The Calvin College Talk on Gender Dysphoria

The AV staff at Calvin College have been working on a better quality video of the talk I gave titled Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture. Here is the video. It is about an hour with some Q&A from the audience:

Several transgender and gender variant people and families who have loved ones who are under the transgender umbrella have reached out to me following the talk. They are hungry for resources and for a way forward.  If I were to summarize the themes from those exchanges so far (and some are ongoing), I would say they are centered on (1) self understanding (How do I understand what I am going through?), (2) the faith community (How do I have more constructive discussions with pastors and others in my church?), and (3) How do I improve existing relationships with loved ones? In some ways these are similar to what we reported in our research with male-to-female transgender Christians a few years ago. I think these themes also line up with what I have seen in counseling individuals, couples, and families over the years.

These are important, significant discussions for every individual and family that is navigating this terrain. So many feel alone and unsure how to even begin a conversation. The section from the presentation on different “lenses” through which different stakeholders “see” the issues and people seemed especially promising to them. There is certainly much more that can be done to be a resource for responsible care in these three areas, and I hope that ongoing discussions and future discussions will be a part of seeing that come about.

 

 

 

 

Understanding Gender Dysphoria – Pt 2

Calvin College has hosted a Sexuality Series for several years now, and just this past week I had the opportunity to participate in the series and to speak on the topic of our series: Gender Dysphoria. If you would like to watch that talk, you can see it here. It will provide you with a sense for where the series is headed.

In the past several years our culture has changed dramatically in terms of popular cultural and professional acceptance of transgender persons. In the popular culture, we see this in the recent Time magazine cover and popularity of shows that have transgender characters. Our culture has in many ways moved past the afternoon television shows that capitalized on “shock and awe” in their presentations, where you might see producers orchestrate a dramatic confrontation between a male-to-female transgender person who once dated a woman and is now surprising her with her true sense of self. These colorful presentations in the media were once an expression of almost gawking at the phenomenon, but they did not reflect the cultural sea change that would soon follow.

In the professional literature, the Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5) reflected a shift away from Gender Identity Disorder toward the use of the phrase Gender Dysphoria to reduce stigma. Actually, several steps in the new nomenclature were intended to reduce stigma. The first is the shift from an emphasis on identity as the disorder to the emphasis on the dysphoria or distress associated with the gender incongruence for many people who report it. The other was the wording to allow for someone to no longer meet criteria following a transition.

In my forthcoming book, Understanding Gender Dysphoria, I define numerous key terms. Let me cover three here:

Gender dysphoria: The experience distress associated with the incongruence wherein one’s psychological and emotional gender identity does not match one’s biological sex.

Transgender: An umbrella term for the many ways in which people might experience and/or present, express (or live out) their gender identities differently from people whose sense of gender identity is congruent with their biological sex.

Transsexual: A person who believes he or she was born in the “wrong” body (of the other sex) and wishes to transition (or has transitioned) through hormonal treatment and sex reassignment surgery.

There are expressions of what we often refer to as gender variance that would not necessarily report gender dysphoria. For example, most people who have an intersex condition (e.g., congenital adrenal hyperplasia), do not report gender dysphoria. They may have a higher incidence rate than those who do not have an intersex condition, but gender dysphoria is not a given for someone with an intersex condition. Nor would it be common for a person performing drag. That person may not even think of him or herself as transgender, and many in the transgender community would not think the transgender umbrella covers most drag kings and queens.

So it’s complicated. This is an area that requires time and patience to unpack and truly understand—and even then, we do so with humility given how much we do not know at this time. But Christians are going to need to spend some time on this topic–to spend time in careful reflection as we think about the best way to engage the broader culture while simultaneously considering how to come alongside people within our own Christian communities who are navigating this terrain.

As I bring this post to a close, I want to point out that there has been one study published of male-to-female transgender Christians. My research team conducted this study a couple of years ago. It was a study that addressed gender identity and religious identity in terms of personal faith, God, and the local church. Perhaps surprisingly, some transgender Christians shared that their gender dysphoria led to a strengthening of their personal faith; others reported a past struggle with their faith, and still others left the organized religion with which they grew up. For some, the challenges they faced brought them closer to God, but others reported a strained relationship with God because of their gender dysphoria. What was particularly common were past conflict with the local church community or the persons and leaders who represent these organizations. I’m sure I’ll come back to this study in a future post, but needless to say, it provides an interesting perspective on the topic.

