Intersex and the Nashville Statement

By Lianne Simon

The recently published Nashville Statement represents the beliefs of a coalition of conservative evangelical leaders regarding same-sex marriage, gender identity, and even intersex.

Although their position regarding intersex may seem innocuous enough, I want to take a closer look at its implications.

I’m a Christian housewife. My husband and I are long-standing members of conservative Presbyterian churches. We’re familiar with quite a few of the signatories of the Nashville Statement and acknowledge them to be learned Christian men.

I’m intersex. My body’s not entirely female or male. I was raised for a time as a boy. In 1974, after prayerful consideration, and with the consent of my doctors and mother, I switched to living as a girl.

The Nashville Statement repeatedly stresses a male-female sex binary and the connection between what they call biological sex and one’s self-conception as male or female (what most of us would call gender identity).

Although intersex is not directly mentioned, Article VI says:

“WE AFFIRM that those born with a physical disorder of sex development are created in the image of God and have dignity and worth equal to all other image-bearers. They are acknowledged by our Lord Jesus in his words about ‘eunuchs who were born that way from their mother’s womb.’ With all others they are welcome as faithful followers of Jesus Christ and should embrace their biological sex insofar as it may be known.

WE DENY that ambiguities related to a person’s biological sex render one incapable of living a fruitful life in joyful obedience to Christ.”

Intersex is, to the signatories, a disorder. Note that Merriam-Webster defines a disorder as a physical or mental condition that is not normal or healthy. By specifying ‘physical disorder of sex development,’ the Statement effectively eliminates any mental differences resulting from intersex, including gender identity.

How should one interpret the last line of the affirmation? How does an intersex Christian embrace their biological sex insofar as it may be known?

I struggled for a long time to embrace my intersex condition as God’s particular providence in my life rather than constantly longing to be entirely female or male. By God’s grace, I’m reasonably content with my body now. Embrace my status as a Matthew 19:12 from-my-mother’s-womb eunuch? You bet. But is that what the crafters of the Nashville Statement meant?

With their emphasis on the male-female binary, it’s more reasonable to assume that they don’t consider intersex a sex category. They seem to think that an intersex person is still either male or female, but the disorder of sex development has obscured or confused their true sex. It is that so-called true sex (i.e. male or female) that the signatories want an intersex person to embrace.

Medical studies of intersex suggest that the most reliable way of determining the gender of an intersex child is to wait until they’re old enough to speak and then ask them. But with the signatories’ refusal to recognize the biological roots of gender identity (i.e. self-conception), I must assume that the sex they wish that child to embrace would be based on some subset of their physical attributes—a reduction of the diversity of the child’s biology to fit a male-female binary.

Should we look to chromosomes for the “true sex”?

We’ve often heard that boys are XY, and girls are XX—it’s as simple as that. The reality, though, can be a lot more complicated. My chromosomes are mixed—some of my cells have a Y chromosome; others don’t.

If you consider a woman with the complete form of Androgen Insensitivity Syndrome—someone who has XY chromosomes as well as internal testes, but typical external female genitalia—the Bible would consider her a barren woman rather than a man. So the Bible doesn’t seem to care about XY or XX.

Should we look to gonads for the “true sex”?

Most boys have testes and most girls have ovaries. I had a mix of tissue types. So I guess that doesn’t help much. And, again, the Bible would consider our lady with Complete Androgen Insensitivity Syndrome and internal testes to be a woman.

Should we look to genitals for the “true sex”?

Quite a few people will say it’s all between the legs. And one could argue that the Bible agrees. But Deuteronomy 23:1 tells us that if a male cuts off his penis and testes, he’s no longer male in the eyes of the law, but a eunuch. Let me repeat that in another way—he just changed his legal sex category surgically. And in Matthew 19:12, Jesus says that some people who do that do so for the sake of the Kingdom. He also goes on to say that a lot of people just won’t understand the changing your legal sex thing.

Did I have a penis? Suffice it to say that I wasn’t capable of vaginal intercourse without surgery—as a man or a woman. I’ve had that surgery. So I’m pretty much female-typical down there now.

What then is the sex I should embrace? And who should decide?

So why did I switch from living as a boy to living as a girl? Did I one day decide to rebel against God’s clear plan? No. I prayed about it. A lot. Did I have a desperate need to be a girl? Um. No. At times being a girl sucks. Like when a man won’t listen to me because I’m a woman.

So why did my gender matter so much? Because I was close enough to death to smell the lilies at my funeral. My life revolved around my inability to function socially as a boy to the satisfaction of those around me.

I wanted a life. I wanted peace. I wanted to live for Jesus rather than die by my own foolishness. I wanted to honor God with the hand he’d dealt me.

I liked my feminine body. And—most of all—I wanted people to leave me alone.

My doctor said that with my face and demeanor I wouldn’t have any trouble being accepted as a girl. He was right. The bullying stopped.

For more than 40 years I’ve been able to focus on things other than my gender, to be a productive member of society—or as Article VI of the Nashville Statement says, to “live a fruitful life in joyful obedience to Christ.”

