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Being transgender or transsexual.
Gender dysphoria, & gender identity

How a lack of consensus about
the nature of Gender Dysphoria
harms people. Webmaster rant.


This is an essay intended for general informational use only. If you believe that you are personally experiencing Gender Dysphoria, we recommend that you not make decisions based upon the information in this essay, but seek professional counseling instead. If you are feeling seriously depressed, and need immediate support, you might consider phoning a crisis hot line. One may be listed at the front of your telephone book.

The term "sexual reassignment surgery" refers to medical procedures to make the transgender individual's body more closely match the gender that the person currently identifies as. The term is being replaced by "gender confirmation surgery."

Beliefs about Gender Dysphoria by those working in the field:

As in the case of lesbians, gays, and bisexuals and the concept of sexual orientation, there is no consensus in North American concerning transgender persons and transsexuals.

Individuals working in the gender identity field generally fall into one of two "solitudes," as described in the table below.

We call them "solitudes" because:

  • The beliefs of the two groups are very different, because the beliefs of most religious conservatives are based on their understanding and interpretation of the Bible, whereas religious liberals, researchers, therapists, etc. are based on scientific studies of individuals.

  • The two groups confidently promote their own beliefs concerning Gender Dysphoria as the only valid understanding.

  • The two groups' beliefs conflict on each point.

  • The two groups rarely communicate with each other, even less often debate, and essentially never dialogue.

Unfortunately, the lack of dialogue and communication results in a lack of consensus. transgender individuals are presented with two mutually exclusive belief systems. This can have very serious consequences in the lives of those experiencing Gender Dysphoria.

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Item Beliefs of almost all religious conservatives Beliefs of almost all religious liberals, secularists, human sexuality researchers, psychiatrists, psychologists, other therapists, etc.
How Gender Dysphoria is experienced A person is confused about their gender. The client knows precisely what their gender is. However, it does not match their genetic gender.
Source of beliefs Derived from their interpretation of scripture passages. Derived from scientific research, observation and personal experience.
Only effective treatments Therapy to resolve the conflict, accompanied by prayer to God. Gender reassignment surgery (a.k.a. gender reassignment surgery; GRS) for those who qualify.
Goal of the treatment To have the client accept their genetic gender as their actual gender, as God created them, and as God expects them to be. Since the client's perceived gender is fixed, altering their physical appearance to match their perceived gender can help resolve the conflict.
Rate of regret after undergoing gender reassignment surgery Greater than 50%. Less than 10%; some estimates as small as 1%.
Resulting gender of a male to female transsexual (MTF) who has undergone GRS Male. Their gender is unchanged from their biological sex. Female. Their appearance is changed so that it more closely matches their gender identity. They identify as female and hope that others will accept this.
Sexual orientation of a male to female transsexual (MTF) who is sexually attracted only to women Heterosexual, because the person is regarded as male. Lesbian, because the person is regarded as female.
Sexual orientation of a male to female transsexual (MTF) who is sexually attracted only to men

Gay Heterosexual
Marriage of a MTF transsexual to a woman An opposite sex, traditional marriage A same-sex marriage
Marriage of a MTF transsexual to a man A same-sex marriage An opposite sex marriage

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Beliefs about gender reassignment surgery (GRS) by each "solitude:"

In an associated essay, we concluded: As in the field of sexual orientation, persons who are active in the field will adopt one of two positions, which we will arbitrarily call "religious" and "secular" solitudes in this essay:
  • Secular solitude: Multiple surveys by secular sources show that there is a near consensus among the vast majority of transsexuals who have gone through gender reassignment surgery (GRS) that hormone treatments and surgical procedures have made their physical appearance closer to their perceived gender, and have had a positive effect on their life. They believe that reparative therapy and prayer are ineffective.

    This position is firmly held by this "solitude" and is derived from their experience with therapy, their analysis of the long-term outcomes of GRS by their clients, and surveys of post-operative transsexuals. Professionals working with Gender Dysphoria exhibit very little doubt that about the correctness of their position because it is based on observation.

  • Religious solitude: Comments by religious conservatives are rare. We have discussed two references elsewhere: -- one anonymous Catholic and one evangelical para-church director. However, it would seem that there is a strong belief among many conservative Christians that:
    • Transgender individuals may be more accurately described as suffering from "gender confusion," not from Gender Dysphoria.

    • Gender reassignment surgery (GRS) usually "doesn't work" and often "increases the likelihood of depression and psychic disturbances."

    • GRS basically involves mutilation of the client's body from what God intended it to be to be something quite different. Curiously, many accept the circumcision of male babies to be acceptable to God.

    • Transgender persons are best helped through reparative therapy and prayer.

