Saturday, 8 August 2015

Book review: Understanding Gender Dysphoria by Mark A. Yarhouse

I chanced upon this book while aimlessly browsing through Instagram. Someone had posted a photograph of couple of books he was reading and one of them was this. Intrigued, I decided rather quickly that I was gonna get a copy with my next paycheque.

Mark Yarhouse does not disappoint. This is a work written by a clinical psychologist who'd worked with those who identify as trans for many years. But apart from the in depth understanding he provides, he is also an elder in church and provides a refreshingly nuanced view of how to approach this topic often scarred by controversy.

In 7 concise chapters, he covers much ground, the titles of each chapter speak for themselves:

1. Gender Identity, Gender Dysphoria and Appreciating Complexity
2. A Christian Perspective on Gender Dysphoria
3. What Causes Gender Dysphoria?
4. Phenomenology and Prevalence
5. Prevention and Treatment of Gender Dysphoria
6. Toward a Christian Response: At the Level of the Individual
7. Toward a Christian Response: At the Level of the Institution

Each chapter was crucial in educating me and providing greater insight into this issue. Chapter 1 taught me about the lingo and jargon associated with those who have gender identity issues or who might experience gender dysphoria. It draws us into the complex world of these people and shows us that there is more than meets the eye. If you're looking for simple answers to answer your doubts about Caitlyn or Bruce Jenner's transition, you'd not find it here.

Chapter 2 suggests a way in which a Christian could approach this topic with love and compassion. Yarhouse provides 3 frameworks we could "engage the work being done in the area of gender incongruence or gender dysphoria", and these include (with all the definitions in Yarhouse's words cos I can't put them any better):

a) The integrity framework - This lens views sex and gender and, therefore, gender identity conflicts in terms of "the sacred integrity of maleness or femaleness stamped on one's body."1 Cross-gender identification is a concern in large part because it threatens the integrity of male-female distinctions.

b) The disability framework - In this framework, gender dysphoria is viewed as result of living in a fallen world in which the condition - like so many mental health concerns - is a nonmoral reality. Whether we consider brain-sex theory of any other explanatory framework for the origins of the phenomenon, the causal pathways and existing structures are viewed by proponents of the disability framework as not functioning as originally intended. If the various aspects of sex and gender are non aligning, then that nonmoral reality reflects one more dimension of human experience that is "not the way it's supposed to be."2

c) The diversity framework - A third way to think about transgender issues is to see them as something to be celebrated, honored or revered. The diversity framework highlights transgender issues as reflecting an identity and culture to be celebrated as an expression of diversity. This understanding also frequently cites historical examples in which gender variant expressions have been documented and held in higher esteem, such as Fa'afafine of Samoan Polynesian culture and the Two-Spirit people identified in some Native American tribes.3 Evangelical Christians are understandably wary of the diversity framework.

We are then called to take up an integrated framework as a new lens to view such issues so that we can employ the best practices of each framework and subsequently offers examples of how this would look like. Brilliant stuff.

In Chapter 3, he explores the various theories out there on the etiology of gender dysphoria. I don't like sound-bites when approaching sensitive topics, and so does Yarhouse, (but to be brief because this is turning out to be an ultra long review,) as of today, we know of no definite cause for gender dysphoria.

Chapter 4 brings us into the continuum that is gender dysphoria. We learn that there are many different expressions and manifestations (from cross-dressing only at home with undergarments, to full-on transition to another gender). We explore how gender dysphoria presents in children, and then moving on to adolescents and adults and learn that sometimes it resolves, and at other times, it doesn't.

The fifth chapter is interesting because of the many approaches one can take in the prevention and treatment of gender dysphoria. Just as it exists on a continuum, depending on the situation, various treatment methods present themselves. He provides the huge variety of options out there and carefully analyses which might be the best methods depending on the individual. Sex reassignment surgery (SRS) might not be the sole or best option for the individual that identifies as trans. There are other options out there that can be explored.

The last two chapters provide an excellent guide as to how a Christian or a church should respond. Almost all the trans Christians Yarhouse interviewed had experience some form of hurt from either the church or the individual Christian. We are called to explore how showing grace and love might look like even if we disagree with their choices.

All in all, this is a great book that is sorely needed. In the culture war that is being fought, it is unfortunately the trans individual that is often the most wounded casualty. I would recommend this book to every pastor, Christian leader, or even the average Christian seeking a better way to understand those who are trans and to developed a more nuanced insight into this topic.

Be blessed!

1 Gagnon, "Transsexuality and Ordination,"

2 Neil Plantinga Jr., Not the Way It's Supposed to Be: A Breviary of Sin (Grand Rapids: Eerdmans, 1995)

3 Lynn Conway has a helpful summary that includes historical and current global perspectives. See

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