How to pastor someone struggling with their gender

Dealing with transgender issues is not something that pastors had to handle very often a generation ago. It’s quite possible that a minister twenty or thirty years ago might have gone through their whole ministry without having to tackle the issue. But times have changed. The rise of transgender ideology, and the profile of gender issues in the media, means that pretty much everyone in an average congregation has thought about questions of gender. It is quite likely that there will be some within your church who will know someone who is questioning their gender, whether family or friends.

Navigating questions of gender can seem like a minefield for most of us, whether we are in pastoral ministry or not. Even understanding the terminology used can be challenging (and you may find this article helpful to get to grips with them). For a pastor it can quickly feel as if we are out of our depth!

Despite the complexities of the gender debate, you are much more equipped to help someone struggling with their gender than perhaps you think. Even the most thorny of pastoral issues is a question of who we trust with making sense of the world and ourselves. We have the good news of the gospel, which contains all we need for life and godliness (2 Peter 1:3).

As we hold out the hope and truth of the gospel to those with questions about gender, there are some helpful principles of pastoral work that can help us.

As every pastor knows, the heart of pastoral care is listening. To truly listen to someone, especially someone who is vulnerable, is to demonstrate love and compassion toward them. For many people, the time we spend listening can be just as impactful as the words we say and the counsel that we give.

Listening is essential when it comes to questions of gender. The chances are that most of us will have very little grasp of the struggles the person in front of us is going through. Unless you or I have questioned our own gender, there will be a big gap between our experience and the experience of those we are talking with.

Listening, therefore, is vital to help us to understand their struggle. We may not agree with every conclusion they have come to, and there will be Biblical truth we will want to share into their situation. But our first step is to seek to understand, to put ourselves into their shoes, and do what we can to empathise with their emotions.

The good news is that listening itself is a powerful help to the person who is suffering. While we can often think that listening is a precursor to speaking, which is where the real work happens, God is active as you simply listen to another person in need.

Pastor Brad Hambrick says: “Not having an immediate next answer may feel a little frail and helpless to the pastor,” yet it is precisely this kind of response that can lead someone who is struggling to say “You get me”. He explains that those with gender dysphoria would be likely to say: “If at the end of me talking you had an answer, it would be harder for me to believe that you really understood what I was going through.”

When we listen to someone well, we are offering the kind of welcome that Jesus does. We don’t want to shy away from Biblical truth (as we will see in the next section), but we also want to extend a loving invitation to talk, and to be a safe person to speak with. Jonathan Gass, writing for the Gospel Coalition, comments on his own experience of becoming a Christian while transgender:

Before we open the Bible with someone who struggling in this way, we want to open our hearts to them first. Our attitude toward them tells them that they are loved by God, and loved by us. We need them to know we see them as a person, created in God’s image, rather than a problem to fix. We want them to understand we are not going to leave, or stop caring about them, because of their struggles with gender.

Some who has opened up to you about their gender questions has trusted you with something that makes them very vulnerable. It is important, therefore, that we do not abuse that trust. We must be very careful not to share what has been told to us to others without that person’s permission. If we feel that it is too great a burden to bear alone, ask them if you can tell to another person (another pastor, a spouse, or perhaps a mentor) so you can support them well.

You cannot, however, promise complete confidentiality within a pastoral setting. If they disclose something that puts a child or vulnerable person at risk, you have a duty to follow safeguarding principles and inform someone about it. You cannot accept an agreement of confidentiality without this caveat. However, you can offer the person you are speaking with an offer such as: “I will not tell someone else without you knowing.” Note that you are not asking them to agree before you tell someone, since this may not be possible from a safeguarding standpoint. But you are telling them that they will know who does know, so that they know there is no sense of gossip within the church community.

We begin by listening well, but we also want to speak the truth into a struggling person’s life. Someone questioning their gender may have been influenced by a secular and cultural worldview, and shaped by things other than Scripture. As pastors, we will need to carefully and compassionately challenge that worldview, replacing it with what the Bible teaches.

The world around us tells us that we define our own existence and identity. Gender is simply a construct separate from our biological sex, and we can make gender whatever we want. The Bible, however, tells us that we are created by God in his image. He has made human beings as male and female, and our sex is given to us by God not defined by ourselves.

Many struggling with gender can view their biological sex as ‘bad’ and want to change to a different gender because it is ‘good.’ We need to affirm that, since our sex is given to us by God, it is good. If we are born male, then our masculinity is a good thing; if born female, God has given femininity for your good.

Our bodies are given to us by God, and are good too. Those questioning their gender can have a view of the body as something less essential to their identity: the ‘real me’ lies inside, and the body is simply something that can changed and altered to fit that inner reality. But God has created us with physical bodies which are part of his good plans and purposes for humanity. Physical bodies will also be part of God’s perfected world of the New Creation. We need to affirm the goodness of our bodies, as well as the goodness of our gender.

There are, of course, many gender stereotypes surrounding masculinity and femininity that aren’t always helpful. Some of those stereotypes exist, and are even magnified, within the church. As we affirm the goodness of being male or female, we need to avoid those generalisations and stereotypes that are unhelpful and have no basis in Scripture.