Who then should decide the “true sex”? Based on which sex markers?

The assumption of a true binary sex in the Nashville Statement ignores the complexity of human biology, the variety of the experiences of intersex people, and the damage done to intersex people by a medical establishment that enforces a binary sex on them.

I’m grateful that the Nashville Statement says that we who are intersex are “created in the image of God and have dignity and worth equal to all other image-bearers.” But I’m troubled that this affirmation appears to require us to give up our bodily integrity and embrace some doctor’s guess at what sex God meant us to be.

Understand this—your Nashville Statement drives intersex people away from the Gospel. Historically, doctors have castrated us, surgically assigned us a sex, given us hormones, told us lies, kept secrets from us, and caused us to live in shame. All in the name of your precious binary vision of sex.

It’s time you stood up for us rather than telling us to embrace what’s being done to us.

Lianne Simon is the author of essays and novels about what it means to live as an intersex person. An Oriented to Love alum, she is partnering with theologian Megan K. DeFranza on an important documentary about intersex and faith.

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5 Responses

  1. Michelle Bickers says:

    Lianne – A thousand thank you’s for this article. I understand so little about intersex and never realized the pain and suffering you all have endured until the last couple of months! Many years ago I read something by Bod Ekblad, in Reading the Bible With The Damned, that said every human is created in the image of God and so each person reflects a facet of God’s face. Mr. Ekblad was referring to the importance of seeing every race as a reflection of God, but as I read your words I am reminded about the importance of making sure people who are born intersex understand they are a reflection of the beautiful face of our God and should be treated with love and respect. I look forward to the documentary! God bless you for sharing this information with us.

  2. David says:

    Hi, I really appreciate a lot of this article as it has helped me to understand intersex and some of the theological thought around it. I do have a couple of question that I would appreciate the authors perspective on.

    1. While I understand that intersex definitely challenges the binary assumptions on sexuality, I still am having trouble understanding how the binary still isn’t normative. As I understand it, even if there are exceptions to the norm, that doesn’t mean that a binary still doesn’t exist. It just shows that there is biological diversity within the binary (which happens in every biological system). It also seems that theologically the stated intent in creation was binary, as Genesis quite specifically points out “God created them male and female.” While the scripture acknowledges the complexity, it still doesn’t seem to redact the original intent in creation. How would you respond?

    2. It makes a lot of sense to me that anyone who is intersex ought not to be forced to accept a reality that doesn’t honor the complexity of their biology. However, what about the complexity of sexual psychology? How would you differentiate a path forward for a person that is intersex instead of a person who is claiming to be transgender?

  3. Lianne Simon says:

    Thank you, Michelle.

    Thank you, David, for the questions. And for stating your views in a positive way.

    Is the binary normative? If you take every member of the human race and plot us all on some multi-dimensional chart that shows where each of us is for each sex parameter (chromosomes, genes, gonads, genital shape and size, etc), you’ll find that most of us cluster around two points that, for the sake of argument, I’ll call modal male and modal female. Then you can start talking about how far away from that mode each person is. There’s nothing wrong with individuals varying from that modal point. Otherwise we’d all be clones. The question is where do you draw the line between male and not-male and between female and not-female. Wherever you want to draw the lines, the distribution and the people are the same. The problem is when people try to shift the distribution and call that coercion good. And then justify it because they think God created the modal points and didn’t mean for the system to have the outliers.

    There’s nothing immoral about having a body that’s part male and part female. Nothing at all. The signatories to the Nashville Statement may want me to embrace male or female. God, however, wants me to be content with his providence in my life. I embraced being a woman and had surgery toward that end. But my body’s still intersex. I chose female over male largely because it was a better overall fit for me. But some would say I should be a man instead.

    How does God treat intersex? Or at least eunuchs?

    Isaiah 56:3-5 says

    … let not the eunuch say, “Behold, I am a dry tree.”
    For thus says the LORD:
    “To the eunuchs who keep my Sabbaths,
    who choose the things that please me
    and hold fast to my covenant,
    I will give them in my house and within my walls
    a monument and a name
    better than sons and daughters;
    I will give them an everlasting name
    that shall not be cut off.

    So, the eunuch says “Behold, I am a dry tree.” He’s infertile. A failure at being male.

    What is God’s response?
    “I will heal you.” No.
    “You’re male, so act like it.” No.
    “You deserve to be an outsider.” No.
    “You’re a result of the Fall.” No.

    God’s response is to promise the godly eunuch something better than what he’d have if her were male or female. Something better than sons and daughters.

    In Acts 8, Philip shares the Gospel with an Ethiopian eunuch.

    The eunuch says, “See, here is water! What prevents me from being baptized?”

    What is Philip’s response?
    “I will heal you.” No. Even though he just got through healing a bunch of people in Samaria.
    “You’re male, so act like it.” No.
    “You deserve to be an outsider.” No.
    “You’re a result of the Fall.” No.

    Philip’s response is to baptize the eunuch. Even though he knew that God’s Law excluded eunuchs from temple worship (Deut. 23:1).

