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Understanding Transgender, Non-Binary, and Intersex

biological sex

Big Idea: Understand complicated issues around biological sex, sexuality, and respond with biblical conviction and a willingness to walk with people.


We’re in the middle of a tough series on sexuality and gender, and I want to warn you up front: this is going to be perhaps the most difficult message in the series. It’s good to acknowledge that up front. We’re going to talk about transgender, non-binary, and intersex issues and people. This is a very complicated topic, and I am a learner. I don’t want to speak beyond my level of knowledge, and I want to approach this topic as carefully and accurately as I can.

So a few notes as we begin.

  • This is a complicated topic. I’ve already said this, but I want to repeat it again.
  • We’re not just talking about an issue; we’re talking about people. Because It’s about both people and an issue, and so we must aim to be both biblical on the issue and loving to people. We don’t want to just focus on activists and deconstruct their ideology. We must think accurately and biblically, but take care not to destroy people in the process.
  • We need God’s help. So let’s pray right now for that. Father, we ask that as we look at these topics that you would lead us into both grace and truth. Thank you for your help so far in this difficult series. And we pray once again for your help today. May we love well, and may this sermon be marked by your wisdom and your compassion. In Jesus’ name, Amen.

Defining Terms

The first thing we want to do today is to define terms. We can’t really talk about these issues if we don’t know what we’re talking about.

So let’s look at some important terms:

  • Sex and gender — These terms used to be interchangeable, but increasingly they’re not. For the sake of clarity, we’ll talk about sex as biological sex: the physical and biological dimensions of being male and female, including the sexual anatomy, chromosomes, and secondary sex characteristics. We’ll talk about gender as “the psychological, social and cultural aspects of being male or female,” and gender identity as “how you experience yourself (or think of yourself) as male or female, including how masculine or feminine a person feels” (Mark Yarhouse, Understanding Gender Dysphoria).
  • Transgender is an umbrella term for the various ways in which some people experience incongruence between their biological sex and their gender identity. Gender dysphoria is related: it’s “the feeling that their biological body is lying. A person in this situation really thinks that he or she is, should be, or would feel better as, the gender that is opposite to their biological sex, or no gender at all.” (God and the Transgender Debate)
  • Transsexual is someone who has pursued or is pursuing medical treatment — a sex change or hormone therapy — to align their biological sex and their gender identity, or is thinking of doing so — although this is a bit of an outdated term.
  • Intersex is used to describe someone who is born with atypical characteristics in their sexual anatomy and/or chromosomes. In 99% of cases of intersex people, there is little to no ambiguity about the biological sex of the person, but in 1% of cases there is significant ambiguity about the biological sex.
  • Non-binary — which includes terms like gender queer, gender fluid, pan gender, gender non-conforming — refers to people who don’t like to be put in a box, who see male-female as a spectrum and argue that they are somewhere in the middle. It’s a social term more than a medical one.

Can you see how complicated all of this is? Here’s the number one thing we need to understand: transgender people are not all the same. As someone has said, “If you have met one transgender person you have met one transgender person. No two experiences are the same.”

Really there seem to be, broadly speaking, four kinds of stories we may encounter:

  • Some people are gender dysphoric. This can range from mild to severe. They feel that their sense of gender is at odds with their biological sexual anatomy. It causes them stress and anxiety.
  • Some don’t fit masculine/feminine stereotypes. They don’t meet cultural expectations of what it means to be male or female.
  • Others are autogynephyliac. This one is controversial. It’s about males who are sexually aroused by the thought of themselves as a female. According to a study at the University of Lethbridge, it’s a form of “erotic target identity inversions” in which men desire to impersonate or turn their bodies into facsimiles of the persons or things to which they are sexually attracted. Some transgender activists become really upset at this label, but it does exist, but can’t be used to label all kinds of transgender people.
  • And then there are trans-trending, or what some call rapid-onset gender dysphoria (ROGD). It describes people who identify as trans and maybe even experience some gender dysphoria, but it comes from mostly social pressures. As someone has said, “Trans is trendy.” One doctor who runs a gender clinic says that only a small number of those who come to him would be identified as having gender dysphoria. For instance, a teen can come out as trans seemingly out of nowhere, sometimes as a result of peer and social pressures.

To get some ideas of the numbers that we’re talking about:

  • 0.005% – 0.014% experience gender dysphoria, according to the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders).
  • Approximately 1 in 10,000 males and 1 in 30,000 females experience gender dysphoria, according to a 2016 study published in the Annual Review of Clinical Psychology.
  • 0.6% identify as transgender. In other words, many people identify as transgender but don’t experience gender dysphoria.
  • And then it’s really interesting to look at how age affects this. 12% of Millennials identify as transgender or gender non-conforming. 27% of Californian youth (13-18 years old) identify as gender non-conforming, or neither completely male or female. 50% of Millennials believed that gender is not binary (male and female) but exists on a spectrum.

So there are a variety of experiences. We need to understand the diversity.

Today we will focus on gender dysphoria and intersex, although you’ll see the implications for other areas.