Understanding Gender Dysphoria by Mark A. Yarhouse

1genderdysreviewed by Beth Malena

If I have learned anything from the flurry of Christian responses to Caitlyn Jenner's Vanity Fair cover, it is the need for widespread transgender education in the church. The most fearful and hateful reactions betrayed a total ignorance of transgender experiences. And maybe we shouldn't blame them. While Christian books on homosexuality abound, pastoral resources about transgender people remain limited. In an attempt to fill that gap, Mark Yarhouse, a licensed Christian psychologist, offers his latest book, Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture.

Yarhouse is at his best when he is descriptive. In his first chapter, he carefully guides readers through the vocabulary of the transgender community and untangles the distinctions between sex, gender identity, and gender roles. This chapter is valuable for anyone seeking clear, concise introductory information for this conversation.

Some red flags emerged while reading his second chapter. Here, Yarhouse removes his clinician's hat and enters the realm of theology, but maintains his professional, ostensibly objective voice, which may lead readers to absorb his theology as uncritically as they do his science. He is guarded when unpacking the few Bible passages that directly address cross-gender behavior. But when he discusses how gender dysphoria fits into the context of the broader gospel narrative, he seems to presume what "the Christian" believes about gender without acknowledging the reality of diverse views.

Yarhouse's theological anthropology depends on the concept of gender complementarity. For him, "the view that 'gender enables unity,' that is, that 'man and woman become one flesh,' is an important biblical theme." This perspective is common among evangelicals, but to imply that this is the only Christian understanding of gender is misleading. Today, more and more Christians dispute that gender complementarity is the primary priority of the creation account. Theologians like James V. Brownson in his book, Bible, Gender, Sexuality: Reframing the Church's Debate on Same-Sex Relationships, present valid alternative interpretations of Genesis 1-2 that prioritize kinship and covenant. Additionally, significant exceptions to the gender binary exist in Scripture, such as eunuchs, who find increasing welcome and dignity through the arc of the biblical story, inspiring hope for gender minorities today. Yarhouse unfortunately only spends two skeptical paragraphs discussing them.

In that same chapter, he outlines three frameworks through which people might view gender dysphoria: the integrity framework (male-female bodily distinctions are sacred), the disability framework (gender dysphoria is a non-culpable reality deserving compassion), and the diversity framework (transgender experiences are to be celebrated as part of diverse humanity). These categories are beneficial for clarifying how different starting points produce different approaches to transgender people, but things fall apart when Yarhouse attempts to combine all three into an "integrated framework." The result is not true integration, given the impossible task of harmonizing such contrasting views; it is a tentative hybrid of "integrity" conservatism with "disability" compassion, mixed with warnings that transgender Christians might be lured in by the gender-deconstructing "diversity" crowd if churches do not provide them with an adequate sense of identity.

Yarhouse's final chapter, directed toward Christian churches and institutions, is a breath of fresh air.  Though he persists with generalizing references to "biblical absolutes" and "biblical perspectives," his focus here is on inclusion.  He believes we need to prioritize helping people "belong" before expecting them to "become," acknowledging that "become" won't always mean "conform to birth gender," and that growing in Christlikeness does not necessarily correlate with a decline in gender dysphoria.  I particularly appreciated Yarhouse's plea that churches avoid responding to our increasingly gender-fluid culture by over-correcting and promoting stricter gender stereotypes.  He promotes clarity, relationality, humility, and gender-neutral bathrooms, among several other practical suggestions for institutions.

Chapters about causation, prevalence, and treatment are commendable for their thoroughness, summarizing a breadth of scientific studies, though some savvy readers will question Yarhouse's dependence on controversial, disputed work from researchers like Zucker and McHugh. Yarhouse's own therapy prioritizes helping gender dysphoric patients reconcile with their birth gender. If that fails, he suggests they consider less invasive solutions first, cautioning them not to take lightly the use of hormones and surgery, which could sound patronizing to transgender readers who have spent entire lifetimes weighing these options.

If cisgender Christians learn to see transgender Christians as perpetually disabled and in need of their benevolence, they risk forgetting that they are siblings in Christ, valuable community members, with gifts and knowledge to contribute.

I'm grateful that Yarhouse dignifies transgender people by modeling the use of preferred pronouns, and he promotes family bathrooms in churches. I applaud him for trying to convince Christians to stop seeing transgender people as depraved sinners. But replacing "depraved sinners" with "unfortunate victims of mental illness" will do little to keep transgender Christians engaged in churches, much less to attract new transgender members. I believe Yarhouse's good intent is to promote compassion, but when his doctor-patient framework is transplanted into the "priesthood of all believers," that compassion too often becomes condescension. If cisgender Christians learn to see transgender Christians as perpetually disabled and in need of their benevolence, they risk forgetting that they are siblings in Christ, valuable community members, with gifts and knowledge to contribute. Even in this book, transgender Christians are not empowered to contribute their own voices; their stories are almost exclusively paraphrased as case studies.

While cisgender medical professionals have their place in this conversation, transgender voices are indispensable to our collective understanding. If we can transcend our overwrought fears of "gender deconstruction" and humble ourselves to listen, transgender Christians might become our teachers, giving us crucial insights about our God who transcends gender. Please do not read this book without also seeking out perspectives of transgender Christians themselves. I recommend Austen Hartke's excellent "Transgender and Christian" video series and Lisa Salazar's autobiography, Transparently.

Beth Malena's life has been transformed through friendships with people on the margins. Her journey of faith and work has brought her into relationship with refugees, Native Americans, people who are poor or who struggle with mental illness or addictions, and many others who have felt excluded by the church and society. Today she works with the Toronto-based ministry New Direction, where she offers pastoral care and facilitates connections and understanding between LGBT Christians, their families, and their churches.


Recommended on same topic: "The Unclean Spirit of Gender Ideology" by Melinda Selmys

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1 Response

  1. Thorin25 says:

    Thank you for the review. As a Christian and someone who has struggled with these issues myself, here is my review – https://healingcd.wordpress.com/2017/08/15/book-recommendation-understanding-gender-dysphoria/

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