Mark Yarhouse and Julia Sadusky are Christian psychologists with extensive experience working with youth navigating gender identity questions. They offer “practical wisdom” (p. 76) for parents and church leaders who are similarly engaged with trans youth. (For simplicity, I will use “trans” as the comprehensive description for the range of “emerging gender identities” discussed in by the authors—many of which reject binary notions of gender.)

The book focuses on how to care for trans youth, not on building a case for a particular view of transgender, though the “orthodox” view is apparent throughout the book (see p. 81). It is a timely volume, since “much more has been written on how to think about gender theory as Christians than on how to support people navigating gender identity concerns” (p. 170).

The book’s title reflects the fact that youth culture now includes a wide range of alternative gender identities—transgender, genderfluid, genderqueer, agender, nonbinary, etc. The authors comment that tracking the changes can be “like trying to follow the plot of a favorite series by watching it at four times or ten times the normal speed” (p. xi). The first chapter includes a helpful glossary of about thirty relevant terms. (Of course, the vocabulary has moved on since publication.)

Part 1 sets the scene by describing the rise of gender identity questions in Western culture and the debates about how to care for trans youth. Part 2 offers guidance for parents and pastors caring for young people.

Chapter 1 traces how views of trans people moved from a punitive legal approach to a therapeutic psychiatric paradigm to an affirming political position. The “standard” view now rejects any necessary relationship between biological sex and gender identity and sexual orientation, and holds that gender is “a constitutive feature of the psyche that is fundamental, immutable, and not tied to the material of the body” (p. 16, citing Tey Meadow, Trans Kids: Being Gendered in the Twenty-First Century [Oakland: University of California Press, 2018], 3). This has promoted diverse “emerging gender identities” which are not always connected to experiences of “gender dysphoria” (pp. 19–20).

Chapter 2, in my view the highlight of the book, asks how to understand the rapid changes in presentations of gender and the growing numbers of young people who are gender diverse. Yarhouse and Sadusky note the common explanations on either side of the culture war: increased acceptance and awareness allow expression of diversity which was always present, or it is the result of a social contagion. Their alternative explanation uses the idea of a “looping effect” developed by philosopher Ian Hacking, according to which a classification or category is applied to people who in turn interact with it. They use it to understand themselves and adapt it. Institutions associated with the classification develop and produce ‘knowledge’ and theories confirmed and used by experts. This social system tends to increase the number of people who are identified with a particular category.

Yarhouse and Sadusky apply this analysis to trans phenomena arguing that “something like gender incongruence has been reported throughout history and across cultures” and “the experience of gender incongruence is understood in evolving ways by society” (pp. 32–36). The looping effect helps to explain how trans experiences have rapidly spread and variegated. This does not invalidate a trans experience but emphasizes that it is shaped by complex factors. A “trans industry” has developed as an extension of the looping effect. The authors identify four overlapping groups who are subject to this looping effect: those who are transgender; those who are gender dysphoric; those with emerging gender identities; and searching teens.

The discussion of the looping effect invites theological reflection. Humans are self-conscious, embodied and embedded in community and complex social relationships. These factors interact to direct and distort our experience of sex and gender.

The third chapter reviews current models of care for trans youth, building on the discussion in Yarhouse’s Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture (Downers Grove, IL: InterVarsity Press, 2015). This covers responses to pre-pubescent gender variation, the use of puberty blockers and the rise of rapid onset gender dysphoria. The authors are sympathetic to the experience of trans youth and warn churches and Christian families against doubling down on gender stereotypes. They also critique mainstream approaches that reinforce the looping effect by always affirming the gender identities of young people.

Part 2 suggests ways that parents, youth ministers and others can engage well with trans youth. While part 1 explains that not all trans people experience gender dysphoria, much of the discussion in this part of the book refers to various forms of inner distress. This probably reflects that dysphoria is still a common experience.

Chapter 4 considers some of the theological foundations for ministry to trans people. It considers the three lenses on transgender previously set out by Yarhouse—integrity, disability, and diversity—and how these are applied by three theological stances—ultraconservative/fundamentalist, orthodox, and liberal. Later it uses a Christological pattern of prophet, priest and king to summarize the range of ways in which parents and leaders should minister to trans youth. It encourages carers to develop “an integrated, flexible posture of accompaniment” that “gestures that each person is dignified and worth accompanying by the very nature of their humanity” (p. 108). This discussion offers useful insights and warnings. It does, however, trade on caricatures. No doubt some who are theologically “conservative” deal with trans youth only in terms of sin and repentance. However, there are many who are empathetic, pastorally sensitive and willing to walk alongside young people. It is notable that this chapter, unlike others, lacks a basis in research. It would be valuable to investigate the extent to which pastoral practices correspond with theological stance.

The last five chapters can be summarized briefly. Chapter 5 reminds us that we encounter trans people expressing a political identity, a public identity or a private identity. We should differentiate between these and adopt appropriate strategies for each. The focus is on developing personal relationships which foster productive dialogue. Chapter 6 applies previous research on the narratives of Christian trans youth to help a carer locate where a young person may be on their journey. It suggests productive areas of discussion for different stages and ways in which parents can be supported. Chapter 7 opens with critique of the application of gender theory in psychology (p. 170). Yarhouse and Sadusky then encourage carers to explore the experience of trans youth carefully, recognizing the range of influences on them and seeking to respond to the emotional and spiritual needs which are often below the surface. On the controversial issue of nouns and pronouns, they suggest we can use a person’s preferred nouns and pronouns “without feeling as if we are making an anthropological statement” (p. 177).

Chapter 8 stresses the importance of engaging gender identity in youth ministry and suggests how this can be done (p. 188). The authors warn that describing trans identities as “sin” and “disobedience” not only alienates trans youth but limits the range of ways in which a youth ministry can respond to them (p. 191). They argue that teens should be seen and named as beloved and we should consider how to address the shame which often accompanies adopting a trans identity. They also encourage ministries to avoid rigid gender stereotypes, arguing that it is “more helpful to expand (rather than constrict) what it means to be a man or a woman in terms of gendered interests, activities, and appearance” (p. 197).

The final chapter calls for Christians to live in light of their hope of glorification in Christ, in contrast to the pessimism of our culture. This is relevant to trans teens, their families, and those afraid of and challenged by trans culture.

Emerging Gender Identities rightly emphasizes listening, understanding and dialogue as keys to caring for trans people. It recognizes the importance of teaching but has relatively little to say about that. At the start of the final chapter, the authors comment that “there is certainly a place to more deeply explore what sanctification could look like in the lives of Christians navigating gender identity questions” (p. 205). It would have been appropriate for the book to take this up. We should certainly accompany trans youth on their journey, and Yarhouse and Sadusky recognize that the church should, carefully and prayerfully, speak to the nature and goal of that journey. But fuller discussion of the content of that teaching is essential.

Similarly, the book warns repeatedly about the risk of excluding trans youth from church but has no discussion of the possible need for discipline. Is there a point at which a person who adopts a trans identity and embraces trans ideology cannot remain in communion with a church with an orthodox view of gender? It would be helpful to have some discussion of this (admittedly difficult) issue.

The goal of Emerging Gender Identities is practical wisdom in caring for trans youth. It offers this with a clear orientation to wider issues and a series of chapters with valuable insights and suggestions based on the experience and research of the authors. I recommend the book to everyone in youth ministry. It will be useful for Christian parents of trans youth, although perhaps overwhelming for those at the start of their journey. It will likewise help pastors find their way in difficult terrain and share the journey with youth facing greater challenges.