Gender Identity

So God created man in his own image, in the image of God he created him; male and female he created them. Genesis 1:27

Today’s blog on gender identity is one of those I’d really prefer not to write. I’m almost sure that I’ll offend friends on both sides of the issue. My liberal friends will find me too conservative, and my conservative friends will find me too liberal. But I’m not interested in politics and this blog isn’t a rant about biologic males competing in women’s sports. As a physician, it’s not uncommon for me to see patients who identify as the opposite gender than their biologic sex. This is relatively new territory for me, and I don’t automatically know what to say. So, here’s the question I’m really interested in – How would Jesus treat them and how does he want me to treat them? Frankly, I don’t have it figured out, but I’m working on it, and it seemed disingenuous to avoid the subject just because I don’t have all the answers. So, here goes . . .

In today’s passage, we’re told that God created two kinds of humans: male and female. A few verses later, it’s explained that A man shall leave his father and his mother and hold fast to his wife, and they shall become one flesh (Genesis 2:24). Genesis laid out the Christian foundation for our beliefs on sex and gender identity. This is the Biblical or Christian ideal – the way God made things to be in the perfection of Eden. Man didn’t remain perfect or in the Garden of Eden though. In Genesis three, we read about the fall of man – and all of nature. I won’t repeat the whole story, but basically man rebelled against God, wrecking everything. On that day, thorns sprang up from the ground. Reproduction became imperfect and painful. Sickness and disease were born. And conflict arose between man and woman.

If you buy into the Genesis story – literally or allegorically – I’d suggest that it’s not such a leap to believe that reproductive genetic errors originated that day as well. Now, those infants born with Trisomy 21 (Down syndrome) have an extra copy at chromosome 21. In Klinefelter syndrome, where most males have XY sex chromosomes, these individuals have XXY. In a condition called XY gonadal dysgenesis, the patient is genetically male but looks female and has female genitalia. There are multiple genetic and metabolic disorders that result in intersex individuals – those who have some ambiguous features when it comes to their biologic sexual identity.

For me, it’s not such a leap to believe that some individuals are also born with a genetic predisposition to feel they’re in the wrong body. Added to this are environmental factors that can affect the development of gender identity. I realize that I’m probably going to lose many of you here. Some Christians who feel that we still live in the ideal of Eden will object to people being born that way or that they don’t have a choice. Those who embrace a more liberal view will object to any suggestion that gender confusion is caused by a genetic mutation or by a pathogenic environment.

Here’s the thing though. Since the fall, we’re all broken in a myriad of ways. None of us lives up to the genetic perfection that existed in the Garden of Eden. Why would we be surprised if the idyllic relationships established by God before the fall have drastically changed since the fall?

So, the question remains. How would Jesus treat my patients and how does he want me to treat them? To answer, I must look to God’s approach to me and my struggles. God loves me and wants what’s ultimately best for me – to live in a loving relationship with him. I often prefer to go my own way though, rebelling against God’s plan. I’ve gone my way, which ultimately led to the profound self-destruction of my addiction. Then because Jesus loved me, he saved me from myself. Now, it’s my job to share with others the love that Christ has shown me.

And that’s the first thing I want to communicate to my patients – That I love and care for them. If they want to know why, I can explain that it’s because I believe that’s what God asks of me. In addiction medicine, it’s not uncommon for us to talk about our faith and so, in that context, I often share how I found faith and recovery. I tell my patients that we can know God, but to find faith and recovery, we must abandon our plan and follow his. The problem is that we all have stuff we want to keep for ourselves – stuff we don’t want God to touch or change. Guess what God wants though? Everything – particularly the stuff we want to keep. Maybe he’ll change that thing and maybe he won’t. The more you try to keep it from him though, the more that thing will keep you from God and the life for which you were created.

I don’t have it all figured out. Right now though, I do know that God wants me to show my patients the love he’s shown me. When it comes to those with gender identity issues, I honestly don’t know what God wants for those patients’ future. I really haven’t got that part figured out yet. I do know that I can’t imagine the inner turmoil that these individuals experience and I feel compassion for them. I also know that God loves them and wants what’s best for them – to live in a loving relationship with him. So, today, hopefully, I’ll communicate that message to anyone who wants to know why I try to be kind and loving to all my patients.

Author’s Note: As I said, I’m still working on this subject myself. I’d love to hear your thoughts. If you have an opinion and are willing to share it, please comment on the blog website or on Facebook.