My experience walking with families touched by gender dysphoria has shown me how painful it can be for parents and siblings. When a mother suddenly learns her 13-year-old daughter identifies as a boy and wants to transition, hard questions follow: Is this a passing phase or something deeper? Is it ethical, even possible, for my child to change genders? Is the science behind this trustworthy? How did this happen? What do I do?
How should parents respond when their child exclaims “You’re choosing your religion over me” or “If you don’t let me transition, I’ll kill myself”?
Moments like these require discernment, a biblical posture and convictions, and an intentional discipleship plan. What does this look like practically? Here are eight encouragements for parents to keep in mind.
1. Show compassion.
When he encountered the sick, confused, and weary, Jesus acted with compassion (Matt. 11:28–30; Mark 1:41; 6:34). So must we. Rates of depression, anxiety, and suicide are alarmingly high among trans* youth—those whose gender identity doesn’t align with their biological sex. Whatever the causes, it’s clear people who experience gender dysphoria are hurting. They may feel out of place in their own skin or experience bullying at school.
Engaging a loved one or friend in such a state begins with listening, sympathy, and acknowledging that sharing about this experience took courage. Christian parents should pray with a child going through this, helping the child to invite Jesus into his or her struggle.
2. Ask what else is going on.
For adolescents, questions about gender don’t arise in a vacuum. Being a teenager has always been hard. Alongside the pressures of typical adolescent development, today’s teens face the social and cultural pressures of growing up in a digital and hypersexualized age that obsesses over identity. For this reason, it’s wise and necessary when caring for an adolescent (or adult) who identifies as trans* to consider co-occurring conditions like anxiety or depression before having any conversations about transitioning.
As Mark Yarhouse and Julia Sadusky write, “We almost always recommend treating co-occurring concerns first. We do not want a person making weighty decisions about gender dysphoria out of a state of significant depression.” By first helping friends or loved ones address other factors that affect their mental health—anxiety or depression, difficulty with peers, or a negative body image—you may help them to grow more comfortable with their biological sex.
3. Don’t be anxious if your child’s interests aren’t stereotypical.
Parents of young children shouldn’t anxiously think a son or daughter is struggling with gender dysphoria simply because the child doesn’t conform to typical gender norms. After all, many modern ideals about masculinity and femininity are more cultural stereotypes than biblical truths. Stereotypes can create unnecessary confusion and pressure for children as they grow up.
Moments like these require discernment, a biblical posture and convictions, and an intentional discipleship plan.
The Bible offers contours for gender expression—especially in relation to sex and marriage—but says less than we might think about male and female preferences. Scripture doesn’t say men must like sports and hunting or be unemotional. Nor does the Bible tell us little girls must wear pink, enjoy dolls, and avoid rough-and-tumble play. If a girl likes karate, excels in math, and prefers short hair, this doesn’t mean she’s a boy. And if a boy likes dance, excels in art, and grows his hair out, this doesn’t mean he’s a girl.
Sadly, gender dysphoria can, at times, be caused or increased by evaluating oneself—or being evaluated by others—according to caricatures. Some of the distress associated with gender dysphoria isn’t inherent to the condition but reflects social rejection. For example, if a boy feels rejected by his peers for not enjoying stereotypical boy games, he might mistake that distress for gender dysphoria.
4. Get help if gender confusion persists.
Studies show it’s not uncommon for a young child periodically to express the desire to be the opposite sex, but in most cases, this desire wanes with age. But what if your child’s gender confusion continues into puberty and shows no signs of abating? If this is the case, your child may have a clinical case of gender dysphoria.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gender dysphoria affects only a sliver of the population, less than 0.01 percent (or fewer than one in 10,000 people), and historically it has predominately affected males in early childhood.
In terms of clinical assessment, the American Psychiatric Association states that a child must meet six of these eight criteria for a minimum of six months to be diagnosed with gender dysphoria:
1. A strong desire to be of the other gender or an insistence that one is the other gender
2. A strong preference for wearing clothes typical of the opposite gender
3. A strong preference for cross-gender roles in make-believe play or fantasy play
4. A strong preference for the toys, games, or activities stereotypically used or engaged in by the other gender
5. A strong preference for playmates of the other gender
6. A strong rejection of toys, games, and activities typical of one’s assigned gender
7. A strong dislike of one’s sexual anatomy
8. A strong desire for the physical sex characteristics that match one’s experienced gender
Someone living with insistent, persistent, and consistent gender dysphoria will likely experience great pain. Believing parents can help their children pursue what will help them manage: being involved in a strong Christian community, cultivating loving Christian friendships, and perhaps seeking Christian therapy or finding medical means to treat depression and anxiety.
5. Establish clear boundaries.
To care for a child who experiences gender dysphoria, we must have clear convictions. We must guide daughters and sons toward alignment with God’s creational and redemptive designs. Parents must frame their care for a child who wants to transition with biblical truth. Guidance that cuts against the grain of creation or moves away from the arc of redemption may seem palliative in the moment, but it will only increase pain in the long run.
An adolescent who comes out as trans* will often express urgency about beginning a transition. Some teens, like a helicopter, want to reach altitude with their transitioning straightaway. Meanwhile, cautious parents are like an airplane on the tarmac, wanting to taxi for a while. But when it comes to gender, the individual isn’t in the pilot seat; we’re all passengers. Because gender transitioning doesn’t cohere with God’s creational and redemptive designs, a Christian cannot affirm it.
