Understanding Gender Dysphoria
In this episode, Drs. Darrell L. Bock, Timothy Yoder, and Gary Barnes discuss understanding gender dysphoria.
Timecodes
- 00:15
- Yoder’s background in ethics, philosophy, and theology
- 02:18
- Barnes’ background in counseling, psychology, and theology
- 04:22
- Philosophical and theological considerations in gender dysphoria
- 07:58
- Defining gender dysphoria and the sense of incongruence
- 14:56
- Prevalence of gender dysphoria
- 16:45
- Pastoral and personal considerations when approaching the issue
- 23:37
- Three factors to consider in trying to understand the issue
- 29:04
- Models for applying those factors to individual people
- 38:02
- Engaging people with gender dysphoria
- 40:31
- Caution against reflexive responses
Resources
Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture, by Mark Yarhouse
The Reason for God: Belief in an Age of Skepticism, by Timothy Keller
Transcript
Darrell Bock: Welcome to The Table, where we discuss issues of God and culture. I’m Darrell Bock, Executive Director for Cultural Engagement at the Hendricks Center, at Dallas Theological Seminary.
And today, our topic is transgenderism, a topic that I would dare say maybe a decade or two ago, we wouldn’t even have brought up, but it certainly has come on the radar screen of our culture these days, and I have two wonderful guests with me, as we engage on the topic. I’ve got Dr. Yoder here, I wanna treat him with respect.
Tim Yoder: Wow.
Darrell Bock: [Laughter.] Who teaches in Systematic Theology, and teaches ethics, and Dr. Barnes, Gary Barnes, who is in our counseling department. So we’re gonna try and wed theology and counseling which is always a good thing.
And so I think the way to start here is how did you get into this area of work? And I’ll begin with you.
Tim Yoder: Okay, well thank you. Thank you for having me. So my background is in both theology and philosophy, and my PhD is in philosophy. So teaching philosophy courses and ethics courses, I think it’s so significant to wed those into our Christian worldview.
And so I come at it from the perspective of trying to articulate what a Christian system of ethics looks like, how we as Christians should think about deep and important ethical issues in our world.
There’s an apologetics concern, because there’s lots of folks in our world that believe that if we don’t show the proper love and respect, or give the answers that they want, they’re just gonna write off the Christian faith.
And so we’re concerned about holding onto our values, but also presenting in a way that makes the Gospel attractive, and displays God in the right way. So I come at this from the perspective of ethics and apologetics.
Darrell Bock: And Gary, how do you deal – how – you’ve been involved in this area for a long time, haven’t you?
Gary Barnes: Yes, thank you. I really appreciate the chance to be with both of you here today. So I teach in our counseling department here at Dallas Seminary, and that includes pastoral counselors, as well as licensed professional counselors; and when I was a student here myself in the ThM degree, I was a Systematic Theology major.
Darrell Bock: Okay.
Gary Barnes: And was in ministry as an Assistant Pastor for seven years, and then went and got my doctorate in Clinical Psychology at Columbia University and so the – I love how you mentioned about bringing counseling and theology together, and that’s what we do on a daily basis here in our counseling.
Darrell Bock: [Laughter.] That’s right.
Gary Barnes: So this is really a great fit for us. In the process of teaching, and also having a private practice, I began to experience people who were coming to seek services, who had needs that were not within my previous training that I had, and so it kinda forced me back to the drawing board.
Darrell Bock: So we didn’t have – we didn’t discuss transgenderism when we were in seminary?
Gary Barnes: That’s right.
Darrell Bock: [Laughter.]
Gary Barnes: I don’t recall. I missed that day, I think.
Darrell Bock: [Laughter.]
Tim Yoder: I think I missed that day, month, week, and semester.
Darrell Bock: Yes.
Gary Barnes: So I’ve continued training, and now also Board Certified as a Sex Therapist, as well as a licensed psychologist, and so these are all day to day issues that we have to work with.
Darrell Bock: So your practice has been – what, in family ministry and that kinda thing?
Gary Barnes: Yes.
Darrell Bock: Is that basically where you focused?
Gary Barnes: Marriage and family, yeah.
Darrell Bock: Yeah, and you’ve been doing this a while?
Gary Barnes: Yes, I have.
Darrell Bock: A few years?
Gary Barnes: Yes.
Darrell Bock: You aren’t gonna say how many?
Gary Barnes: Well, I’ve been meeting with people professionally since 1990.
Darrell Bock: Okay. I’ll let people do the math and they can put that in.
Gary Barnes: Yeah.
Darrell Bock: So – great. Well, let’s start at kind of at a philosophical level, and then I do wanna talk a little bit hopefully about some of the science and conditions that we deal with, and then move to the counseling. That’s kind of the way I wanna structure this. So how do you ethically walk into this space?
Tim Yoder: All right. Well, so I think that we begin with the fact that there are people in the world that experience this kind of gender confusion, right?
Darrell Bock: Mmm-hmm.
Tim Yoder: What Yarhouse calls gender dysphoria.
Darrell Bock: Yeah, dysphoria is not a word I use every day. So yeah, confusion.
Tim Yoder: Yeah, I won’t ask you to spell it either.
Darrell Bock: Okay.
Tim Yoder: Y’s in strange places.
Darrell Bock: You’re so compassionate.
Tim Yoder: So we begin with that, right there, and as Christians, I think we recognize that it’s a reflection of the world in which we live in. We live in a fallen world. It shouldn’t shock us that these kinds of things show up.
