gender dysphoria


The term dysphoria is defined as a state of feeling unhappy, uneasy, or dissatisfied. When applied to gender, the uneasy feeling is related to one’s birth sex. Therefore gender dysphoria (an actual medical diagnosis) would be defined as: the experience of distress associated with incongruence between one’s birth/biological sex and one’s psychological and emotional gender identity.

Simply put, if someone experiences gender dysphoria, the gender they feel in their mind or emotions does not match up with what they observe in the mirror. Let that sink in for a moment. When someone is experiencing gender dysphoria, they are uneasy, unhappy, and dissatisfied (see above definition) with the gender that they see in the mirror. Every time they look into the mirror. Every day. This discomfort is felt in varying degrees.

Over the last few weeks, we’ve been working to define the terms sexual identity and gender identity. The goal has been to gain a handle on the language that we use so that we can speak not only accurately, but also lovingly. Taking the time to understand terms, definitions, and phrases people use conveys love and care. It is work, and it takes effort. But the Church has been down the “low effort and low understanding” path, and I would advocate for a sharp turn away from that.

I’ll start with two quick stories that have been very impacting for me. The first happened about seven years ago. I had gotten to know a young woman who identified as lesbian, was a believer, and who volunteered at a homeless shelter for teens. While being homeless as a teen has to be uniquely difficult, she shared that many of the teens were also LGBTQ and had been ejected from their homes following coming out to their families. And a large percentage of the LGBTQ youth in the shelter also either identified as transgender and/or experienced gender dysphoria. I asked her one day over lunch, “Can you explain the transgender experience to me?” She replied, “We gay people have a hard time explaining being trans—it’s just hard.” I began to wonder if I would ever get a working understanding, if this woman, who already was light years ahead of me, also struggled to grasp or explain the experience.

My second story happened at the summer camp where I work. I sat last year with a camper who was trying to explain her feelings of gender dysphoria. I had finished reading Mark Yarhouse’s book Understanding Gender Dysphoria, so I grasped some of the language she used, but I still remained very quiet as I listened to her story. The most striking thing to me was her explaining how, for years, she always showered in her swimsuit. The sight of her body was so alarming and disquieting that she remained covered whenever possible. We spent a lot of time talking that week and in the months that followed, but her wrestling remains to this day.

Since listening to this camper, I’ve had the incredible privilege of sitting with several others and hearing their stories and struggle with gender dysphoria, and it has impacted me deeply.

I have not struggled in this way. The experience of feeling as if my own body is foreign and “wrong” seems uniquely difficult. And the questions growing in me has been, “How can we, as brothers and sisters, walk alongside those struggling in this area?” “How can we pray for and encourage our brothers and sisters?” “What does it look like to thrive as a believer who struggles with gender dysphoria?”

We aren’t going to debate the existence of gender dysphoria. It exists.

Nor are we going to come to a consensus on issues like clothing, transitioning, testosterone, etc.Those are certainly hard things to wrestle through in prayer with the Lord for either yourself or for the friends that you love and are walking alongside.

What we are going to do is discuss a couple “shoes on the pavement” ideas regarding pastoral care, shepherding, or being alongside someone who daily faces uneasy and disquieting feelings related to their birth sex.

You are welcome to agree or disagree with me. I am going to simply share some of my thoughts and a few experiences that I’ve had. As I said earlier, many of my thoughts are shaped by the research and writing of Mark Yarhouse. I also owe a great gratitude to Mindy Selmys for long and honest answers to emails from a woman she’s never met, but wanted help to understand.

I would distill my thoughts into three big ideas:

  1. We must respond with humility and love.

  2. We must pay our own “brain bill” and not expect to be spoon fed information.

  3. We need to be able to discuss thoughtfully which of our ideas regarding gender come from the Scriptures versus from society.

