As typically defined, gender dysphoria is a state of consciousness that consists at its core of a qualitative feeling of a discordant “gender identity.” According to the common understanding, the individual has an “inner” self that has a gender or sex that’s different from what the body indicates, and hence the individual feels like—and in stronger cases believes him or herself to be—a woman trapped in a man’s body, or vice versa.
The cultural upheaval surrounding gender and sexuality presents many challenges for Christians and pastors. Have we done the theological reflection that’s necessary to respond carefully and pastorally? Do we have thoughtful theological responses to questions like, “Could God create someone whose inner self is one gender and place that individual in a body of the opposite gender?”
Answering thoughtfully will mean exploring our underlying assumptions about the human constitution. Are we purely physical bodies? Are we a combination of body and soul? Does our human constitution support the idea of a misgendered inner self? Let’s consider contemporary ways of answering these questions.
Materialism
Materialism (or physicalism) holds that people are simply and merely physical. We comprise no additional nonphysical or immaterial substances. Consequently, materialists affirm there’s nothing required for conscious mental properties like beliefs, desires, intentions, and feelings other than the occurrence of biophysical and neural states and processes in an individual’s brain and body. The most generous materialist might allow for a mental entity that constitutes the inner self, but he would see this “inner self” as made up solely of the body and its constituent parts, not of a wholly new, distinct, immaterial substance.
Gender dysphoria [as typically defined] presents a challenge for theologians and pastors.
When materialists explain the causes of gender dysphoria, they can only appeal to biophysical states, especially those involving neurology. Many turn to brain-sex theory. Simply put, the theory states that the brain of transgender individuals has “brain features that don’t fit the sex of their cells.” This leads to a situation where the biophysical and neural operations of the brain produce an “inner self” who experiences discordance in his or her gender identity. The current scientific consensus about brain-sex theory is it’s just that—a theory—and it remains unclear whether and to what extent neurobiological findings say anything meaningful about gender identity. More research is needed before scientists can draw definite conclusions.
Substance Dualism
Unlike materialism, substance dualism maintains there are two distinct mental and physical realms or substances—the mind/soul and the body. These together constitute the human person. Both soul and body are fundamental and not reducible to anything more basic. As distinct entities, body and soul are capable both of existing separately and of entering causal relationships with each other so that the soul can act directly upon the body and be acted upon by the body.
Under substance dualism, one’s inner self could be identified with one’s soul. However, such an identification opens the substance dualist to the charge from a gender-dysphoric person: God created my soul, and therefore my inner self, of a particular gender but mistakenly placed that soul in a body of the opposite gender.
This charge is answered by the three main varieties of substance dualism.
First, emergent dualism says the soul (or mind) emerges from a properly configured body with all the biological, chemical, and neural relationships and interactions in place. Once emerged, the soul is constituted and exists as an immaterial substance that’s distinct and separable from the body. Because the soul is not created “externally” and subsequently added into a body but rather emerges “internally” from the physical, chemical, and neural operations in the human body, the soul couldn’t emerge with a gender that’s mismatched with the body.
Thomistic dualism (named after Thomas Aquinas) sees all material objects as composed of matter and a form that determines the matter’s essential nature. With human beings, the soul is the form that animates or actualizes a body to be a sexed human body. Because the soul serves as the vivifying and animating principle for a human body that is biologically sexed, it’s virtually impossible for the soul to be gendered another way. A “male” human soul cannot serve as the animating principle for a “female” human body, because the soul-body composite exists as a female human being.
Stronger forms of Cartesian dualism construe body and soul as so fundamentally different that there’s little interdependence between the two. Gregory of Nyssa’s understanding is one example, but he viewed the human soul as asexual in nature, not gendered by itself in abstraction from a human body. In this view, sex or gender isn’t an essential property of a human soul but rather a property it can only hold in conjunction with a biologically sexed body.
2 Theological Implications
Whether your starting point is materialism or substance dualism, a person’s inner self is inextricably linked to his or her body and its constituent parts. When primary sex characteristics such as genitalia are developing normally, the gender identity of a person’s inner self should (in accordance with materialism’s and substance dualism’s own commitments) be the same as that of the biological sex of the body. There’s little to no logical basis for the charge that God created but misplaced my inner self in the wrong body.
This conclusion carries two theological implications.
1. The causes of gender dysphoria cannot arise from creation but instead must result from humanity’s fall.
Gender dysphoria is not a natural state of consciousness God created us to experience. This isn’t to belittle in any way the genuine sense of gender identity discordance that the gender dysphoric person struggles with, but it is to say that in the case of biologically sexed individuals, the conscious state of gender dysphoria is a psychological phenomenon resulting from the fall rather than a physiological (involving the proper functioning of the human body and brain) or ethereal (involving the human soul) phenomenon that finds its origin at creation.
Two things to note about this reality: First, whether we understand our human constitution through materialism or substance dualism, our inner self, or soul, is gendered in conjunction with our biologically sexed body. We’re created as whole people, and we experience the fall as whole people. These two premises rule out any basis for the Gnostic claim, “God made my male soul good, but it’s mismatched with my fallen female body.” Second, for some, gender dysphoria has been part of their life experience since early childhood and not something they would have chosen. In their case, the mere fact of their dysphoria shouldn’t be seen as owing to sin they’re actively engaging in but rather as a uniquely difficult trial the church should help them bear in a sanctifying way. Nevertheless, the actions one chooses to take in one’s gender dysphoria always have ethical and moral bearings.
2. We need to retain some aspects of what has been termed as ‘essentialism.’
Cultural contexts and social constructs shape the way we understand gender norms, but ultimately sexuality and gender identity cannot run away from the biological givens of life.
Whether your starting point is materialism or substance dualism, a person’s inner self is inextricably linked to his or her body.
A basic “essentialism” should guide our pastoral care and lend us restraint in our psychological assessment and treatment of gender dysphoria in individuals. Not only do gender reassignment surgeries do irreversible violence to one’s bodily integrity and directly harm one’s capacity for reproduction, it’s also questionable whether such surgeries achieve the alleviation of psychological distress they’re purported to bring about. Even if they do, the surgery’s success in relieving psychological distress is ultimately premised on a falsehood. Accounts of the constitution of human persons testify to a clear grounding of gender identity in the biological sex a person is created with.
This article is adapted from “Gender Dysphoria and the Body-Soul Relationship” by Edmund Fong, which appears in Themelios 47, no. 2 (August 2022). Access the full journal online.