We live in a world that is fallen, we live under a curse, and so the – there’s disorder present in every aspect of our world, from human beings, to structures, to individual actions and the whole gamut.
And so we live in a world in which these things take place, and then our response is to think through these things and how do we respond? Ethics can be understood in two ways: there is the rules, the do’s, the don’t’s, the boundaries, the things that we’re supposed to do.
That’s one thing. That’s a deontological approach, or a deontic approach to ethics, but there’s also the kind of person we are, the virtue approach; what kind of person are we becoming? What is our character? How are we molded and shaped?
And it’s interesting. I think we see both of those reflected in the Scriptures. Clearly, there are rules: the 10 Commandments, which are repeated in the New Testament, except for the Sabbath one.
But Jesus is also very concerned with what kind of person we are, and how do we respond, and acting in love. Paul says that the whole thing, all, the whole law resolves into love; and so I think that love is the priority in Christian ethics, and that gives us an opportunity; how do we display love to people in the situation, and then unpacking that I think is where we go forward in ethics.
Darrell Bock: Well, in fact that becomes a particular challenge in certain situations where you might have the issue of what your convictions are, but then thinking through how do I relate to someone, either who doesn’t share those convictions or who is a challenge to the way I think life should be lived, or even a challenge to the way we think God has said life should be lived, and how we relate to people in that context is an extremely important concern.
So that’s a nice, quick overview of the general approach to ethics, and I like the contrast between the ontological, here’s how you think about this, but then there’s the whole relational element as well.
Tim Yoder: Right.
Darrell Bock: That has to come into it or else —
Tim Yoder: Right.
Darrell Bock: — we can think the right thing in the wrong way and still be wrong.
Tim Yoder: Speaking the truth in love.
Darrell Bock: Yeah.
Tim Yoder: Marries those together nicely in a single phrase.
Darrell Bock: Right, exactly. So you have a lot of experience dealing with these kinds of situations. Let me begin here because I think some people say well, gender confusion is just a confusing category to begin with, and how do you, as you think about either counseling or talking to people who face this situation, kind of where do you start in the relating part of what we’re talking about?
Gary Barnes: Let’s back up to definition first, before we talk about the relating part.
Darrell Bock: Okay.
Gary Barnes: Because people who would be experiencing gender dysphoria may have some confusion about it, but you can have many, many more people who have no confusion about it.
Darrell Bock: Mmm-hmm.
Gary Barnes: It’s not defined, based on confusion.
Darrell Bock: Okay.
Gary Barnes: It’s defined based on an experience of incongruence, and I could be very, very clear about my incongruence of my psychological and emotional sense of my maleness and identity not being congruent with my assigned gender or my biological sex.
Darrell Bock: Okay.
Gary Barnes: So I think just in terms of relating to people, that’s a very good first step that we’re not mislabeling their experience.
Darrell Bock: Okay.
Gary Barnes: Right from the very beginning.
Darrell Bock: Okay, which is something that’s easy to slip into.
Gary Barnes: Oh, yes.
Darrell Bock: Yeah.
Gary Barnes: Yes.
Darrell Bock: So let’s talk about that a little bit. So a person comes in and begins to share this incongruence, which I take it is a sense of a disconnect between who they are biologically, and the way in which they respond to what’s going on around them. How would you define that incongruence?
Gary Barnes: So this kinda drives us back to the cause question.
Darrell Bock: Right, that’s where we’re going.
Gary Barnes: Yeah.
Darrell Bock: Okay.
Gary Barnes: And so this is – it’s a very interesting question at this stage. The short answer to that is we don’t know.
Darrell Bock: Okay.
Gary Barnes: Okay, but we do know a lot. It’s not like we don’t know anything. What we do know is if we look at normal development, in utero, there’s such as thing as homologous development.
Okay, so I can have in utero male and female genitals that are exactly the same at that particular stage of development. So those continue in a pathway of development.
Now simultaneous to that, I also have brain development. Okay, in normal human development, those things continue to develop congruently with one another.
Darrell Bock: Okay.
Gary Barnes: And so through a process of hormones developing and becoming active in the overall development of the human, then the homologous organs begin to become distinct as either male or female.
Darrell Bock: Mmm-hmm.
Gary Barnes: Okay, you could say there’s development in the brain in normal development that is tracking with, in a congruent way, the male development and the female development.
Darrell Bock: So congruence here is not – how do I say it, is not a strictly emotive description. There’s something holistic going on between the body and the person that brings them a degree of harmony.
Gary Barnes: Yeah, this is like we’re talking whole person congruence here.
Darrell Bock: Right, okay.
Gary Barnes: So it does include an emotional congruence.
Darrell Bock: But it’s not exclusively that. That’s the point.
Gary Barnes: But not exclusively that, no.
Darrell Bock: Yeah, yeah. So, go ahead.
Gary Barnes: So that’s all normal development.
Darrell Bock: Right, right.
Gary Barnes: See, but just as was being explained, this side of Eden, we would say, there are things that are not normal.
Darrell Bock: Mmm-hmm.
Gary Barnes: In a broken, fallen world, things happen in inconsistent ways with normal expectations, and so in utero, we also have abnormal development.
Darrell Bock: Mmm-hmm.
Gary Barnes: What’s important about this is to understand that this could be 100 percent independent of personal choice.
Darrell Bock: Right.