Responding with humility is necessary. Most of us do not experience gender dysphoria, therefore we have absolutely no idea of the mental and emotional toll this takes on someone. I want to listen well and then listen some more. I want to lead with love and compassion, seeking to understand.

I remember my first night at a gathering called “Living in the Tension” sponsored by the Marin Foundation in Chicago. The topic was intersex conditions (when a person is born with sex characteristics or anatomy that does not lend to clear identification as either male or female). I spent the entire two hours in silence, trying to wrap my mind around the difficulty faced by parents following the birth as well as by the individual progressing through the stages of development. The Lord used those hours to begin to grow me in a deep sense of humility. I did not understand. I had not experienced this. I was not the expert or the helper. I’ve sat and talked with persons experiencing crippling gender dysphoria. I’ve also sat with a friend praying and wrestling through issues of transitioning. Always I want to point us both to the Holy Spirit who leads, guides, and gives counsel. I need humility and love for the people who have privileged me with their stories.

Paying the “brain bill” involved doing my own reading and research. I have not gotten all my questions answered, but I gained enough information to begin intelligent discussions using correct terminology.  Questions regarding gender, sex, transitioning, and the like can be extremely invasive. Unless I’m invited into a space to ask questions, I want to learn what I can on my own. Then from a place of humility, I can approach my friend with questions still lingering in my mind. Or better yet, I can approach my friend just to hear his/her story. I also want to always, always remember that when someone is willing to share all/part of their story, it is an incredible privilege and should be treated as a sacred space.

Lastly, I want to think through what Scripture says related to sex and gender and be able to distinguish that from what I learn from society, from media and from my home. We all have biases, stereotypes, and expectations in this area, and if I’m not really careful, I will transform those into “Scriptural mandates” fairly easily.

As I look at the Scriptures, some conclusions that I have drawn are:

  • All throughout the Scriptures God refers to Himself in the masculine (he, himself).

  • Also throughout the Scriptures the traits ascribed to God reflect both masculinity and femininity.

  • This leads me to conclude that it takes both sexes expressing masculinity and femininity in varying degrees to begin to represent the “image of God.”

  • Gender roles vary greatly from culture to culture.

  • I find it hard to “peg” a narrow definition of either masculinity or femininity in the Scriptures—rather it seems to be in the context of relationships that I would say “that response is feminine.”

  • Times when God is describing Himself as either masculine or feminine allow me to paint a picture of those adjectives with a broad brush.

    • For example, God as the avenger, the conqueror, and the leader of the heavenly armies paints a broad picture, to me, of being masculine.

    • Jesus wanting to draw those in Jerusalem under His wings paints a broad picture of femininity.

In saying these things, I also want to recognize that all of us express masculinity and femininity in a spectrum. Often in our American culture, there is little room to vary widely in our gender expression before negative comments or stares ensue. I think that’s a shame, and it pushes rigid stereotypes where they are not necessary or helpful.

Speaking of helpful, I will conclude with a few bullet points of principles that I find helpful in daily life as I interact with those experiencing gender dysphoria.

  • I do not want to assume how someone is feeling. I can ask if they are willing to share.

  • If someone asks me to use a certain pronoun, I will respect that (although I know that this is very debated).

  • If someone does not want to share their thoughts with me, I will respect that.

  • I will realize that I don’t necessarily deserve to be trusted—that is earned.

  • If I’m allowed into someone’s process of discernment and struggle in this area, I will walk humbly and sensitively.

  • Though I personally believe that when God creates a person male or female, He would desire them to work to remain in that sex, I can allow the Holy Spirit to speak individually to people and not feel stressed that I must work towards a given outcome. (So while I believe that for a female to transition to male is sin and vice versa, there is enough grey in this discussion for me to not draw a hard line in the sand related to non-medical intervention.)

I hope and pray that the Lord grows us into a people, a Body of believers, a Church that can speak into this issue with compassion, intelligence, and respect. But it will take work on all our parts.

I am praying you are willing to do this work.

Susan Titus