Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture

The book is divided into seven chapters, and I will break them down into 3 major chunks as we discuss them. Chapters one and two deal with the definition of Gender Dysphoria (GD) and Christian perspectives on it. Chapter three to five discuss scientific study, causes, ranges, and treatment of GD. Finally, chapters six and seven handle application of the topics of the preceding chapters with a Christian response towards GD on an individual level and an institutional level. Throughout the book Yarhouse peppers in case studies, personal experience and a wide range of opinions to display what is out there while responding with acceptance and push back to the content.

The author begins his discussion with a list of terms that he will consistently reference throughout the book (Gender, Sex, Primary Sex Characteristic, etc.). He defines GD as “the experience of having a psychological and emotional identity as either male or female and that your psychological and emotional identity does not correspond to your biological sex –this perceived incongruity can be the source of deep and ongoing discomfort.” He also distinguishes this as different from transgender, “Transgender is an umbrella term for the many ways in which people might experience and/or present and express (or live out) their gender identities differently from people whose sense of gender identity is congruent with their biological sex.” He also builds upon these concepts with a plethora of different labels currently used in the transgendered community.

The second chapter starts with a mini discourse of systematic theology on GD in light of Deut 22:5, 23:1, Matt 19:12, Acts 8:26-39, and 1 Cor 6:9-10. Yarhouse moves from that discussion to bring to bear the four Acts of the biblical drama, creation, fall, redemption and glorification, on GD. He then travels on to build a three lensed framework through which we can interact and understand GD that are woven throughout the rest of the book: Integrity, Disability and Diversity. Integrity highlights that gender incongruence distorts the sacredness of maleness and femaleness. Disability sees gender incongruence as an effect of the fall and regulates it to a disability. Diversity celebrates transgendered issues as an identity and culture.

The next major section deals primarily with the science and the theory of GD. To the question of what causes GD, the consensus appears to be “we don’t know.” He continues on to define the multiple different theories, and display the strengths and weakness of each. The following chapter deals with the range of what it means to be under the designation of GD. Yarhouse deals with criteria, symptoms and things usually associated with it (i.e cross dressing) that don’t qualify for a diagnosis. The last chapter in this section is prevention and treatment and focuses most of his time talking about approaches to treating children. He mentions four current approaches for treatment: Decrease Cross Gender Identification, Watchful Waiting, Exploring Cross Gender Identification and Puberty Suppression. The last half of section two addresses treatment and ongoing care for adults, including a portion on sex reassignment surgery.

The last section focuses on developing a Christian response to GD on both the institutional and personal level. In both situations, GD is viewed as internally determined or externally determined. In the personal response section he looks at how the language of “who I am,” internally determined, vs. “how I am,” externally determined by our fallen condition, may help create categories for people as they interact with this issue. Institutions respond in two ways as well. One approach views behavior as the basis of accepting an individual with GD. You behave this way, therefore we accept you. While the other approach starts with acceptance, then addresses the behavior secondarily.

Yarhouse has brought a level of true humility to his pages as he states in the introduction “Gender identity concerns were not that well understood in the 1950s. Frankly, they are not that well understood today.” He is constantly calling people to seek to understand the different voices in this conversation so that we will be able to dialogue and find meaningful discussion. His Framework discussion was one of the most helpful aspects of the book, in that using them will help me understand how I am interacting with others based on how I see the gender and sex issues at hand. I also enjoyed his idea of redemptional space, a safe place for people experiencing GD to wrestle with it in relation to their faith and sanctification in the midst of social support from others. Such an environment will help further the conversation with those in our own churches who feel marginalized regarding this issue.

A major criticism I have in the book is his assessment that there is “a minority voice who is calling for a deconstruction of norms related to sex and gender.” The movement challenging sex and gender norms is more influential than he acknowledges and we should engage with it as such.

Yarhouse brings grace to a difficult conversation and a framework for loving people with different presuppositions and conclusions on gender issues. This is a difficult book to read as there are many moving parts but I suggest this book to whoever works in a Christian Institution or is interested in interacting more with the LGBTQ community. We are called to love the marginalized and he provides a foundation from which the believer can do that while staying faithful to God’s Story of creating mankind male and female in a world that has been ravaged by the distorting effects of sin.