Gary Barnes: See, and that’s – you’ve got to be able to have a grid, a lens to look through that takes you away from automatically concluding that anything that is not in the bell curve or normal, we would say, is a result of somebody’s choice making.
Darrell Bock: So I’m gonna take a shot at making an analogy. It may not be a good one but I’ll take a shot at it. Just as there is normal and abnormal development with just raw physical characteristics in human being, most babies are born with two arms and two legs, and 10 fingers and 10 toes.
So sometimes that doesn’t work out, and so in this area that happens to touch on sexuality, we get sometimes a similar phenomenon, where it doesn’t work out the way it would normally work out, and that’s what you’re calling incongruence?
Gary Barnes: Yes, and it can happen at multiple levels. It can happen between our sexual biology as we understand it in terms of genitals.
Darrell Bock: Mmm-hmm.
Gary Barnes: It can also happen with our gonads, it can also happen in our chromosomes.
Darrell Bock: Mmm-hmm.
Gary Barnes: It can also happen in a difference between the brain and all of those other things. We can also have confusion just within the biology itself.
Darrell Bock: Yeah.
Gary Barnes: See, and so my very first case when I was at NYU Medical in Bellevue Hospital in my clinical internship is what is referred to now as intersex.
Darrell Bock: Mmm-hmm.
Gary Barnes: And so that’s when a person has a biological anomaly that prevents them from being clearly identified as male or female.
Darrell Bock: Hmm.
Gary Barnes: And in this particular case, the person had both male and female genitals.
Darrell Bock: Hmm.
Gary Barnes: See, so we have all of these possibilities of anomalies that are outside of normal development.
Darrell Bock: Do we have any sense as – I mean it’s probably not the best question to ask but I’m curious and it is one that it’s curious and I think other people would be too.
It’s do we have any sense of what kind of percentage we’re dealing with in terms of the percentage of people who have this kind of experience?
Gary Barnes: So if you look at the most broad term of all, which is kind of our umbrella term we would use, transgender.
Darrell Bock: Mmm-hmm.
Gary Barnes: Okay, and so that’s where the expression in my experience of who I am as male and female is not consistent. It’s not congruent with my assigned gender, or my biological sex.
Darrell Bock: Okay.
Gary Barnes: Okay, and if you look at adults, prevalence rates for males tends to be like one out of 11,000.
Darrell Bock: Okay.
Gary Barnes: And females, like one to about 30,000.
Darrell Bock: Oh wow, okay, so significant difference across gender.
Gary Barnes: Male and female, yes.
Darrell Bock: Yeah, yeah. So let me work out some of the implications of this. So this means that sometimes what the person is experiencing, this is kind of where you started, is not a matter of confusion. It’s a matter of the way – I’m gonna say it, it’s the way they’ve been built or the way they have emerged?
Gary Barnes: You might say it’s a — I could be very, very clear that things aren’t congruent for me.
Darrell Bock: Right, that in fact if there’s [laughter]—
Gary Barnes: Yeah.
Darrell Bock: If there is confusion, that’s where it lies.
Gary Barnes: Yeah.
Darrell Bock: Is that it’s so clear that it’s not clear.
Gary Barnes: Yeah.
Darrell Bock: If that makes sense.
Gary Barnes: Yeah.
Darrell Bock: Okay, so what does that mean – let’s – let me – I’m gonna shift to a pastoral question, then come back. So what does that mean pastorally when I meet such a person and I know that my reaction would be – I’d be just – I’d be the one who would be confused [laughter.]
Gary Barnes: That’s where the confusion usually lies.
Darrell Bock: That’s right [laughter.]
Gary Barnes: [Laughter.] Yes.
Darrell Bock: What do I do?
Gary Barnes: Yes.
Darrell Bock: I mean I would walk into a situation and go well, this is awkward. I quite don’t know what to do with this.
Gary Barnes: Right.
Darrell Bock: So, help me.
Gary Barnes: So this is where I think Mark Yarhouse has really been helpful for me and his book, [Understanding] Gender Dysphoria, especially explains this well, although I use some different labels than he uses on this.
But he says the very first thing that can be helpful is to have an understanding of the different types of lenses that we look through when we’re trying to give understanding and then a response.
Darrell Bock: So part of what we have to do is wrestle with our own reaction to what we are confronted with, whereas what we tend to do is to project onto the person a series of expectations and realities that may not in fact be what they – where they are coming from and what they’re dealing with.
Gary Barnes: Yeah. So if I’m confused —
Darrell Bock: Right.
Gary Barnes: — and I’m responding out of confusion, that’s not gonna be a good experience for the person on the receiving end.
Darrell Bock: Right. Yeah, or else it’s gonna be probably a poor experience for everybody [laughter.]
Gary Barnes: Yeah, and so – and this is especially the case when people are wanting to work from a theological grid.
Darrell Bock: Mmm-hmm.
Gary Barnes: That’s a good news, bad news situation.
Darrell Bock: Okay.
Gary Barnes: Right, and so the more I’m unclear about how my theological grid applies to this, the more likely I am to do damage in the process.
Darrell Bock: Okay, all right.
Gary Barnes: And so that’s where I think the three lenses that Mark gives us between —
Darrell Bock: So now I’m hearing a Surgeon General’s warning —
Gary Barnes: [Laughter.]
Darrell Bock: — that goes something like be careful how you walk into the space.
Gary Barnes: Yeah.
Darrell Bock: Okay.
Gary Barnes: Yes, most definitely.