This doesn’t mean we can’t respect or interact with coworkers and friends who are trans*. But when it comes to our spheres of responsibility—our bodies and the bodies of our under-18 children—we cannot support treatments that so drastically deny God’s work.
We must guide daughters and sons toward alignment with God’s creational and redemptive designs.
Christian parents must also be leery of soft transitioning, like cross-dressing and changing names or pronouns. Because we live in a pluralistic world, there will be situations when it’s necessary, for civility’s sake, to call someone by his or her preferred name. But within a Christian home, parents shouldn’t support soft transitioning. A study conducted on children in the Netherlands found soft social transitioning makes it less likely a child will outgrow gender dysphoria. Using your child’s preferred pronouns may feel low-risk, but doing so dishonors the Creator and has documented long-term effects.
6. Don’t give away your authority.
Refusing to compromise on convictions and boundaries will put Christian parents in difficult situations. Some in our culture will judge an uncompromising response as a form of rejecting one’s child. There are even those who would like to see unbending parents charged with child abuse. Amid such pressure, Christian parents must bear in mind their tremendous calling.
The Bible commends the wisdom and leadership of godly parents (Ex. 20:12; Prov. 1:8–9; Eph. 6:1). A child’s emotions shouldn’t be her North Star. God and his Word must be. It’s easy for parents today to think their job is to ensure their children always find happiness. But adolescence is an inherently tumultuous stage. A parent’s role is to set healthy boundaries and limits. You mustn’t relinquish your responsibility and authority, even if cultural pressures undermine it. Your role is to aim your child toward holiness, not painlessness—eternal joy, not immediate gratification. In this responsibility, your no is as important as your yes. Do all you can to stay in close relationship with your child, but don’t neglect your biblical call to lead.
7. Guard against negative cultural influences.
Most cases of gender dysphoria today aren’t early onset diagnoses or along the lines of the DSM-5. Rather, they’re part of a phenomenon called rapid-onset gender dysphoria, and many worry that the recent spike in cases is more the result of social pressure than actual struggles with gender identity.
In her study of teens who came out as trans*, Lisa Littman noted two patterns among females: (1) most adolescent girls discovered transgender ideas “out of the blue” after a period of social media saturation, and (2) “the prevalence of transgender identification within some of the girls’ friend groups was more than seventy times the expected rate.” Littman concluded that the increase owed to “social contagion.” Gender dysphoria had spread in the same way fads and rumors do, because of the social incentives gained by identifying as trans*.
What should parents do if they believe their teenage child’s sudden gender confusion stems more from social pressures and challenges common to adolescents than from an underlying condition? They must find the big cultural influences and intervene. Many parents have found their child’s gender dysphoria dissipated when they took him or her out of public school and off social media.
What should parents do if they believe their child’s gender confusion stems from social pressures? They must find the big cultural influences and intervene.
While public education can be a great blessing, public schools increasingly discriminate against traditional and religious views of sexuality and gender. Some affirm and even aid youth in transitioning, at times without parental consent. Parents must be vigilant in understanding what their children are taught in school and what policies local school systems have that may influence their children negatively. Don’t hesitate to pull your children out of a school and place them into a different educational environment if you believe doing so will guard them from negative influences—whether from teachers or peers.
Social media also plays a large part in the social contagion that surrounds rapid-onset gender dysphoria. This shouldn’t surprise us. Social media exposes youth to the perpetual gaze and judgment of peers and other potentially negative influences. The pursuit of “likes” on platforms such as Instagram can exacerbate the pressure felt by teens who may already be insecure about their changing bodies. Parents must count the cost before getting their teen a smartphone, and they shouldn’t hesitate to remove access to a smartphone as a first defense against negative cultural influences when any concerns arise.
8. Celebrate the beauty and goodness of gendered bodies.
The beauty of gender difference adorns God’s world. We need to help the next generation see and honor it. As a pastor, I have the joy of seeing couples meet, marry, and have children. The fruit of their union reminds us that only a biological male and a biological female can produce life. “People often present the sex binary as oppressive,” Rebecca McLaughlin writes. “But at its very heart, the male-female binary is creative.”
In appropriate ways, parents must teach and remind their children that the complementarity of the two-gendered world—the dance of male and female—is the creative source that stands behind each one of us. By God’s design, every human being owes his or her existence to one man and one woman.
Another place the beauty of gender shows up is in church worship. In my church, when songs have parts for men and women, the guys can’t help but sing a little louder when it’s their turn. They send a low rumble through the pews. When the women have their go, it’s as if a bright and gentle joy enfolds the congregation. When all the voices finally sing together, one hears, even feels, the truth and goodness of our gendered world. Surely this will be an enduring display of our maleness and femaleness as we worship the Lamb in heaven (Rev. 5:9; 14:3; 15:3).
Christians must point out this beauty to the next generation whenever we experience it. We must celebrate the goodness of God’s design—that we are our bodies; that our gendered bodies are temples for the Holy Spirit, made to glorify God (1 Cor. 6:19–20); and that this is anything but restrictive. It’s beautiful.
*Note: In this article and the book from which it’s excerpted, I use terms like “biological sex,” “gender identity,” and “trans*” with contemporary usage in mind, but I also probe how current definitions and understandings do or do not square with biblical teaching.