Book Review: Understanding Gender Dysphoria

Review by David E. Carlson

I attended the 2016 EFCA Theology Conference with great interest, mainly to hear from Mark Yarhouse on the topic of gender dysphoria.* I have been living in the center of a very progressive city for the past 20 years. During that time, I have watched the church be more engaged in cultural warfare than in missional work among persons who identify along the LGBTQ cluster of letters.

In this work, Yarhouse does several helpful things.

First, he clarifies the terms being used in the field. For example, sex generally refers to biological sex and gender refers to how that is culturally expressed. The term gender dysphoria is defined as the distress resulting from a conflict between a person’s biological sex and his or her gender identity.

I do not have to agree with the various usages, but if I want to engage in a discussion at my local school, I need to know how the terms are being used. I, as a missionary to my culture, need to communicate in a way that can be received.

Second, Yarhouse describes three conceptual frameworks that people use to describe issues of sexual identity:

  • The Integrity Framework views gender in terms of roles assigned by the Creator. We could think of this as the Genesis 1 and 2 perspective.
  • The Disability Framework views gender dysphoria with regard to mental health. We could call this a Genesis 3 perspective: Since the Fall, things are not as they ought to be. We can view someone with discomfort over their biological sex and its expression in gender as something disrupted by the Fall. It is not a choice but a consequence.
  • The Diversity Framework views gender diversity as something that is natural and therefore good. This is where much of our culture has landed on the question.

Yarhouse says evangelical Christians will most likely be grounded in the first framework, but can benefit from taking all three into consideration.

Yarhouse advocates that we help people navigate their dysphoria with less radical interventions. This is in contrast to secular counselors and medical professionals, who might suggest hormone or other treatments as the first and best option.

Finally, there are two chapters on a Christian response. The first is about caring for individuals. Here, Yarhouse shows himself to be a compassionate biblical counselor. I agree with him that we will be better pastors if we learn to take an approach with less judgment and more pastoral conversation. No, I do not believe that this is being relativistic or caving in to the culture. Rather, it is being informed both by Scripture and by what we know from science.

The second chapter deals more with the challenges faced by institutions such as churches, schools and colleges.

Back to the theological conference: I was expecting a handful of attendees to stay for the three extra lectures by Dr. Yarhouse, but I found that most stayed. This is an indication that all of us are aware of changes in our culture regarding sexual identity. I believe this book would be a good place to start. I myself am still digesting the information and think that it may take time for the church to find a proper Christ-like voice in this area. Dr. Yarhouse has done a good thing to help us find that voice.

*To listen to Mark Yarhouse’s talk on gender dysphoria, visit The 2017 Theology Conference information is online as well.

David E. Carlson has been pastor at Bethany EFC in Madison, Wisconsin, since 1994. In Madison, he’s engaged in a variety of settings around the issues of human sexuality, from the larger church community to the public schools.

Review by Donna Arthur

She asked if there was a place we could talk. Bobbi had been coming to my Bible study for just a short time. I asked her to come to our home and intended to meet with her on our back porch over a glass of iced tea. When I answered the door, there stood a young man. “Hi,” he said, “I’m Bob.”

He explained that he was also the Bobbi in my women’s study. I immediately knew I was woefully inadequate for the conversation to follow. I was even more inadequate when he asked to continue in the women’s study.

Gender dysphoria, once called gender identity disorder, refers to the experience of having a psychological and emotional identity that does not correspond to your biological sex. It can be a source of significant distress or impairment.

Mark Yarhouse gives the reader the benefit of his extensive research on the perspective of gender dysphoria: what causes it, how common it is, the prevention and treatment, what a Christian’s response should be, as well as some of the minefields he encountered while writing about it.

Yarhouse explains what it means to be a missional church and asks if today’s church would welcome a cross-dresser or a transgender person. Would a missional church hire this gender dysphobic person as a staff member? What about the health care needed to provide for this person? What about the physical changes that might need to be done, such as restrooms, etc.? Could this person be an usher or even a children’s helper or teacher?

At this point, my anxiety level and my fixed religious beliefs began fighting with one another. I felt compassion, willful resistance and then a sincere wondering if my own worldview was about to make a huge paradigm shift. I realized how slanted I was in thinking that people could “just change if they wanted to.” While the verdict is still out on how to solve this “third sex” problem, I know that my own harsh and final judgments have softened.

For pastors, church boards and leaders in the Christian church this is a must-read book. You definitely will not agree with everything. But you cannot disagree that the Church as a whole must come to grips with our changing world—a world that Christ died for and whose compassion far too often outweighs our own.

Donna Arthur is a member of Trinity EFC in Eustis, Florida, where she leads an Adult Bible Fellowship and home Bible studies. “Understanding Gender Dysphoria was of great interest,” she says, “because while children are facing these problems in school and our communities are struggling to find answers, the local church has not yet defined its mission to address this dilemma.”

Review by Kristopher Mannale

This book will provide a much-needed deepening in our understanding of gender dysphoria and the transgender community. It will also ruffle some feathers along the way.

I agree with the author that we need to grow in our compassion and acceptance of these communities as people who are hurting and marginalized, desperately desiring to be understood and validated. My issue comes personally with the extent to which we validate some of the lifestyle choices as a way to meet people and our ever-changing culture where they are.

Relatively little is said of Scripture in the book, and what is said is taken in very broad strokes. The book is mainly a journey through individual experiences and leading scholarly research, much of which is helpful to understand but is built on premises that will not align with some of the most commonly held views of Scripture in evangelical circles.

I believe that the most valuable take-away for this book is a deepened understanding as well as popular frameworks for interpreting these issues. Yarhouse offers his own integrated framework, which shows promise but, in my estimation, may border on over-glorifying (or celebrating) transgender issues with a diminished regard for created order and divine intent.

In summary, I truly appreciate Yarhouse’s study and overview of this very complex issue. I genuinely admire his compassion and attempt at equipping the church to respond. I believe he is sold out for God and desires restoration for the church and the LGBTQ community. At the same time, I don’t agree with all of his conclusions.

Kristopher Mannale is assistant pastor of Dix Hills EFC in Huntington Station, New York, and studied at Eternity Bible College in Simi Valley, California. Kris and his wife, Hannah, minister primarily to teens and children in their community (along with their own three kids). Kris believes that a diligent study of these new cultural currents and how they relate to Scripture is necessary for church and ministry leadership.

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