Darrell Bock: Okay. So I’m not sure whether to turn this way or that.
Gary Barnes: Yeah.
Darrell Bock: But – so we’ve kinda signaled there’s an issue here and I think I’m gonna ask this question. It’s kind of a little bit of a theodicy-like question.
Gary Barnes: All right.
Darrell Bock: And because I often hear this, and that is, a person will say why should I get blamed for the way God made me, or some variation of that kind of question or observation, and then of course, that gets translated from the person who meets someone who’s transgender as you’re not what you ought to be.
You know, and so I can see that the theological grid in that situation creates an automatic – you talk about incongruity.
Gary Barnes: Mmm-hmm.
Darrell Bock: There’s an incongruity there that becomes a barrier in relating to this person, if you’re not careful.
Gary Barnes: Okay, yeah.
Tim Yoder: Yeah.
Darrell Bock: Okay, so let’s deal with that part of the question.
Tim Yoder: So I think you’re right, that many people do you know, this is the way I’ve been born, right.
Darrell Bock: Mmm-hmm.
Tim Yoder: I’ve been made this way and so how could I be blamed for something, and, but theologically, we go back to the basis of the story, right. God made a good world. It’s tainted by sin. There is the curse, and we all inherit this condition of sin.
Darrell Bock: Just in different ways?
Tim Yoder: In different ways.
Darrell Bock: Yeah.
Tim Yoder: Sure, and we recognize that we all have various trials and challenges, burdens that we bear that are different individually. Some people are born with a physical handicap, or acquire one throughout their lives.
Other people are prone to alcoholism, or to a temper, or to you know, some other condition, depression or schizophrenia or something. You know, there’s all kinds of things that people have. All of us have, I think, something that is difficult and that we wrestle with that we struggle with, and we have to deal with that.
And so you know, I think that we could put this into that same category, that we wrestle with different things. We live in a fallen world, which means that our responsibilities before God are to bear up under that trial, to recognize that grace and mercy comes through Christ, and we follow through in the situation.
Darrell Bock: So I guess that making that observation should create, for lack of a better description, a sense of empathy for where a person might find themselves, and that rather than issuing a charge against someone, that a place to start would be from this place of having some sense of empathy for what it is a person may be facing.
Gary Barnes: Yeah, I think one thing that could compel us to love —
Darrell Bock: Mmm-hmm.
Gary Barnes: Love that term, compelling love.
Darrell Bock: Yeah.
Gary Barnes: Is to realize how we’re all equally in need of it.
Darrell Bock: Mmm-hmm.
Gary Barnes: There’s not one person – I need it as much or more as anybody else.
Darrell Bock: Mmm-hmm.
Gary Barnes: See, so it’s not like I have this higher ground that I’m standing on, and then when I’m looking at somebody who has some kind of difference from me, I am not responding in love because of that difference.
Darrell Bock: Mmm-hmm.
Gary Barnes: See, we’re all equally in need of grace and love.
Darrell Bock: So there’s no place for condescension.
Gary Barnes: There’s no – I don’t have a leg to stand on for condescension.
Darrell Bock: Yeah, yeah.
Gary Barnes: See, I’m equally in need of God’s grace and love compared to anybody else, and so if I’m really gripped by that, no matter what the difference is, it compels me to move towards that difference.
Darrell Bock: Mmm-hmm.
Gary Barnes: See.
Darrell Bock: And by moving towards, you’re talking about engaging it, but not in a confrontational kind of way, so much as in a – how do I say it, in an understanding and sympathetic way, and in the sense that you’re appreciating where the person is and trying to understand where the person is first.
Gary Barnes: Well, this brings us back to those three lenses.
Darrell Bock: That’s right.
Gary Barnes: So that’s what – in any exchange, there’s gonna be one of three outcomes.
Darrell Bock: Okay.
Gary Barnes: You move towards, you move against, or you move away.
Darrell Bock: Right.
Gary Barnes: See, these three lenses are the things that set up that kind of a response.
Darrell Bock: Right.
Gary Barnes: Of one of those three things.
Darrell Bock: Mmm-hmm.
Gary Barnes: So, do you wanna talk about the three lenses, right now?
Darrell Bock: Sure, go for it.
Tim Yoder: Yeah.
Darrell Bock: We should.
Gary Barnes: Okay, so the first one that Mark identifies and the label that he gives to it is called the integrity lens.
Darrell Bock: Mmm-hmm.
Gary Barnes: And so it’s rooted in God creating male and creating female to both be image bearers of God.
Darrell Bock: Mmm-hmm.
Gary Barnes: And there’s a very, very important theological significance in that, and so this is what’s referred to as the binary model.
Darrell Bock: Mmm-hmm.
Gary Barnes: So you’re either created as male or you’re created as female, and by God’s design, that’s a very sacred model because it all points back to him in a very special and unique way.
So a male is not a complete image bearer of God. A female is not a complete image bearer of God.
Darrell Bock: And we’re designed together to reflect the image of God.
Gary Barnes: Very important, theologically.
Darrell Bock: Yeah, right.
Gary Barnes: That we not only see the difference in male and female, but that points us back to a better understanding of the nature of God.
Darrell Bock: And the nature of the creation.
Gary Barnes: Yes.
Darrell Bock: Yeah.
Gary Barnes: Yeah, the whole big picture.
Darrell Bock: Yeah, exactly right.
Gary Barnes: The whole big picture.
Darrell Bock: Okay.