Most people approach this topic with one question in mind: What are you for (and what are you against) in terms of resolution? I have not found this question to be exceedingly helpful over the years I’ve worked with gender dysphoric persons. As I’ve mentioned previously, it is unclear to me at this time that there is any one outcome that is ultimately satisfying to everyone who has a stake in these discussions. It is such a rare condition that we little good research from which to draw strong conclusions, and I have known people who felt gender dysphoria so strongly that they felt that nothing less than their sanity and their life was at stake. They desperately sought a resolution to a dysphoria that caused them significant distress and impairment. This is not an argument that they then should pursue the most invasive procedures, but I can understand and empathize with that decision, as painful as it often is. Rather than reject the person facing such conflicts, the Christian community would do well to recognize the conflict and try to work with the person to find a path. There is an opportunity here to learn much more than we know at present, and we would do well to enter into the discussion with patience and humility, as we balance multiple perspectives on how best to resolve what people often report to be an impossible situation.

 

Understanding Gender Dysphoria – Pt 1

A male-to-female transsexual Christian, who I will refer to as Sara, opened an exchange with me with a reflection on her decision to pursue hormonal treatment and sex reassignment surgery: “I may have sinned in the decisions I made; I’m honestly not sure that I did the right thing. At the time, I felt excruciating distress. I thought I would take my life. I can’t imagine going back. What would have me do?”

That is a pretty disarming exchange. This is not someone who has made a commitment to a worldview and philosophy bent on deconstructing meaningful categories of sex and gender. If you had come to argue with Sara about a sexual ethic, you would not have found an opponent. She might have agreed with you, in fact. How does a person like Sarah maintain a posture of repentance and a soft heart toward God in light of the impossible decisions she faced? Is there a Christian community that is willing to stand next to her in these impossible circumstances?

As a psychological condition, Gender Dysphoria is such a rare condition that we little good research from which to draw strong conclusions. I have known people like Sara who experienced gender incongruence and a rise in the associated distress so strongly that they felt that nothing less than their sanity and their life was at stake. They desperately sought a resolution. This is not an argument that they then should pursue the most invasive procedures or cross-gender identification, but I also acknowledge that I understand and empathize with that decision, as painful as it often is.

I am going to start a series titled Understanding Gender Dysphoria in anticipation of a forthcoming book that is scheduled to be published by InterVarsity Press Academic in July of 2015. It is titled Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture. In it I define key terms and explore the experiences of those who are accurately diagnosed with Gender Dysphoria and discuss some of the controversies in prevention and resolution of gender identity conflicts, as well as offer an integrated framework for how Christians might respond.

Here is the description from IVP Academic:

Few topics are more contested today than gender identity. In the fog of the culture war, complex issues like gender dysphoria are reduced to slogans and sound bites. And while the war rages over language, institutions and political allegiances, transgender individuals are the ones who end up being the casualties.

Mark Yarhouse…challenges the church to rise above the political hostilities and listen to people’s stories. In Understanding Gender Dysphoria, Yarhouse offers a Christian perspective on transgender issues that eschews simplistic answers and appreciates the psychological and theological complexity. The result is a book that engages the latest research while remaining pastorally sensitive to the experiences of each person.

In the midst of a tense political climate, Yarhouse calls Christians to come alongside those on the margins and stand with them as they resolve their questions and concerns about gender identity. Understanding Gender Dysphoria is the book we need to navigate these stormy cultural waters.

This is a difficult topic for many people. Evangelical Christians, in particular, are not adequately prepared to meaningfully engage the topic of Gender Dysphoria today. What interests me most is the opportunity to help individual Christians (pastors, parents, friends) and the church position themselves to help those who are navigating the difficult terrain of gender identity concerns and engage the topic in a more constructive manner.

If the topic interests you, the book can be pre-ordered through IVP or Amazon. In the meantime, join me in a discussion of Gender Dysphoria over the next several months. Also, if you are in the Grand Rapids, MI, area, join me at Calvin College on February 5th as I’ll be speaking on Gender Dysphoria for their Sexuality Series.

 

Entering 2015

As many of you know by now, I am not particularly good at blogging. Everyone has already posted their top posts from 2014, and I am just now getting around to looking at the stats. For those who are interested in that sort of thing, it looks like the top post was this most recent one, On the Expectation of Change.This was the post suggesting we show more caution in how we interpret findings from the study I was co-author of on people attempting to change sexual orientation through involvement in Christian ministries. The main point was about how those findings might inform ministry and the expectation of change among Christians.

