"What should you do if your son says he’s a girl?" Thoughts on Gender Dysphoria

Gender Dysphoria in the News

It seems you can’t turn on the news today and not see a headline about transgenderism.  It’s not something I would likely preach on, but I realize that sometimes there is some small wisdom in your pastor speaking to the events in the news. So, let me wade into these uncertain waters and see if I can help with this discussion. And, yeah, this is long.

But first, let me start with a little background story. A few years ago a man who was an elder on our Session (and a friend) walked into my office with his wife and said we needed to talk (we pastors know that’s almost always bad news). He told me that most all his life that he knew inside he was really a woman and that he had finally made the decision to transition into presenting as a woman and had legally changed his gender status with the state.

It goes without saying that of all the things I had prepared to help people in my congregation deal with, this was probably last on the list. I was shell-shocked and can’t even really remember what I told him and his deeply conflicted wife.

So I dove into as much literature on the subject as was available for a layman to read. I called and talked to the one Christian professor who has any expertise at all in this area. I’ve kept up with the news. So, while I’m far from an expert, I have read more and thought more about this than most people. So let me launch into a collection of thoughts and observations.

First, and perhaps most important, the people who are dealing with “gender dysphoria” (that is what it’s technically called) are for the most part a bunch of people who are deeply hurting and struggle greatly with life. I don’t believe any of them ask for this and, regardless of how other elements play out, they – and their families – need our compassion. They face a deep inner conflict and most live very unhappy lives.

Second, you need to be aware that there is a spectrum of behaviors that look related, but may not be. Cross-dressers, drag queens, transvestites, female impersonators are often responding to very different internal feeling from those who are gender dysphoric. They should not be lumped together. Nor are the gender dysphoric generally born with elements of two physical sexual identities (known as genital ambiguity or intersex). They tend to be fully biologically either male or female.

Third, in spite of the certainty that seems to be connected to current pronouncements and policies, we actually know very little about gender dysphoria. Even the people who deal with it on a regular basis admit that most of it is a great mystery. So don’t be fooled by people who are now speaking about it with great certainty, we barely understand it.

Fourth, we’re not talking about very many people on a percentage basis. Here is where our lack of knowledge really plays out, because the estimates of how many people are experiencing this vary widely. On the high side, some estimate that about .003 of the population is gender dysphoric. A more standard estimate has been 1 in 30,000; or .00003. The real number is probably somewhere in the middle, but it’s not many people we’re talking about.

Now, let me shift into what is more opinion….

1. When you stand back and look at the issue, how we have suddenly approached the issue seems silly. For a person whose DNA and body is one gender to suddenly and instantly be considered to be the opposite sex simply by saying they are kind of defies logic. Even those who go through the difficult and arduous physical transformations don’t actually change their biological genders; they merely change their bodies’ appearance. To consider Bruce Jenner a woman (indeed, a “woman of the year”) simply because he wears a dress, heavy makeup, a wig, and say he is a woman is a strange idea.

There are also people who see themselves as “gender fluid”, who may feel they are more male or female at various times, in spite of their DNA. The truth is, there is more to gender than feelings.

We read in the very beginning of the Bible: Genesis 1:27 “So God created man in his own image, in the image of God he created him; male and female he created them.”

Gender and gender differences are an integral part of the created order. Yes, too often societies have used gender differences to oppress women. But to imagine a society where we treat the world as ‘genderless’ is a triumph of political correctness over created order and common sense.

That said, there is no reason why we cannot come to some simple, reasonable, and polite accommodations for those who wish to consider and present themselves as another gender. But, they should not expect everyone else to change their view of common sense reality and normal public accommodation to fit their unusual perspective. There ought to be some reasonable middle ground.

2. It seems that, in spite of all the emotional news stories we see about the six year old boy who knows he’s a girl, it actually seems that the very best thing we can do for children with gender dysphoria is to encourage them to wait until after high school to act on any change in their appearance or bodies.