Gary Barnes: And so the integrity model, theologically speaking, is kind of not only helping me to understand how to think about the world and about each other, and about God, but it’s helping me to know how to move in my world.
Darrell Bock: Right.
Gary Barnes: See, and so I would want to be very a good steward of the binary model.
Darrell Bock: Mmm-hmm.
Gary Barnes: I would not want to, like, do away with the binary model.
Darrell Bock: Mmm-hmm.
Gary Barnes: Because then that has so many other theological implications that I’m doing.
Darrell Bock: Right.
Gary Barnes: See, so that’s referred to as the integrity model.
Darrell Bock: Okay.
Gary Barnes: Or the integrity lens.
Darrell Bock: Lens.
Gary Barnes: That I look through.
Darrell Bock: Okay, that’s one down.
Gary Barnes: Okay.
Darrell Bock: I’ll tell you, there are gonna be three. That means we got two to go.
Gary Barnes: Okay. So if you go to the other direction.
Darrell Bock: Mmm-hmm.
Gary Barnes: We have the diversity lens.
Darrell Bock: Mmm-hmm.
Gary Barnes: And this could be a lens that is generated by a theological position or it could just be independent of a theological position, but what it’s saying is there’s not a binary model.
Darrell Bock: Hmm.
Gary Barnes: That’s the main distinction.
Darrell Bock: So these are – what you’re saying to me, if I’m picking it up, is these are different ways people can look at the same phenomenon, and in the process, filter what they are seeing in ways that could be either positive or negative.
Gary Barnes: And it’s gonna shape how they respond.
Darrell Bock: Exactly right.
Gary Barnes: Yeah.
Darrell Bock: Yeah.
Gary Barnes: It’s your worldview.
Darrell Bock: Right, okay.
Gary Barnes: That directs how you live in the world.
Darrell Bock: So this is a non – the diversity lens is a non-differentiating lens or what?
Gary Barnes: It’s a continuum view.
Darrell Bock: Okay.
Tim Yoder: Yeah.
Darrell Bock: Okay.
Gary Barnes: So you could have very distinct male and female, or you could be really, really male, or really, really female.
Darrell Bock: So the alpha male for example.
Gary Barnes: Yeah, yeah.
Darrell Bock: Is one edge of that spectrum.
Gary Barnes: You could be anything in-between.
Darrell Bock: Okay.
Gary Barnes: And see – and every single one is all equal and valid.
Darrell Bock: Okay.
Gary Barnes: And should be celebrated, not just tolerated.
Darrell Bock: Right.
Gary Barnes: Okay.
Darrell Bock: Right.
Gary Barnes: That’s the diversity model.
Darrell Bock: That’s another big – okay.
Gary Barnes: Now that could be independent of a theological position —
Darrell Bock: Right.
Gary Barnes: — or it could actually be a part of a theological position as well.
Darrell Bock: Right, and as I’m listening to this, I’m going — and that’s actually where a lot of people are, right?
Gary Barnes: Well, it’s the whole direction of our culture today.
Darrell Bock: Yeah, right. Okay, so two down, one to go.
Gary Barnes: Okay.
Darrell Bock: [Laughter.]
Gary Barnes: So the one that becomes most helpful for me to have a working model that actually directs how I live in my world is what I would call the anomaly lens.
Darrell Bock: Mmm-hmm.
Gary Barnes: And so what that’s saying is there is a very, very important reason to not only identify but preserve the binary model.
Darrell Bock: Mmm-hmm.
Gary Barnes: But there’s also exceptions to the model.
Darrell Bock: Yeah.
Gary Barnes: There are anomalies.
Darrell Bock: So that means that I don’t try and shove the anomaly into a binary slot because it’s a round peg in a square hole.
Gary Barnes: That’s exactly right.
Darrell Bock: Okay.
Gary Barnes: See.
Tim Yoder: Yeah.
Darrell Bock: Okay.
Gary Barnes: It totally directs not only how I have understanding but how I have a pastoral care, or how I have a counseling approach, or how the body of Christ actually does the “one another” dynamic as the body of Christ.
Darrell Bock: Okay, so let me ask this question and I’m not sure who I’m gonna direct it to. Maybe I’ll let you both speak to this one.
I take it then that the impact of that for the person who is encountering someone who is experiencing gender dysphoria is their first commitment is not to try and fix the person, okay, but to understand the person. Is that a helpful distinction to be making?
Gary Barnes: Yes. You’re talking about what I would call now, two different models of how we work out of our lenses that we’re working from.
Darrell Bock: Okay, so take – so we’ve got the three lenses there.
Gary Barnes: Yeah.
Darrell Bock: And now how am I gonna approach this?
Gary Barnes: So a common model that people who are limited to the binary model.
Darrell Bock: Mmm-hmm.
Gary Barnes: Okay, so there’s good news and bad news about that.
Darrell Bock: Right.
Gary Barnes: The good news is we’re protecting the sacredness of the model.
Darrell Bock: Right.
Gary Barnes: Of maleness and femaleness.
Darrell Bock: Right.
Gary Barnes: Okay. The limiting part of that is any time I’m working with an exception, I’m having to make it fit a binary model.
Darrell Bock: Right.
Gary Barnes: See, so what I tend to do is say, okay, I need to get you to fit the model in order for you to belong with us, see.
Darrell Bock: Mmm-hmm.
Gary Barnes: And so, if the person doesn’t fit the model, then they can’t belong.
Darrell Bock: Mmm-hmm.
