What is Gender Dysphoria?

Here is a talk I gave at Q Denver titled, What is Gender Dysphoria?  It is being featured on Q Ideas. I try to explain the phenomenon, as well as provide a little background information on theories of etiology, prevalence, and management strategies. Also, check out the talk by Melinda Selmys, who shares about her own experiences with gender dyshporia.

After we both spoke, Gabe Lyons invited us to join him for a time to Q & A from the audience. This was a helpful opportunity to reflect further on gender dysphoria:

To give you a little background on Q Ideas, here is a description from their website:

Q was birthed out of Gabe Lyons’ vision to see Christians, especially leaders, recover a vision for their historic responsibility to renew and restore cultures. Inspired by Chuck Colson’s statement, “Christians are called to redeem entire cultures, not just individuals,” Gabe set out to reintroduce Christians to what had seemed missing in recent decades from an American expression of Christian faithfulness; valuing both personal and cultural renewal, not one over the other. Re-educating Christians to this orthodox and unifying concept has become central to the vision of Q.

Together, we explore topics that fall into four broad themes: culture, future, church, and gospel. Q facilitates the investigation of deeper engagement and responsibility in each of these areas. As we continue to work through these ideas on a deeper level, so grows our commitment to equipping innovators, social entrepreneurs, entertainers, artists, church-shapers, futurists, scientists, educators, historians, environmentalists, and everyday people to do extraordinary things. At Q Ideas, you’ll see a broad spectrum of content represented in our small group curriculum, essays, videos, blog articles, and podcasts. These are all contributed and commissioned to shed light on unique areas of culture and the church.

An Exercise in the Removal of Saccharine

more-reflections-smallI love the exchange between Melinda Selmys and her husband recounted in the opening pages of Sexual Authenticity: More Reflections. They are discussing her earlier book, Sexual Authenticity, and he says of it: “It’s shit. It’s fake. It’s saccharine. It’s not honest. It’s not you. Write it again.”

That is part of the backdrop for the book Sexual Authenticity: More Reflections.

Another part of her motivation to offer further reflections was the way in which she and her book had been surreptitiously brought into a larger culture war. Reflecting on one of her first public interviews in which she shared the spotlight with a reparative therapist, she writes, “I felt like a fraud. I’d written a book about how the Culture Wars mentality was wrong, and suddenly I was in the thick of that war, an artillery piece in the battle against the Gay Agenda.”

But Selmys has another personal reaction I have not known:

Moreover, I knew that the politicization of my sexuality was an obstacle to the work that I actually wanted to be doing. I was producing the kind of ex-gay narrative that appeals to good Catholic mothers and father and sisters and brothers who dearly want their loved one’s to be able to achieve a full, vibrant, healthy, happy heterosexuality – the kind of ex-gay narrative that has failed the LGBTQ community so badly because it falls afoul of the real experience of many people with SSA [same-sex attraction]. (p. 37)

selmysI haven’t had this reaction because I do not personally experience my sexuality in this way. As an academic who conducts research on sexual identity, however, I have seen my research used toward political ends in ways that I, too, believe have not been helpful to sexual minorities who are navigating this terrain. I am thinking primarily of the Ex-Gays? study. The reality is that 90% of my research is actually on sexual identity development and the experiences of sexual minorities of faith in Christian colleges and universities, in mixed orientation marriages, and in navigating family relationships. So I appreciated her transparency in sharing this motivation to offer more reflections.

The sections that were particularly compelling to me were her personal accounts of how trying to follow the expectations of others (and their related narratives) did great damage to her and her marriage. It gets into the whole area of what to do with one’s same-sex sexuality. Celebrate it? Keep it at arm’s length? Vilify it? Selmys comes to the conclusion that her same-sex sexuality is not “accidental” to her sense of self or her marriage. That doesn’t mean that her same-sex sexuality is central either. She is committed to naming false dichotomies:

Nor is [my homosexuality] accidental to my marriage. I did a lot of damage, both to my identity and to my relationship with my husband, by trying to conform to some sort of one-size-fits all narrative of sexual complementarity. Because I could not acknowledge the part of me that is “queer” in the early years of our relationship, I withheld that part of me from our marriage and tried to replace it with a simulacrum of “authentic femininity” which was not in any way authentic to me. This was a significant omission in my gift of self. (p. 67)

Readers of her blog will recognize many section of the book. She will offer a post and then reflect on it as she has clearly interacted with readers around significant themes that have shaped her thinking in an area. That may sound like it would be somewhat disjointed, but the book does not read that way at all. It is well-written and flows from reflection to reflection in ways that readers will appreciate. The two things that stand out to me as possibly “difficult” about her book are that (1) Selmys, as a Catholic, engages with Catholic theology and philosophy in ways that may not be as familiar to evangelical Protestants, and (2) she pulls no punches. I found the connections to Catholic theology interesting and helpful. Too often evangelicals limit their connections to what John Piper or Tim Keller have said. It’s not that these pastors and theologians are the concerns–it’s that evangelicals can forget the broader theological landscape that is in front of them.

