of navigating through sexual ethics is to see how they fit into God’s redemptive plan. This metanarrative is often called Creation, Fall, Redemption, and Glorification (or Restoration). Careful thinking through gender identity issues will require a biblical view of the Fall and its effects on our lives and in our world. Nothing is exempt from the reach of sin, including our bodies and minds. Yarhouse writes, “The fall can be seen in the lack of congruence between birth sex and psychological sense of gender identity, particularly when this is strong enough to cause distress and impairment.”[4] However, gender incongruence in a fallen world is not beyond the realm of redemption and sanctification found within the person and work of Jesus Christ.
Yarhouse explains three different frameworks for thinking through gender identity issues. These frameworks appear throughout the book and offer the reader lenses through which to view the topic:
The integrity framework – Yarhouse defines the integrity framework to be a lens that views gender identity conflicts as threat towards the male-female distinction. Proponents of this view focus primarily on passages such as Genesis 2:21–24 that highlight the complementary, yet distinct genders of male and female God ordained as sacred.
The disability framework – This framework sees gender dysphoria primarily “with reference to the mental health dimensions of the phenomenon.” Yarhouse writes that some Christians may resonate with this framework because they see gender dysphoria “as a result of living in a fallen world in which the condition—like so many mental health concerns—is a nonmoral reality.”[5] However, Yarhouse notes that Christians “may recongnize the utility of the disability framework insofar as the person has not chosen to experience gender dysphoria, and the disability framework evokes in the Christian a greater sense of compassion and empathy.”[6]
The diversity framework –This framework views transgender issues “as something to be celebrated, honored or revered.”[7] This framework seems to explain the rapid pace in which many sexual ethic issues are moving. Yarhouse explains, “The diversity framework highlights transgender issues as reflecting an identity and culture to be celebrated as an expression of diversity.”[8] The question worth considering is whether a Christian can endorse this framework? Yarhouse considers two forms of the diversity framework: a strong form, which seeks to deconstruct standards related to sex and gender; and a weak form, which recognizes themes of identity and community.[9] The strong form would obviously create problems for Christians, but some may be hesitant about accepting the weak form as well. Yarhouse encourages the reader to reflect on how the weak form of the diversity framework recognizes “meaning-making structures for identity and community.”[10]
Are Christians obligated to cast their lot for one of these frameworks, and if so, which one? Yarhouse explains, “If Christians simply shout “Integrity, integrity, integrity!” and “Sacred, sacred, sacred!” in discussions about gender dysphoria, we will fail to appreciate ways in which these other frameworks inform how people who experience gender dysphoria navigate difficult and quite complex decisions throughout their lives.”[11]
To that end Yarhouse advocates for a more integrated framework of all three mentioned above. Instead of limiting ourselves to just one, we should identify the strengths from each framework and seek to apply them in how we minister to those with gender identity issues.
In the following chapters, Yarhouse looks at some of the causes that may lead to gender dysphoria. He then considers some recommended deterrence and treatments for parents navigating these challenging situations. In doing so Yarhouse engages the three frameworks again to show how they can help parents understand gender incongruence.
Chapters six and seven conclude the book by equipping the reader to think towards a Christian response. These two chapters are filled with pastoral sensitivity and the encouragement to come alongside those navigating gender identity concerns. Yarhouse writes,
Rather than reject the person facing such conflicts, the Christian community would do well 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 and to offer compassion and mercy when that has not been possible.[12]
Yarhouse uses the phrase “least invasive ways” to consider treatment for those struggling with gender dysphoria. However, his prescriptive writing in those areas raises some problems.
Critique and Recommendation
I found much of Yarhouse’s advice to be applicable to other ministerial areas besides gender identity issues. For instance Yarhouse explains that the “gender identity concerns, while important, may not be the greatest concern in this person’s life. . . . Too often Christians can focus almost exclusively on the very aspect of the person with which we are most uncomfortable.”[13]
In two separate places, Yarhouse does not completely rule out surgery or hormonal treatment in some cases as the “least invasive way.” He writes,
Different behaviors or dress may not be ideal, but the person identifies the least invasive way to manage 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 would be the most invasive.[14]
Similarly, Yarhouse explains, “There is potential value in managing dysphoria through the least invasive expressions (recognizing surgery as the most invasive step toward expression of one’s internal sense of identity).”[15]
While I understand that compassion should dominate our thinking in terms of ministry, no surgery or hormonal treatment can reassign gender or help relieve gender dysphoria. To undertake the Creator’s role and distrust His provision in the assignment of genders is a mark of the same kind of limitless pride that got humans thrown out of Eden.
One area that I mention by way of recommendation was how Yarhouse explains how the church could minister to the transgender community. He explains two differing church models and how they relate to the transgender community. The first is described as a “traditional evangelical church,” which focuses on “behavior first, followed by belief in Christ and a sense of Christian community.”[16]
The second model, called a “missional church, “focuses on first being in a relationship (belong) then moves toward an opportunity to live one’s testimony to an unbelieving culture (believe).[17] I recommend this model simply because I believe that it aligns more with Scripture. All of us are broken (Rom. 3:23) and in need of a Savior, so that we may become more like Christ. When the unbeliever in 1 Corinthians 14:20-25 entered the church, he did not need a behavioral change, but a new heart. Yarhouse admits that this model is “messy” and “complicated,” but I would have liked to have seen more practical steps for churches trying to foster this particular environment.
Conclusion
Francis Schaeffer once said,
The church today should be getting ready and talking about issues of tomorrow and not about issues of 20 and 30 years ago. . . . If we found it tough in these last few years, what are we going to do when we are faced with the real changes that are ahead?[18]
Much backlash has resulted over the controversial House Bill 2 lately—and rightfully so. But if Christians are placing their faith in the legislative process without proactively considering how to minister in areas, such as “Christian campgrounds, faith-based institutions of higher education, churches, not-for-profit entities that provide humanitarian relief worldwide,” then something is missing.[19]
Are we prepared to develop a relationship with someone who is experiencing gender dysphoria for the purposes of the gospel? This is a question that we will need to be thinking through carefully. For this reason I would highly recommend Understanding Gender Dysphoria by Mark Yarhouse.
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[1] For more information about Mark Yarhouse’s work, readers can revisit Jackson Watts essay, Homosexuality in Pastoral Perspective.
[2] Listen or watch full lecture here: http://multimedia.sebts.edu/?p=6619.
[3] Mark A. Yarhouse, Understanding Gender Dysphoria (Downers Grove: InterVarsity, 2015), 22.
[4] Ibid., 41.
[5] Ibid., 48.
[6] Ibid., 49.
[7] Ibid., 50.
[8] Ibid.
[9] I was a bit hesitant when I first read the explanation of the diversity framework. I think Yarhouse recognizes this hesitation that many may have in the Christian community with this framework. He explains later in chapter two that “the diversity framework speaks to identity. It validates a person’s experience.” Understanding at least a weak form of the diversity framework will be important for the local church in terms of redemption. The community of local church believers will need to be a place filled with grace and maturity that recognizes and validates a person’s experience.
[10] Yarhouse, 53.
[11] Ibid.
[12] Ibid., 144.
[13] Ibid., 128.
[14] Ibid., 123–124.
[15] Ibid., 137.
[16] Ibid., 147. Yarhouse diagrams the traditional evangelical church as Behave -> Believe -> Belong. He then diagrams a missional church as Belong -> Believe -> Become.
[17] Ibid.
[18] Francis Schaeffer, The Church at the End of the Twentieth Century (Wheaton: Crossway, 1970), 81–82.
[19] Yarhouse, 159.
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