Gary Barnes: That’s not good.
Darrell Bock: Yeah.
Gary Barnes: That’s not good.
Darrell Bock: I’ve immediately marginalized.
Gary Barnes: Yeah.
Darrell Bock: Yeah.
Gary Barnes: Exactly.
Darrell Bock: Yeah.
Gary Barnes: And if I’m – even if I’m saying well, maybe this takes time, okay, come be with us but we’ll know that we have success here when you no longer have gender dysphoria.
Darrell Bock: Mmm-hmm.
Gary Barnes: When you can say now I feel congruent in being male or female, see.
Darrell Bock: Okay, again, I’m gonna take a shot at an analogy, and I’m really nervous about this one but I think that sometimes working with analogies that work or don’t work might help us.
How much is this like a person who says I am an alcoholic. I mean, I know I have this tendency and I’m never going to be able to get rid of, if I take a drink, I’m in trouble; and so, as is commonly a case, a person will say I am an alcoholic but I haven’t had a drink in so long because that’s how I have to live with what —
Gary Barnes: Yeah.
Darrell Bock: With who I am. Good analogy, bad analogy?
Gary Barnes: Ah —
Darrell Bock: Clouded analogy?
Gary Barnes: I think you might lose more than you gain with it, on that one.
Darrell Bock: Okay, explain that, because I think that’s what a lot of people – how a lot of people might process some of what you’re saying.
Gary Barnes: Yeah, yeah. If somebody’s going with an alcoholic analogy, they may say look, the thing that’s disrupting how you think about yourself and how you live out your life is that you’re stuck in a pattern of being changed by alcohol.
Darrell Bock: Mmm-hmm.
Gary Barnes: And once you live a life of sobriety, where you’re no longer experiencing alcohol, you can live life normally.
Darrell Bock: And you’re saying gender dysphoria is not like that?
Gary Barnes: That’s not like that.
Darrell Bock: Okay, got it. So – okay. So we’ve said rather than trying to think about how to fix this, if I can say it that way, we’re better off trying to understand what it is and we’re being – and I’m spending a lot of time focusing on how we react to someone who is there, but we also need to have the discussion about the person who’s in this situation, as well. I don’t wanna forget that.
Gary Barnes: Right.
Darrell Bock: So what advice would you give to the person who’s working to move towards and to understand what this condition means for the person that they’re interacting with?
Gary Barnes: Yeah, I think that’s a great question, and so I’ve been trying to think about this for a while —
Darrell Bock: Yeah.
Gary Barnes: — and getting input from others. I think if we all could keep in mind four points regarding the “How then shall we live?” in this broken, fallen world.
Darrell Bock: Right, right.
Gary Barnes: With one another as broken, fallen people, okay.
Darrell Bock: Mmm-hmm.
Gary Barnes: I would say as it specifically relates to gender dysphoria, your first, most helpful thing is to release a rigid binary model and be able to hold onto it, but still embrace exceptions to it.
Darrell Bock: Okay.
Gary Barnes: Yeah.
Darrell Bock: So know the exceptions are real.
Tim Yoder: Yeah, there’s gotta be —
Darrell Bock: And in the midst of that say, okay, we’re in a different category.
Gary Barnes: Yeah, it doesn’t all fit the ideal blueprint that we had.
Tim Yoder: Right.
Darrell Bock: Right.
Gary Barnes: Because we’re on this side of the fall.
Darrell Bock: Okay, all right.
Gary Barnes: Okay.
Darrell Bock: Okay.
Gary Barnes: So you have a model where you’re not compromising the significance, the sacredness, the importance theologically of the binary model.
Darrell Bock: Mmm-hmm.
Gary Barnes: Okay, but you’re also open, you’re embracing exceptions to that.
Darrell Bock: You’re dealing – if I can say it this way, pretty rawly, you’re dealing with the reality of the real world, the cards you’ve been dealt.
Gary Barnes: Yeah.
Darrell Bock: Okay.
Gary Barnes: Okay, the second point I would say is more of an attitude shift.
Darrell Bock: Okay.
Gary Barnes: The first is more of a cognitive, core belief shift, and this is shifting to our people, rather than those people.
Darrell Bock: Okay, so doing away with the us and them.
Gary Barnes: Yes.
Darrell Bock: Okay.
Gary Barnes: Yes, it’s huge.
Darrell Bock: Okay.
Gary Barnes: That’s a really major shift, I think. Can even be bigger than the first shift.
Darrell Bock: And part of the moving towards is embracing this person as a human being.
Gary Barnes: Yes, they are also created in the image of God.
Darrell Bock: Mmm-hmm.
Tim Yoder: Mmm-hmm.
Gary Barnes: They are of full value, of full worth, okay, not less than.
Darrell Bock: Mmm-hmm.
Gary Barnes: Okay, they have a different anomaly that they’re working with that puts them outside of the bell curve of normal.
Darrell Bock: Mmm-hmm.
Gary Barnes: Okay, but that does not mean they’re not created in the image.
Darrell Bock: And the hard part of that is that relationally and otherwise, that increases the pressure of the conditions they live under because in many cases, that can be transparent that that’s going on.
Gary Barnes: Yes.
Darrell Bock: That they are an anomaly.
Gary Barnes: Yes, yeah.
Darrell Bock: Okay, so that’s two.
Gary Barnes: So that’s two. The other, the third one, I would say is it’s a response. So we got the cognitive, we got the attitude, then we got the response, and that’s a response of journeying with, see.