This position is firmly held by those in this "solitude" and is derived from their understanding of truth as derived from their interpretation of biblical passages. They also exhibit very little doubt in the correctness of their understanding of Gender Dysphoria because it is based on their interpretation of biblical passages, as well as their understanding of God and the nature of the Bible.

As the Christianity Today article concludes:

    "The challenge before conservative evangelicals is persuading transgender people, their families, and faith-based advocates that gender identity disorder is not beyond the reach of God's grace, compassionate church-based care, and professional help." 8

(Gender Identity Disorder is now an obsolete term, having been replaced by Gender Dysphoria.)

Unfortunately, the stakes are quite high:

  • If the religious solitude is correct, then sexual reassignment therapy generally fails, after a major investment in time, effort, and money by the transsexual. The only effective path forward leading to a cure for a transgender person is prayer and therapy. It is also the only treatment that is acceptable to God.

  • If the beliefs of the vast majority of transgender individuals, and the findings of therapists working in the field, and of human sexuality researchers are correct, then the suicide rate among transgender persons is very high. Prayer and therapy will fail, and the only effective path forward is counseling, hormone treatments, and perhaps sexual reassignment surgery if the client meets all of the necessary criteria.

The anxiety caused by having one's body and mind in conflict over gender is extremely intense for most transgender persons. In the past, before puberty blockers, sex hormones, and gender confirmation surgery were generally available, it was estimated that as many as half of all persons with Gender Dysphoria once commited suicide before the age of 30. Many had been driven to kill themselves after a significant life reversal such as a sexual attack, loss of job, or perhaps a failed therapy attempt at curing their conflict.

Whichever treatment is more successful needs to be promoted by both solitudes; whichever treatment is less successful needs to be discouraged by both solitudes. Whichever solitude is currently promoting the less successful or treatment -- whether it be religious conservatives or the therapists/researchers/surgeons -- have blood on their hands.

The solution requires dialogue between the two solitudes to check out what treatment(s) actually work in real life. But little if any dialogue has happened in the past and is unlikely to do so in the future. Unfortunately, even if dialogue were to occur, it would be difficult to reach a consensus, because the two sides have such different, sincere, definitions of "truth."

The same conflict over treatment methods has been seen with reparative therapy which is still promoted by a few religious conservatives to "change" persons' homosexual orientation to heterosexual. Secular professionals have concluded that such therapy appears to almost universally fail. It has been known to produce serious depression in some lesbians and gays who have tried this path. Many of them have suicidal ideation because of the failure, and some of them have committed suicide. On the other hand, some religiously-motivated promoters of reparative therapy regard it as a successful method of producing "ex-gays" by helping sexually active gays and lesbians "walk away from the homosexual lifestyle." Where it fails, they believe it is because the client did not try hard enough; they lacked motivation.

During mid-2013, Exodus International closed their reparative therapy office. They were the main organization promoting reparative therapy. They had been attempting to convert homosexuals to heterosexuality for over three decades. They finally admitted to themselves and the world that they had failed. They recognized that sexual orientation, whether heterosexual, homosexual, or bisexual, is fixed in adulthood. They apologized to the LGBT community for the harm that they had done.

References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

  1. "The Standards of Care for Gender Identity Disorders (Fifth Version)," The Harry Benjamin International Gender Dysphoria Association Inc., 1998-JUN-15, at:
  2. "e T Spider," "The history of gender identity disorder and treatment," eTRANSGENDER, 2006-NOV-17, at:
  3. "Sex reassignment surgery (female to male)," Wikipedia, at:
  4. John Norton, "Vatican says 'sex-change' operation does not change person's gender," Catholic News Service, 2003-JAN-14, reprinted at:
  5. Harry Benjamin, "The Transsexual Phenomenon," (1966; reprinted 1999), Pages 71-72, at:
  6. Ibid, Page 77.
  7. "Transsexualism," Wikipedia, as at: 2011-APR-19, at:
  8. J.W. Kennedy, "The Transgender Moment," Christianity Today, Volume 52, 2008-FEB, Page 5. at:
  9. Daniel Sartori, "Sex differentiation," Slide 35, at: This is a PowerPoint slide presentation. It is readable by downloading Open Office at:
  10. "Jerry Leach & Reality Resources," TransChristians, at:
  11. "Transsexualism," Wikipedia, as at: 2011-AUG-23, at:
  12. "Depraved indifference law & legal definition," USLegal, 2011, at:

Copyright 2011 to 2015 by Ontario Consultants on Religious Tolerance
Original posting: 2007-AUG-27
Latest update: 2017-DEC-18
Author: B.A. Robinson

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