The other popular posts are actually older posts that have staying power (this is what wordpress tells you to give you some encouragement). These include a couple of posts on Value Conflicts in Counseling and the five-part series on Mixed Orientation Marriages.The former dealt with several legal cases in which graduate students refused to work with gay clients on goals that went against their religious beliefs and values and cited sincerely held religious beliefs as their rationale. The latter is a popular series on several studies we have conducted on people in mixed orientation marriages, which are marriages in which one person is a sexual minority (attracted to the same sex independent of behavior or identity label) while the other spouse is heterosexual.

Also popular is a seven-part series on the Psychology of Judgmentalism and a more recent post On Telling People How to Navigate Sexual Identity. The Psychology of Judementalism series was based on a book and opening reflections I was doing in a course on Ethics. The other post had to do with various resolutions people consider when they experience a conflict between their religious identity and sexual identity.

In any case, those are a few highlights if you are new to the blog. As we enter 2015 I anticipate new posts on a range of topics, including gender dysphoria, as I have a book that is due out in June/July of this year. I’ll blog a little more on that as we get closer to the publication date.

 

On the Expectation of Change

A recent World magazine article centers on the hiring of Julie Rodgers at Wheaton College. Julie is a self-described celibate gay Christian who works as an associated in the chaplain’s office at the college. I consider Julie a friend, and I am an alumni of Wheaton (’98) and I have served as an adjunct professor there for the past decade. I also blog occasionally at Spiritual Friendship which is mentioned in the article.

I was surprised to see my research cited in the article about the hiring of Julie. The way the argument was set up was to express concern for Wheaton as the flagship evangelical college hiring a staff member who is known to be gay and who actually uses the word “gay” as an adjective to describe herself to others. Julie had spent about 10 years in Exodus International attempting to change her sexual orientation, and I have spoken with Julie on several occasions about this. She is gracious and positive about her own personal experience with the Exodus member ministries she participated in. However, speaking graciously about involvement in a ministry and declaring that it made her straight are two different things. She, like many other people who have attempted to change, did not experience a dramatic shift in her attractions as a result of ministry.

In my view, the article would serve the Body of Christ better if it were about this reality.

I am co-author of the study cited in the World magazine article about Julie and Wheaton. That study was published in book form in 2007 and then again as a peer-reviewed journal article in 2011, after six years of attempted change. If I were to summarize my view of the findings, I would put it this way: While on average people reported a modest shift along a continuum of attraction, most people did not experience as much of a shift as they would have liked, particularly as people entering ministry envision change as a 180-degree shift from gay to straight.

The author of the World magazine piece frames the study as being about “showing that changing sexual orientation is possible.” A more accurate way to think about the study is this: “Is it ever possible that sexual orientation can change?” This is important because it leaves open the question of what causes the change. The original study was launched at a time when the broader cultural consensus seemed to be that sexual orientation is an immutable characteristic. That is, that sexual orientation is unchanging. Period. We asked whether it is ever possible to witness change in sexual orientation over time and whether such experiences were intrinsically harmful. We documented average changes along a continuum. Averages that suggested that for some those shifts were more significant; for others, not significant (or no change).

The study was an outcome study. That is, we were studying whether changes in orientation occurred; we were not studying the process of change. We do not even know if it was involvement in the Christian ministry that contributed to the changes that were documented. It is possible that the changes that were documented were the result of natural fluidity or some other variable that we did not account for. There was certainly (for some) changes in identity and behavior, as we discussed in the journal article about the study.

Why is this important? It is important because the evangelical Christian community has an opportunity to think carefully about pastoral care which is intimately connected to the message it sends to people who are navigating sexual identity concerns in their lives. We can affirm a God who can bring about the miraculous while also being gracious to those who do not experience the miraculous. We do this all the time when we pray for people for any number of concerns that are brought to us. But in this one area–homosexuality–there seems to be an added expectation that the person receive experience significant shifts in the direction of their sexual attraction or assume a posture of ongoing attempts to alter patterns of attraction even when such efforts have not produced the shift the person has sought.

I once wrote about a man in his forties who came to see me in therapy. He had been to a Christian ministry for the past three years to try to change his attractions. After the first year going through a popular 30-week curriculum, he shared with the ministry leader that he still experienced same-sex attraction. The leader encouraged him to go back through the curriculum for a second year. He did. At the end of that year, he approached the ministry leader with the concern that while he had grown in his relationship with Christ and sincerely appreciated the fellowship with others, he was still experiencing same-sex attractions as strong as ever; what should he do? He was advised to go back through the curriculum for a third time. It was only after the end of the third year that he came to see me to discuss other options. We discussed how he thought about his same-sex sexuality and various postures he could take in light of his personal moral convictions. We discussed an ongoing posture of attempting to change; we discussed living with an enduring condition; we discussed a “thorn in the flesh” that he has asked to be removed many more times that Paul could have imagined. These different conceptualizations were difficult for this particular man. He had been led to believe that it was a personal, spiritual failure to come to terms with his same-sex attractions as something that would not go away–as something he would not experience a shift around. Such a belief drove him to depression and shame.