Darrell Bock: Mmm-hmm.
Gary Barnes: And the idea here is hey, we all are in a journey. You have a unique journey, and a really important part of your unique journey is that we are journeying together with you in this unique journey.
Darrell Bock: Okay.
Gary Barnes: Okay, and this is the “one another” dynamic of the body of Christ, if a person’s already in the family of God, and if they’re not, then we want to be able to still move towards them, regardless of that.
Darrell Bock: Mmm-hmm.
Gary Barnes: See, so it’s still a journeying with, in either way.
Darrell Bock: Okay, and the fourth?
Gary Barnes: And the fourth is journeying together, and so this is an idea that emphasizes the mutuality of us serving one another, and it’s not just a one-directional serving. See, so the body of Christ needs the anomalies in the body of Christ, so the body of Christ can more fully be the body of Christ.
Darrell Bock: Because our calling is to minister grace in the midst of a fallen world, and to display the goodness and graciousness of God towards people in a way of drawing them into a healthier place than where they were without God.
Gary Barnes: Yes, but I have to also add to that and in my journey of growing my identity in Christ, I need the full anomalies in the body of Christ to better do that.
Darrell Bock: To better engage and serve.
Gary Barnes: So it’s not like you need me.
Darrell Bock: Right.
Gary Barnes: I need you.
Darrell Bock: Right, there’s – that’s the mutuality
Gary Barnes: Yes.
Darrell Bock: Yeah, got it. Okay. So what do you think?
Tim Yoder: Well —
Darrell Bock: [Laughter.]
Tim Yoder: I agree. One of the lines from Tim Keller that I really like from his first book, The Reason for God, is he talked about the church. The church is a hospital for people to get better, and not a museum where the perfect saints are on display, and if we could think about this as a place where we are growing together, that would be great.
I would love to see the church to be a place where people that experience this issue and others can feel safe.
Gary Barnes: Yes.
Tim Yoder: Too often in our culture, people feel that they’re going to be judged. One of the things that – distinctions that Yarhouse makes that I really liked is he talked about treating – or yes, interacting with people as individuals that suffer gender dysphoria, and not treating them as a symbol, or making them the symbol for all that’s gone wrong in our society, right.
Gary Barnes: Mmm-hmm.
Tim Yoder: You know, the A on Hester Prynne’s blouse, right, that she’s the adulteress and not an individual. Right, we need to treat people, Christian ethics I think compels us to interact with people as individuals, a person for whom Jesus died.
Gary Barnes: Yes.
Tim Yoder: Now we do have to wrestle with the issues, right, and the fact that there is a standard, right, that God created. There’s a standard for sexuality, there’s a standard for who we are but I really like what you said, Gary, about the fact that the binary model has to allow for some fuzziness.
Right, as a philosopher who comes from the Aristotelian tradition, right, it’s A or not A.
Darrell Bock: [Laughter.]
Tim Yoder: It’s X, you know, but that rigid kind of in or out principle of non-contradiction needs to be updated a little bit to recognize that there is – there just are folks, right, whether it’s with the intersex condition you described or an extra chromosome or something that don’t just naturally fit into that situation.
And if we can allow for that and wrestle with it, and recognize it as part of the reality of the world we live in, then we’re going to take a major step I think towards really loving people, and not dismissing them or marginalizing them.
Gary Barnes: Yes.
Darrell Bock: I’ve got two places I wanna go, and I know I only have time for one of them [laughter]. So let me ask it this way.
One of the things that happens as a result of this conversation is the impact it has on how people view the area in general, and what I have in mind here is that there are people, if I can say it this way, there are people who have – I’m gonna say it this way, I may say it sloppily.
There are people who have real incongruence, okay, they are dealing with something that’s really, really real, but because we have raised this issue to such attention, people, particularly younger people are drawn into a conversation where they may be drawn into thinking that they may be something that they may not actually be, okay.
Gary Barnes: Yes, yes.
Darrell Bock: And particularly, if this is young people, teenagers or very – even younger, and this shows up for a parent. That’s like a huge curve ball.
Tim Yoder: Yeah.
Gary Barnes: Yeah.
Darrell Bock: What – I think this is a natural place to go because I think the more we see this, the more we’re gonna see this kind of side collateral, if I can say it that way about the discussion.
Gary Barnes: Yes, yes.
Darrell Bock: What advice do you have for that kind of a situation?
Gary Barnes: That’s a really great question. I’ll do a quick response.
Darrell Bock: Okay.
Gary Barnes: First, if we just look at it statistically, okay, if you’re – the numbers I gave were about adults.
Darrell Bock: Right.
Gary Barnes: But if you look at adolescents, okay, so in male adolescents, there’s what we call a persistence rate: two to 30 percent would persist in a direction of being gender dysphoric.
Darrell Bock: Okay.
Gary Barnes: Or continuing to experience the incongruence.
Tim Yoder: Okay.
Gary Barnes: Okay, whereas in females, it tends to range from 12 to 50 percent, see. So the fact that your young adolescent is struggling with gender dysphoria right now does not mean necessarily – in fact, statistically the odds are against them continuing to have that experience later on.
Darrell Bock: So they can have feelings of gender dysphoria without being gender dysphoric, if I can say it that way?
Gary Barnes: Well, in the moment, it is.
Darrell Bock: Yeah.
Gary Barnes: But the fact that that predicts the persistence of that is not true.