As for the punches not being pulled, let me offer this as an aside: Melinda helped me with a writing project on gender dysphoria (a workbook soon to be available through the Institute for the Study of Sexual Identity), and she has no qualms about telling a writer what she thinks about his/her work. Within a matter of weeks, I was fully aware of the sections of my writing that she did not like. It was refreshing and humbling. Well, More Reflections is kind of like that. Her writing is refreshing and honest in ways that are just not that comfortable for the existing narratives for faithful sexual minorities in the church today. Those narratives, of course, are largely “ex-gay”, reflecting a clean transformation into a pure heterosexuality, which has not been her experience (she names and challenges an array of narratives on pp. 56ff). And I don’t think it is most people’s experience, and it is THAT narrative (not any one narrative but dozens and dozens of comparable narratives) that needs to be told for the church to come to a more realistic understanding of what pastoral care to sexual minorities can look like.

When I first started conducting research on sexual identity, I participated in a think tank with many folks on the topic of sexuality and marriage. (Let me say outright that I love think tanks. This one met in Lourdes, France, and…well…we were there to think. Not a bad arrangement in my view.) One of the other participants was the late Fr. John Harvey, the founder of Courage, a ministry to homosexuals in the Catholic Church. I enjoyed Fr. Harvey as a faithful man with a gentle spirit. I would have loved to have had a “beer summit” with he and Melinda to discuss pastoral care to the sexual minority. In fact, these two would not have needed me; I’d be there for the beer. But to have them engage in a thoughtful, honest discussion about the lives of Christian sexual minorities is the kind of exchange that is needed with many Christian leaders to move the church away from the culture wars and toward genuine pastoral care. I did not experience Fr. Harvey as interested in the culture wars, either, but so many Christian leaders today are–and there is an important shift that simply needs to take place.

Pastoral care based on a saccharine-based sexual identity narrative will only offer peace to those of us who do not experience sexual identity conflicts. That’s not pastoral care at all. It’s stress management for the majority while our brothers and sisters suffer in the trenches of a battle they should never have had to face on their own.

I have been encouraged lately by the voices of many Christians who are engaging this topic from the standpoint of their own lived reality. People like Melinda Selmys. People like Wesley Hill, Ron Belgau and Julie Rodgers. Others who write alongside them at Spiritual Friendship. This is a book that will stand alongside others like it and alongside the thoughtful wave of younger, devout Christians who are engaging this topic and the church in a more public and honest way.

Recent MercatorNet Article by Melinda Selmys

Melinda Selmys is the author of Sexual Authenticity: An Intimate Reflection on Homosexuality and Catholicism. It is a particularly thoughtful reflection on the complexities surrounding sexual and religious identity conflicts. She recently wrote an article on the Mercator website that deals with the CA ban on sexual orientation change efforts (SOCE) for minors.

What I appreciate about the article is that it attempts to lay out the issues in terms of difficulties. The first difficulty is what change means, followed by misrepresentations of the likelihood of success by some proponents of SOCE. In particular, I appreciated this line: “Clients must, however, have the right to receive accurate information about treatment in order to form realistic expectations and goals.”

In the mental health field, we refer to this as informed consent. It is essentially what the average person needs to know to make an informed, self-consciously chosen decision about participating in an approach to therapy. In my previous writing (tracing back to 1998), I argued that those who provide SOCE obtain advanced or expanded informed consent given the complexities and controversies surrounding change efforts.

In my own clinical practice, I do not provide SOCE; rather, I address sexual identity in a model of therapy referred to as Sexual Identity Therapy (SIT). This is an approach to therapy that is client-centered and identify-focused. It was noted in the 2009 APA Task Force Report on Appropriate Therapeutic Responses to Sexual Orientation as a “third way” approach to addressing sexual identity among those who are religious and experience a conflict between their sexual and religious identities.

In the Sexual Identity Therapy Framework (SITF), we also advocate advanced informed consent to SIT, even though this model is about identity formation and personal congruence (not change of sexual orientation).

Selmys address another issue that I think is important: services to minors. Here is what she shares:

Even if young people are theoretically seeking treatment under their own power, many feel intense pressure to overcome homosexual desires in order to please their parents, and some fear punishment or recrimination if they fail. Unscrupulous therapists often market their services primarily to parents and guardians, preying on the hopes and fears of those who have the ability to place adolescents in treatment.

As I’ve shared in previous posts, I do not see that many minors seeking reorientation therapy. Perhaps they do not come to my office because that is not the therapy I provide; but I think it is more likely the case that most minors who present for therapy do so because of the distress their parents feel (as opposed to personal distress). There have been exceptions, but that is generally what I have seen.

That does not mean I am in support of the CA ban. In fact, I am against it for several reasons I’ve outlined here and here.

But interested readers will find in the article by Melinda Selmys a thoughtful reflection on the issues that are raised by those who provide SOCE. Her own story of being in a mixed orientation marriage adds another dimension to her reflections that I hope are elaborated upon in future articles, as the study of people in mixed orientation marriages has been an interest of mine.