What does God have to say about gender in the Bible? Is gender fixed at birth? Can someone be a “man trapped in a woman’s body?” Such a statement would have been inconceivable to our ancestors. Why?

Dr. Andrew Walker, connected with the Gospel Coalition, writes,

God made men and women different. Contrary to mistaken interpretations, sexual difference does not exist on a continuum where some men are more like women or vice versa. Men and women are different at the deepest levels of their being. Our chromosomes are different. Our brains are different. Our voices are different. Our body shapes are different. Our body strengths are different. Our reproductive systems are different. The design for what our bodies are structured and destined for are different, and these designs bear witness to differences that reflect God’s creative will for humanity.

The Bible is clear that God determines our gender at birth. Sexual difference is the one difference within humanity that is prominent in the creation narrative. Genesis does not suggest a generic plurality of humanity. Instead, humanity’s maleness and femaleness render us a race and establish the primary bonds of our natural relations. They are the source of our given identities. We’ve been empowered as male and female to bring forth new images of God and of ourselves (cf. Genesis 1:27; 5:2-3) and are ordered toward each other in a much deeper way than merely as individual members of a collective.

Dr. Paul R. McHugh is the former psychiatrist-in-chief for Johns Hopkins Hospital and is currently their Distinguished Service Professor of Psychiatry. He is the author of six books and at least 125 peer-reviewed medical articles.

In the following remarks from a 2015 editorial in the Wall Street Journal, McHugh explains that transgender surgery is not a legitimate reality:

Sex change is biologically impossible. People who undergo sex-reassignment surgery do not change from men to women or vice versa. Rather, they become feminized men or masculinized women. Claiming that this is a civil rights matter and encouraging surgical intervention is in reality to collaborate with and promote a mental disorder.

He also reported on a new study showing that the suicide rate among transgendered people who had reassignment surgery is 20 times higher than the suicide rate among non-transgender people. That is something that should deeply sadden all of us.

The reason we get confused about all of this is because we live on a fallen planet that is ravaged by sin. We are all born broken in different ways—with physical, mental, emotional and psychological disorders. In working with individuals who are truly struggling with gender dysphoria, Christians are called to be people of compassion and grace. Helping those with gender confusion is usually a slow process of bringing one’s perceived gender identity back into conformity with their biological sex. This requires a great degree of patience throughout what may be years of psychological, emotional and spiritual valleys. We need Christians who will walk alongside these individuals in every season—in victory and in defeat—encouraging them toward the healing that is found only in Jesus.