Yet he is not alone. Many people do not experience a dramatic shift in their experiences of same-sex attraction despite years of ministry involvement. This man spoke to me about three years. Julie in her speaking references 10 years. The question for the church is: What kind of pastoral care will the church provide in cases in which there is an enduring experience of same-sex attraction? A related question for pastoral care is to reflect on what is the nature of sexual attraction? Is it just a desire for genital sexual intimacy or is it broader than that? How we reflect on these questions will inform our care for one another. Although space will not permit an adequate exploration of that question, we need to at least ask: Is it a moral failure of the person to come to terms with an enduring condition? Although the issues are not the same, it was not in the case with Paul; I don’t believe it was a failure in the case of the man I discussed. I also don’t believe it is a failure on the part of Julie. In fact, I believe these are more likely outcomes than the testimonies of dramatic change. I don’t want to discourage a person from attempting such change, but I also want to be careful not to convey to that person that there worth before God is wrapped up in their capacity to experience sexual attraction to the opposite sex. I know countless men and women who are no more Christlike by virtue of their attraction to the opposite sex.

Also, how ought a person describe him or herself? Same-sex attracted? Gay? Struggler? Sexual minority? Overcomer? There are about as many names as there are opinions on the matter. I find there is a point of diminishing returns for me as someone who is not navigating this terrain to act as though I have the final word on how another brother or sister in Christ ought to use language. This is an internal discussion among followers of Christ who are talking to one another about the benefits and drawbacks of various words or phrases. One observation: younger people–Christians and nonChristians alike–are using gay as simply an adjective to describe their sexual orientation.

The church may benefit from finding  a way to hold onto different ministry approaches. Some will place greater emphasis on a more complete and dramatic shift in patterns of attraction. Most people will not experience this. Others will turn to changes in identity and behavior and language will be important here, as certain words may be experienced as indicative of identity. Still others will pursue celibacy as a way to live faithfully before God; different language may match up with their ways of naming their experience. We have to find a way to extend one another grace. To suggest that all people who experience same-sex attraction have to achieve dramatic shifts as a testimony to the power of God will be unnecessarily divisive, a poor model of pastoral care, and a sure way of driving people out of the church altogether.

Note: This is cross-posted with SF.

 

Transgender & Gender Variant Youth

Over the past two years I’ve been speaking with colleagues at the National Youth Worker’s Convention. This past year I was speaking with Julie Rodgers who works in the chaplain’s office at Wheaton College. We typically co-present a 5-hour intensive, followed by a 1.5 hour breakout workshop and a 30 min interview at the Idea Lab. It has been interesting to reflect on the Frequently Asked Questions (FAQs) that come up in these settings. What are youth ministers really dealing with? What questions do they have? When we conducted a recent study of youth ministers, we did hear interest in learning more about theories of causation and change; however, we asked if they were interested in those questions. What I find interesting is to conduct a workshop and hear what those in attendance actually have on their minds. We did receive a couple of questions like that, but I would say that one common and fascinating theme was actually not about homosexuality or sexual identity. It was about transgender issues and gender variant behaviors.

The question would be something like this: “Our youth group frequently breaks up into smaller groups with guys in one room and girls in another. Well, we recently had a teen visit our youth group who was born male but identifies as female. This teen’s preference is to break out with the females. What should we do?”

The prevalence estimates on transgenderism put it at quite a bit less frequent than sexual identity based on self-report of attractions, behavior, or even identity labels. As we discussed it afterward, it may be more of a reflection of the anxiety of the presentation than the actual frequency of the presentation. However, in one session, this was the actual question asked, so it has occurred in at least one of the youth groups represented at the conference.

I resist the temptation to offer “three easy steps” to navigating gender identity questions that arise in youth group. Transgender and gender variant presentations are going to be a challenge for the church moving forward. It is clearly going to be the next cultural wave that will crest soon over conventionally religious people in a way that will stretch them to think through their own views of the topic, how best to create a place for young people who are navigating that terrain, and how they wish to relate to a broader culture that does not support their presuppositions.

There is a calculus that is involved that is difficult to calculate. One the one hand the Christian community wants to be able to affirm male and female distinctions rooted in the creation narrative and thought to be part of a larger theological anthropology. Evangelical theologians tend to cite these distinctions as important for a Christian ethic centered on both sexual behavior and gender identity, although these are two different discussions in some important ways.