Dr. Eric Vilain is a professor of human genetics and pediatrics at UCLA and director of the Center for Gender-Based Biology. His article “What should you do if your son says he’s a girl?” is well worth a read if you want an educated, research driven opinion; (http://www.latimes.com/opinion/op-ed/la-oe-vilain-transgender-parents-20150521-story.html ). In it, he writes:

“Gender dysphoric children have not usually become transgender adults. For example, the large majority of gender dysphoric boys studied so far have become young men content to remain male. More than 80 percent adjusted by adolescence.”

Another study notes :
“Only 6 to 23 percent of boys and 12 to 27 percent of girls treated in gender clinics showed persistence of their gender dysphoria into adulthood.”  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697020/#!po=45.0000 )

To put it more simply: if a child says they believe they are really the opposite sex inside, give then a good deal of home acceptance, be sure they have psychological support, tell them they need to wait until after high school to begin to take action on it. In these cases, less than 20% will feel the same way by the end of high school.

Imagine the kids who will now will be allowed to ‘transition’ their apparent gender in grade school, taking drugs, possibly undergoing surgeries, who might find that at 18 years old they don’t feel the same way. Dr. Villand ends his article:

“…(lumping) together all therapies, regardless of their motivation, target age and method. Banning all therapists from helping families trying to alleviate children's gender dysphoria would be premature, a triumph of ideology over science.

The president can set a better example by pausing at the limits of our knowledge and encouraging scientists to collect the data we need. Until we have it, let’s be careful about telling the well-meaning parents of gender dysphoric children what to do.”

3. I think that most of the positions I read on the whole transgendered bathroom issue are simply too simple and make sweeping changes to address a very small need. Remember, there are very few gender dysphoric people.

I accept that most people with gender dysphoria who are presenting as the opposite sex are not sexual perverts with want to infiltrate a bathroom for some nefarious purpose. They just want to pee. As such, asking a biological man who dresses and looks very much like a women to walk into the men’s room is asking for all sorts of problems.

That said, opening up all restrooms or locker/changing rooms to anyone of any gender (and make no mistake, this is what these rules do) creates all sorts of problems as other will take advantage of this. Read the comments of this woman who is a survivor of sexual abuse to get a perspective you don’t hear in the news: http://thefederalist.com/2015/11/23/a-rape-survivor-speaks-out-about-transgender-bathrooms/.

Even in schools, it became obvious that in one middle school a biological boy (who is still fully anatomically male) would be allowed to use the girl’s locker room for gym class. This would allow for the circumstances where twelve years old girls could find themselves showering in the same shower room with a biological male. I just can’t imagine how anyone could think this was OK.

Honestly, schools and workplaces have been making quiet, sensitive, and reasonable accommodations for gender dysphoric people for many years and I actually think this sudden attention will tend to make things worse for many of them.

It’s not hard to ask most schools and businesses to make single person bathrooms (like the bathroom in every Starbucks I've ever been in) or changing rooms available and to ask gender dysphoric people to use them. Most schools and businesses have them available already. That’s a reasonable accommodation on both sides.

If the federal guideline was that there should be single person unisex bathrooms available for any students to use, as needed, I think we would not be having this divisive debate. But again, much of this is simply politics over practicality. One group trying to force others to adopt their new worldview of gender and sexuality, brushing aside any unintended consequences as unimportant.

I hope that we can avoid both extremes in this complicated and poorly understood issue. I do know that in our increasingly non-Christian culture that anyone who opposes the new fluid gender mantra will be branded as ignorant and “haters”. We need to be thoughtful and caring, but not fold under pressure.

Perhaps one day we’ll have a better understanding of why someone is fully and completely biologically male or female, but feels their body and their mind don’t agree. Until then, let’s not let ideology get ahead of understanding and lead us to make decisions with unintended negative consequences. Let’s be compassionate, but also practical. And let us not assume that the way God made us doesn’t matter.

Pastor Al Sandalow

Ellensburg Presbyterian