    In Matthew 19:12, in the context of a discussion about marriage and divorce, Jesus says:

    “For there are eunuchs who have been so from birth, and there are eunuchs who have been made eunuchs by men, and there are eunuchs who have made themselves eunuchs for the sake of the Kingdom of heaven. Let the one who is able to receive this receive it.”

    Jesus could have said,
    They’re really male or female and should embrace that.
    They’re a result of the Fall.
    They deserve to have you all treat them like outsiders.

    Of all the things he could have said?
    “There are eunuchs who have made themselves eunuchs for the sake of the Kingdom of heaven.”

    You can try to erase that statement by saying that Jesus didn’t really mean eunuchs. But nowhere else in the Bible is eunuch used that way. And Jesus clearly uses eunuch in that same sentence as someone who is intersex—a physical sex difference, and he uses eunuch in that same sentence as someone who has been castrated. There’s no call to say that third type isn’t literal.

    And what does he say? That some males change their sex category to eunuch by surgically modifying their gonads/genitals. For the sake of the Kingdom of heaven.

    Even if you believe that Jesus isn’t being literal, he’s still commending some people who choose to be sexual outsiders rather than embracing what the Nashville Statement signatories would call their ‘biological sex.’

    No wonder the next thing Jesus says is that people aren’t going to understand.

    What about transgender?

    Medical studies of intersex people indicate that gender identity (i.e. that most basic internal sense of being male or female) correlates well with the level of in utero androgen exposure. But not necessarily with genital shape.

    For example, there’s a condition called Cloacal Exstrophy. In it, the abdominal wall doesn’t close, and often the genitals don’t form. Historically, for XY babies, the practice has been to castrate them, use surgery to build a vaginal canal, and raise them as girls. One recent study by Dr. William Reiner, showed that a majority of these children still consider themselves boys. Why? Gender identity is rooted in biology.

    The signatories to the Nashville Statement reject the concept of a gender identity that is rooted in biology. Even though they reference, “the God-ordained link between one’s biological sex and one’s self-conception as male or female.”

    I suspect that most Christians would agree with you regarding intersex being entirely biological and transgender being psychological. I don’t think that’s the Nashville Statement’s position, though. I think they’re at least being more consistent by taking a position that says gender identity isn’t rooted in biology in intersex either. And that, combined with their insistence on a strict adherence to a male-female binary, means that an intersex person has no say in their gender, and they must accept the horrid medical interventions necessary to make them appear to fit the binary.

    Thank you.

  4. Kurt Wolfe says:

    My wife worked for over 12 years taking care of newborns at a major hospital in Seattle, a hospital where questionable pregnancies would be sent for delivery. In all that time she only recalls that 1 baby was born whose sex was difficult to determine physically, that is one in thousands. (The figures used on the ISNA site appears skewed.)
    I think that people make a big deal about something that is not the real matter at hand. It’s not about the one in many thousands who is born with an anomaly. We are caught in a societal movement away from living God’s design of male and female. What is important is to promote little boys to be boys. However, with the disentegration of marriages many boys are being raised in lopsided female dominated homes. Many of those mothers cannot handle the male perspective and want their boys to be feminine, and they mold them toward the girls behavior. Then when they are older their mothers say they have always acted feminine. Duh! Thanks mom for confusing them. Here is a major problem.
    Today you have social scientists telling students that they choose their sex, and these students are becoming teachers of younger students, grade school even!! How stupid can a scientist be. (Well it is really not a matter of stupid as much as it is a matter of denial of God’s natural and revealed will.) These people hold a teacher or professorship in public places of learning??? Here is a major problem.
    I am no ones judge and jury, but clearly someone born with a biological make up that is messed up and who has corresponding genetic flaws will be one among many thousands of normal births. Among Christian families they should raise each child to love and follow the Lord Jesus treating each gender accordingly. This is what the Nashville Statement is promoting.
    If an adult chooses to deny what God gave them and wants to be altered then that is on them and the doctors who perform the operation. If a child needs constructive surgery at birth that is not any different than other needed surgeries on new borns. But Christian parents should never choose to turn a male baby into a female even if the male baby can never reproduce. As an adult the child can always adopt kids with his wife. However, giving testosterone treatments to a girl baby the rest of her life or estrogen the rest of a boy babies life because they were switched is only required because God’s design has been thwarted by all involved, except the baby.
    Boys who choose to engage in same sex relationships and then decide to have a sex change are again violating God’s design. Girls who follow suit are doing the same. This is a major problem. And this is what the Nashville Statement is declaring.
    The Nashville Statement wants to set a standard to follow. It is not a statement about how a person who repents would correct a sex change operation. It’s that Christians should be who they were born to be.
    I know that most people’s decisions about who they see themselves to be is largely formed by the image placed on them by their parents/guardians. It is too bad that so many parents can no longer lovingly nurture a boy as male and a girl as a female.
    I am interested in God being glorified by His images, as imperfect as we may be.

  5. David says:

    Lianna, I really appreciate your response here and have been thinking about it on and off for a couple of days. I have a couple of further follow up questions/clarifications that I will get to you soon. However, I just wanted to say thanks for the dialogue for now.

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