Having acknowledged the challenge, let me say that youth ministers want answers. What do we do? This is part of the reason why I am drawn to speak at these events. No fluff. I think the most thoughtful accounts from the Christian community will balance both teaching and ministry; theology and pastoral care–in a cultural context that will increasingly not share an identical point of reference with respect to sex and gender norms. As I said to the group in attendance, I don’t have a list of what you should do. I would fall back on a more careful assessment of what is being presented and what is being requested. And churches vary considerably in how they intend to approach divisive topics, how they relate to their local community, and so on. These differences are due to location, theological assumptions, personnel, and key stakeholders. For example, I know of many churches in southern California, for instance, that are trying to be missional in their attempts to accommodate a range of requests that might come from transgender and gender variant persons. Certainly if your youth group is taking that posture in the context of a larger church that has more of a missional approach, such a stance will inform your options and interests in that moment.

A little background: transgender is an umbrella word for many ways in which people might experience themselves as different than those who biological sex and gender identity correspond to establish a kind of congruence. A person could have a strong cross-gender identification with a desire to cross-dress; some may cross-dress to manage dysphoria while others to express their sense of self; still others might experience their gender identity as residing along a continuum rather than a cross-gender identification (a person might think of themselves as genderfluid or genderqueer). Those who are transgender who experience significant gender dysphoria have a serious condition that would likely have brought them under the care of a mental health professional (and possible multidisciplinary professional team including medical professionals). This condition is quite rare and I would want to seek some consultation from those who are working closely with the teen who is demonstrating a preference for one break out group over another (or whatever the question is that we are discussing).

So the place to begin is actually not in offering a definitive answer to where the person should go during a breakout. A place to begin might be, How well do you know the person and how do you best understand the request in the context of your larger mission? That will require a relationship–a sustained relationship in which discussions take place about the experience navigating gender identity questions or concerns. I could imagine working out different solutions with different youth given a number of potentially important variables. Do those in ministry (and parents who support them) have the patience for that kind of ministry care? I hope so. If the church hopes to provide a place for young people to navigate difficult issues in a changing culture, we will have to be rather thoughtful and mature in our responses.

For those who are interested:  I have been working on a book on the topic of transgender and gender variant persons that is due out in 2015. It has been fascinating to conduct background research in this area, as well as to draw upon clinical experiences over the years. I hope it will at least provide information and an integrated framework that will inform how a youth minister or pastor responds to transgender and gender variant people in a culture that is changing in terms of attitudes toward sex and gender norms and presentations. I’ll do a few posts on the topic as we get closer to the release date.

 

 

NYWC in Atlanta

This week I’ll be joined by Julie Rodgers to speak at the National Youth Workers Convention (NYWC) in Atlanta. We did this earlier this fall in Sacramento. In California, we provided a 5-hour pre-conference workshop titled, “Sexual Identity and the Youth Minister: Walking with LGBT Youth.” We’ll do the same in Atlanta. We plan to go back and forth explaining research conducted through the Institute for the Study of Sexual Identity of some of the key considerations for Christian youth who are navigating sexual and gender identity questions. Julie will share from her own experience and connect the dots from what others tell us in surveys and interviews and the lived reality as someone who has been navigating this terrain for many years.

The developmental context is probably the most important thing I try to help youth ministers understand. There are specific milestone events that many LGBT adults identify as important in their own journey. We discuss those, as well as opportunities to explore meaning-making during this stage of life. We will also cover social support and healthy coping. We will try to stay practical and focused on the specific needs of those who are attending.

We also plan to open with a little data from a survey we conducted of youth ministers and how they approach the topic. There is a lot I could say about that study, but it was interesting the young people want to talk about sexual identity. They want to be able to approach youth ministers. As a youth minister, you don’t have to be a certain age or have certain life experiences or hold a certain theological position or have sufficient schooling/education for a young person to come to you. None of those things were connected to having youth come forward to share their same-sex sexuality or gender identity.

The second talk is an abbreviated version of the 5-hour talk. It is titled, “Teens and Sexual Identity.” This is a much less ambitious workshop that goes about 1.5 hours. We’ll discuss the conflict between religious identity (as a Christian) and sexual identity (in light of same-sex sexuality) that a percentage of young people experience. We will again discuss the context of identity development, as well as the messages that a young person hears about identity and community from their faith community and from the LGBT community.

Much of what we share comes from content published in Understanding Sexual Identity: A Guide for Youth Ministry (Zondervan). In fact, this book was written in conjunction with talks given at this same conference last fall. So if you are looking for information on the topic of sexual identity and Christian youth, you might find that book helpful.