Darrell Bock: Okay.
Tim Yoder: Okay.
Gary Barnes: But the other point that’s really important is my third point of journeying with.
Tim Yoder: Okay.
Gary Barnes: See, and so that’s being able to be with not only the adolescent but the families during this process, to accept it as a process, even though we don’t know what the outcome of it will be.
Darrell Bock: Okay, so I seem to remember in the back of my head – now I’m – it’s been a while since I’ve read Yarhouse but I seem to remember that he has three categories of reaction to these kinds of situations. He says when he talks to parents or people who encounter this, they need to process, so they don’t immediately jump to the wrong conclusion.
Gary Barnes: Yes, yes.
Darrell Bock: So elaborate on that a little bit.
Gary Barnes: So, as it specifically relates to gender dysphoria, you would want to take the least radical strategy, as you’re going through this time period.
Darrell Bock: And by which you mean least radical conclusion about what’s going on or is that part of it?
Gary Barnes: Or even responding to trying to get rid of the dysphoria.
Darrell Bock: Yeah, okay, that’s what I mean.
Gary Barnes: So hormonal treatments.
Darrell Bock: Yeah.
Gary Barnes: And surgery reassignments, see.
Darrell Bock: Yeah, yeah.
Gary Barnes: You’re saying let’s hold off on those kinds of things.
Darrell Bock: Don’t get ahead of the game, yeah.
Gary Barnes: In the meantime, we’re not really sure what the direction of this is gonna be, and we’re not trying to force it into a binary model because we don’t know if —
Darrell Bock: We’ve gotta discover and understand first.
Gary Barnes: Yeah, so maybe we can be a little more flexible in our acceptance of your dressing patterns right now, or names that you wanna go by as nicknames might be more gender neutral names.
Darrell Bock: Mmm-hmm.
Gary Barnes: Okay, we might raise our tolerance level for that while you’re – so we’re not forcing it into a binary model at this early stage, but we’re also not making conclusions that right now just because you’re experiencing this dysphoria.
Darrell Bock: We aren’t accepting that that’s the conclusion either.
Gary Barnes: Yeah.
Darrell Bock: Okay.
Gary Barnes: So we’re not gonna jump the gun and try to get you further down that path.
Darrell Bock: Right, right.
Gary Barnes: Because statistically, it’s less likely that you will be.
Darrell Bock: Right.
Gary Barnes: Okay.
Darrell Bock: Okay, well obvious – our time is gone and obviously we’ve just only gotten started in the conversation, but hopefully what we’ve tried to do is to lay out some elements of how this works.
We still need to have another conversation I think on – we spent a lot of time dealing with how you respond to this, and not talking about the person who finds themselves in the midst of it, which is a whole ‘nother conversation.
Gary Barnes: Yes.
Darrell Bock: And so I guess what I’m saying to you guys is I may invite you back [laughter] to do a part two but this is – I think this has been a good opening.
And it certainly is – I’m trusting that people have found the conversation almost defining for thinking through how they even begin to approach an area that generally speaking, we’ve said so little about, and oftentimes don’t understand very well, to be able to have some sense about how to go, and I think the message has been walk carefully, walk sensitively, don’t be too quick to judge.
It's kinda that quick to hear, slow to speak, and slow to anger mode that you need to be in when you walk into this space. So I thank you guys for helping us.
Gary Barnes: Thank you.
Tim Yoder: Thank you.
Darrell Bock: And I thank you for being a part of The Table, and I hope you’ll join us again soon.
About the Contributors
C. Gary Barnes
Dr. Barnes is an ordained minister and a licensed psychologist who specializes in marriage and family research, counseling, and training. After graduating from DTS he served as an assistant pastor for seven years. While in the New York area he was a research project coordinator at NYU Medical Center’s Family Studies Clinic and later completed a two-year postdoctoral fellowship through Parkland Hospital (Dallas) and the Child Guidance Clinics of Dallas and Texoma. His great celebrations of life are his wife, four adult kids plus three more by marriage, nine grandkids, and bicycle racing.
Darrell L. Bock
Dr. Bock has earned recognition as a Humboldt Scholar (Tübingen University in Germany), is the author of over 40 books, including well-regarded commentaries on Luke and Acts and studies of the historical Jesus, and work in cultural engagement as host of the seminary’s Table Podcasts. He was president of the Evangelical Theological Society (ETS) from 2000–2001, served as a consulting editor for Christianity Today, and serves on the boards of Wheaton College and Chosen People Ministries. His articles appear in leading publications. He is often an expert for the media on NT issues. Dr. Bock has been a New York Times best-selling author in nonfiction and is elder emeritus at Trinity Fellowship Church in Dallas. When traveling overseas, he will tune into the current game involving his favorite teams from Houston—live—even in the wee hours of the morning. Married for over 40 years to Sally, he is a proud father of two daughters and a son and is also a grandfather.
Timothy S. Yoder
Dr. Yoder is passionately committed to the maxim that all truth is God’s truth and that to love God with all one’s mind is to discover His truths in theology, in philosophy, and in all other academic disciplines. In a teaching career that has spanned thirty years, he has taught a wide variety of theology, philosophy, and apologetics courses at Marquette University, Cairn University, and DTS. Dr. Yoder also served as a missionary to Russia in the 1990s and, together with his wife, Lisa, they have participated in missions trips to Northern Macedonia, India, and other countries. Originally from the East Coast, they love to read, travel, watch movies, and follow NFL football.