As we speak with those who struggle, we need to remind them that their identity is found in truth, not in feelings. The experience of gender dysphoria is an experience of unwanted feelings. Those emotions may be powerful, but they do not define us. Our identity is shaped by what God has said. We can affirm the pain of the feelings they are going through while helping them to be shaped by something bigger and better. Their feelings are not the ‘real’ them.

We know that struggles are part of living in a fallen world, and waiting for the redemption of creation (Romans 8:22–23). It can be helpful, therefore, to give those who are suffering words to express the difficulties that they face, and to know it is okay to express these frustrations to God. The Biblical category of lament is a powerful resource for those who are going through seasons of struggle. Mark Vroegop, in his book ‘Dark clouds, deep mercy’ calls lament “the honest cry of a hurting heart wrestling with the paradox of pain and the promise of God’s goodness”. Most Christians with gender dysphoria would relate closely to this idea.

It might be useful to share, and perhaps pray through, some of the psalms of lament with someone struggling with gender. Psalm 6 (“My soul is in deep anguish. How long, Lord, how long?”), 13 (“How long must I wrestle with my thoughts and day after day have sorrow in my heart?”), 38 (“All my longings lie open before you, Lord; my sighing is not hidden from you.”), 42-43 (“Why, my soul, are you downcast? Why so disturbed within me?”), and 86 (“give me an undivided heart, that I may fear your name.”) are all helpful passages to dwell on.

Psalm 22 is an immensely powerful psalm to share with those who are suffering. It gives voice to our own struggles with verses such as: “I am poured out like water, and all my bones are out of joint” (Psalm 22:14). But it also points us towards Jesus, who took these words for himself as he suffered on the cross. We need to point the struggling Christian to Jesus who knew struggle and suffering, and who meets us in the point of difficulty.

For all the complexities of the gender issue, what someone with gender dysphoria needs most of all is Jesus. Resolving their struggles with gender, if that was possible, will not meet their greatest need. Only Jesus can do that, and we serve our struggling brother or sister most when we point them to Christ. Jonathan Gass speaks about his own story of conversion as he writes:

As we meet with those struggling with gender, and as we listen well and speak truth, this will inevitably lead to questions about how to respond. As pastors, we want to counsel people on how to live as a Christian in the midst of struggles, and to do that with compassion.

Different people who come to talk to you about their questions about gender might be in very different places in their lives. For some, their struggle will be entirely internal and they will not have changed their clothing or way of life. Others will be outwardly living as a different gender, and contemplating taking further steps such as hormones or surgery. Some will have transitioned completely to the opposite gender, including having undergone surgical procedures.

As we love and listen to each person, we will want to affirm the Bible’s picture of sex and gender: That God has given us sexes for our good, and that the sex given at birth is to be honoured and upheld. How someone does that will vary depending on their current status right now.

The general principle to apply is to counsel someone to align as closely to their birth sex as possible. For someone who has not taken steps to implement any changes, this will mean not taking those steps. If someone is referring to themselves by a different name and pronouns, and wearing clothes of a different gender, then it will be transitioning back to their birth name and sex.

For someone who is on hormone medication, or who has had gender-reassignment surgery, the picture is much more complex. Some changes made by drugs or surgery are not able to be reversed. But where there are reasonable options, they should be prayerfully considered. As Brad Hambrick notes, a person who has transitioned to a different gender should be “as willing to take bold steps in following Christ as they were in taking steps to come to peace with their dysphoria. But if there are not viable options that have a reasonable probability of success, I would not want them to feel compelled to do something that is medically foolish.”

None of this is likely to happen quickly. God may work a miracle and after talking and praying with you, the person you are counselling might make a dramatic change. But for the majority, God works through the slow, everyday process of growing in obedience and holiness. It will take time.

That means we need to live in uncertain messiness for a while. A person may be repentant of their desire to change gender, and trusting in Jesus, but has not yet fully aligned themselves back to their birth sex. That can be tricky to manage within a church environment. You will need to think carefully about how this works with your church’s policies with regard to baptism, membership (if you have one), and service.

Should a transgender person who becomes a Christian be fully aligned with their birth sex before being baptised, for example? There is no clear answer here. We do not expect people to be sinlessly perfect before baptism, only that they express genuine repentance and faith in Christ. Do we need to see a transgender person dressing differently or using a different name before we can say they have truly repented? Christians would disagree on this. The best you can do is think about it before the issue arises, talk it through with your church leadership, and apply what you decide fairly and consistently.

The long process of change for someone who is transgender also means we need
to be with them for the long haul. The person struggling with their gender may only have their struggle resolved in the new creation. That means the church needs to walk alongside them throughout their journey of growing in godliness, just as we need to do with every believer. Sanctification is a long process, whether we struggle with gender or not.

It can seem daunting to have the right words, or arguments, to counsel someone with gender issues. We need to remember that it is only the power of God as seen in Jesus Christ that can transform lives, and can provide the salvation that those with gender dysphoria need. Once again, Jonathan Gass communicates it well as he details his own story. He writes: