Physician Erik Strandness explains his medical and ethical concerns about the transgender movement.
While the issue of transgender makes many in the Church uneasy, it also presents a wonderful opportunity to expand our Christian understanding of sex, gender and identity. Unbelievable? gave us just such an opportunity by hosting a discussion between Preston Sprinkle, author of ‘Embodied: Transgender Identities, the Church, and What the Bible Has to Say’, and the Reverend Christina Beardsley, a transgender priest in the Church of England. While this topic often generates more heat than light, it was refreshing to listen to a respectful conversation between two human beings sharing their hearts and not two talking heads spouting slogans.
Medical diagnosis is based on risk factors and biological sex is an important part of the equation. Pediatricians aren’t labeled misogynists because they have separate growth charts for boys and girls. Oncologists aren’t considered sexist for treating uterine cancer in women and prostate cancer in men. Neonatologists aren’t practicing racism when their data reveals that black female premature babies have better rates of survival than their white male premature counterparts. Biology matters in the real world of medicine.
I find it interesting that the most objective participant in this discussion turns out to be disease. Pathology does not bow at the altar of political correctness. It doesn’t care what gender you choose because it knows your choice is irrelevant to your biology. Unfortunately, believing you are a man trapped in a woman’s body doesn’t decrease your risk of uterine cancer. We ignore biological sex at our own risk.
As physicians, we cannot let this vulnerable group of beloved image-bearers be used as poster children for a cultural movement committed to redefining biological reality. We cannot allow ourselves to become medical tools for a transgender agenda that hasn’t been properly medically studied.
We need to come alongside those who are conflicted about their gender and compassionately help them explore the reasons for their mental – physical disconnect, but we cannot allow culture to silence potential health issues with an award and a magazine cover. I fear for the gender conflicted who are told to proudly hoist a rainbow banner when deep down inside their emotional flag flies at half-mast.
Contrary to what Beardsley stated, we don’t have enough data to recommend puberty blockers, hormone therapy or the surgical removal of normal body parts. Physicians are not engineers, they are repair men and women. Medicine needs to be very careful when it gets into the business of treating desires and not diseases. When humans try to create better living through chemicals they all too often fail to read the warning label.
Our experience with COVID has revealed just how intimately science has become intertwined with politics, which should serve as a warning when we see medical therapy tailored to meet the needs of a shifting culture. The pandemic has proven that the scientific emperor has no clothes, or is at least scantily clad. It appears that everyone has a scientific study and a personal anecdote to support their pet theory, so we need to be very careful about claiming scientific consensus when the data has not been thoroughly vetted.
Beardsley tried to make the case that there was a medical consensus concerning the role of transitioning in the treatment of gender dysphoria and pointed to several multidisciplinary transgender medical societies. The problem with these organizations is that dissenting voices are not allowed to be part of the discussion. Multidisciplinary should mean different perspectives on a problem and not the same perspective expressed in academically different languages.
Sex-reassignment surgery and hormone therapy are experimental medical measures that potentially cross a therapeutic line and need to be rigorously studied before they are embraced as the “treatment of choice” for gender dysphoria. I fear that entering into such a grand social experiment will leave behind many medical casualties.
What About the Children?
As a physician, I am very concerned that we have headed down a pathway that empowers young people, who have no concept of the consequences of their decisions, to transition. If adults feel like transitioning is the right choice for them then that is their decision, but recruiting children for this experiment verges on child endangerment. As Beardsley acknowledged, children are enormously affected by social media, so we need to be very skeptical of a fancy medical term like Rapid Onset Gender Dysphoria when all it really diagnoses is the fearsome power of social media.
We used to have court cases where explicit or hidden messages in rock music lyrics were alleged to cause young people to take their own lives or the lives of others. But we uncritically hand a flute to social media and encourage it to be the cultural pied piper. The influence of rock music on our youth may be unclear, but the power of social media is undeniable.
Sadly, we buy blue-blocker glasses to protect our eyes from the light emanating from our computer screens, but then seem unconcerned by the content that burns our young people’s retinas. Maybe the better treatment option would be to put social media into a treatment program rather than our young people.
Fighting the Wrong War
I think all parties agree that biological sex is determined by our chromosomally dictated external body morphology, so the real question confronting us is this – What is gender? Sprinkle made a point of asking Beardsley to define gender because he recognizes that gender is the core issue in this debate.
The UCSF Lesbian, Gay, Bisexual and Transgender Resource Center defines gender as:
“A social construct used to classify a person as a man, woman, or some other identity. Fundamentally different from the sex one is assigned at birth; a set of social, psychological and emotional traits, often influenced by societal expectations.”
If this statement is true, then I feel the transgender community has been deceived by the culture. If gender is truly a social construct then the dissonance they experience between their inner gender and outer biology is not really an internal struggle at all, but rather a conflict between their biology and cultural gender stereotypes. They have been cruelly enlisted to fight a proxy war over social constructs within their own souls and the battlefield ends up being littered with emotional and physical casualties.
I think the transgender community would be better served by fighting for a better cultural understanding of gender rather than battling for societal acceptance of physical transitioning. It seems to me that once you transition you have lost the war and surrendered to the societal dictates of what it means to be male or female.
I think the real problem is that people no longer have a sense of identity, and rather than finding it in the One who fearfully and wonderfully made them, they consent to a form of societal in-vitro fertilization where their identity is culturally conceived. Justin Brierley, the host of Unbelievable?, brought up a statement by Elliot Page, one of the stars of The Umbrella Academy who recently came out as transgender, in order to clarify this idea of identity or “authentic self.”
“I can’t begin to express how remarkable it feels to finally love who I am enough to pursue my authentic self.”
What is the authentic self? Is it physical or spiritual? While those outside the Church define it by how culture sees them, Christians like Beardsley and Sprinkle, must ask: “How does God see me?”
St. Paul made it clear that outward appearances such as ethnicity, sex and social standing are irrelevant to God, so maybe we need to stop defining our image bearing by physical differences and do some real soul searching. The problem is that our culture, rather than allowing us to be our authentic selves, steals our identity by forcing us to choose from a culturally approved list of sexual categories.
Sprinkle and Beardsley agreed that you cannot lump transgender people together because they all have unique stories. I think this is a very important point because in this day and age of identity politics the individual is often drowned out by the shouts of the mob and their unique voices become auto-tuned to conform to the elevator music standards of political correctness.
Sadly, our unique image bearing has been dumbed down to color, ethnicity, gender and sexual preference, none of which describes the genius of who we truly are. While these categories may be important components of our personal journeys, they do not define us. The reason this is important is because when our identities become slogans we no longer have conversations between unique individuals but rather shouting matches between ideologies. Name calling and yelling is the default mode of interaction between movements, but polite dialogue and civil debate should be the norm when two image bearers meet.
Ironically, our culture, which seems to value individuality, ends up homogenizing its citizens in identity group blenders. We are fooled into believing that identity politics will help us find out who we truly are, when in reality it only steals our identity. Instead of articulating those things that make us unique we are encouraged to chant slogans, instead of engaging in dialogue with other interesting human beings we are encouraged to lecture at them, and instead of ruminating on our own lives we are encouraged to spit at others.
Identity politics co-opts our personal biographies and uses them as infomercials for somebody else’s political product, and the more we are forced to watch them the more we believe the lie. If you insist on draping yourself in somebody else’s flag no one will ever see your true colors. You may want the world to see you as a rebel with a cause, but Jesus sees you as a sheep without a shepherd. In the first instance, you will be a dime a dozen but in the second you will be that rare lost coin that keeps old ladies up at night.
Warning! If you seek family by becoming a poster child for an organization you will end up becoming the intellectual property of those who market the ideology, and if you ever decide to break ranks you will quickly be tossed aside as a cultural orphan, such as those who publicly regret their decision to transition. The beauty of the gospel is that Jesus has already visited the orphanage and adopted you as his child. You no longer need to try and find intimacy in a political commune where a village raises a child, but rather can be adopted as a child of God where you are personally loved by your Abba Father.
Our individuality is found in Christ where there is no democrat or republican, black or white, male or female, conservative or liberal. God created you as a unique image bearer so don’t let culture make you a victim of identity theft.
Turning a Chair
I love to watch the television show, The Voice, because at the beginning the contestants are picked through blind auditions. The judges have their backs turned and cannot see what the contestants look like and have to assess their performance strictly on the basis of their singing. While their technical competency is important, what really seems to make an impression on the judges is their emotional vulnerability because what truly makes an artist is their passion and not their proficiency.
Sadly, once the contestants are chosen, the genuineness of the blind audition is replaced by a series of performances where the external appearance is put on an equal footing with their vocal skills. The unadorned expression of their souls that initially made them contestants is considered inadequate for the next level of competition and they undergo an image makeover where their genuine voice is muted by the deafening roar of a fashion statement.
I think we can learn something from The Voice by considering every first encounter with another human being as a blind audition where we turn our chair because of their willingness to bare their soul and not expose their sexuality. We, however, must also be careful not to let that unique image-bearer be hidden underneath the latest cultural couture.
Caution Steep Drop
We need to be sensitive to the exhilaration our friends and family experience when they believe they have reached the summit of the authentic self, but must also make sure that they don’t ignore the warnings of those who have a healthy respect for heights. Listening to voices outside one’s experience is not violence or oppression but rather wisdom.
I appreciated Sprinkle’s humility when discussing this topic and his admission that ultimately he can’t understand the disconnect that Beardsley experiences as a transgender person, but I think we do a disservice to our gender conflicted friends if we don’t ask important psychological, medical, spiritual and philosophical questions. We may not be able to walk in their shoes, but we would be remiss if we didn’t hike ahead of them and warn them of potential danger.