Research

Transsexuality-An Evangelical Christian Response

        Author: ES (Research)
Transsexuality


TERMS

SEX refers to the biological characteristics which define humans as female or male [These sets of biological characteristics are not mutually exclusive as there are individuals who possess both] (WHO, 2002).

GENDER refers to the economic, social and cultural attributes and opportunities associated with being male or female in a particular point in time (WHO, 2001).

TRANSSEXUAL is a person who undergoes surgical and/or hormonal interventions to reassign his/her sex (WHO, 2002). See below for syndrome.

TRANSVESTITE is a person who has compulsion to dress and act like members of the opposite sex, but does not have strong desire to change sex.

GENDER IDENTITY DISORDER a psychiatric term for transsexuality, transgender and (subject to debate) transvestism.

INTERSEX refers to rare medical conditions where people are born with ambiguous sexual characteristics, and nearly always due to physiological causes.

HERMAPHRODITE refers to rare clear physiological causal medical congenital conditions where the sex of newly born babies is ambiguous due to the presence of gonads and genitalia of both sexes.

Incidence of transsexuality

1 in 30,000 males, 1 in 100,000 females
(1993, 1997,USA)

1 in 11,900 males, 1 in 30,400 females
(1996, Netherlands)

In Malaysia , a survey taken in 2000 estimated that there were 50,000 transsexuals in the country (The Star, 2001-1-21). Muslim transsexuals formed the majority of population.

THE SYNDROMES

Transsexuality is a Gender Identity Disorder (GID) in which there is strong cross-gender identification. There are currently two main diagnostic systems for transsexualism.

The current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, 1994) has five criteria that must be met before a diagnosis of Gender Identity Disorder can be given:

  1. There must be evidence of a strong and persistent cross-gender identification.
  2. This cross-gender identification must not merely be a desire for any perceived cultural advantages of being the other sex.
  3. There must also be evidence of persistent discomfort about one's assigned sex or a sense of inappropriateness in the gender role of that sex.
  4. The individual must not have a concurrent physical intersex condition (e.g., androgen insensitivity syndrome or congenital adrenal hyperplasia).
  5. There must be evidence of clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The current edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10, 1992) has the following criteria for transsexualism:

  1. The desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his or her body as congruent as possible with the preferred sex through surgery and hormone treatment.
  2. The transsexual identity has been present persistently for at least two years.
  3. The disorder is not a symptom of another mental disorder or a chromosomal abnormality.

Transsexuality has been considered by many a phenomenon of the late 20 th century when the function of hormones began to be understood and surgical options became technically possible. The word was probably popularized in the late 1940s and 50s by Dr Harry Benjamin, an American psychiatrist. Dr Benjamin believed that genetic and endocrine systems provided a ‘fertile soil' for environmental influence.

Research into the genetic and physiological origins of transsexuality remains inconclusive. The scientific study is relatively limited in scope and has become a highly controversial area in which interest groups with specific agendas sometimes anticipate what they would like the outcome to be.

Development

In males, transsexuality may begin in childhood with feelings of discomfort with bodily sexual characteristics, and occasionally with a desire to be the opposite sex. This may often lead to cross-dressing, which may develop into a fetish form of transvestism in which sexual arousal occurs. This conflict with the male gender identity may then lead to the adoption of a different gender role identity. In effect, a biological male believes that he is somehow ‘trapped in the wrong body' and should really be a woman. The development is different in females where the fetish element is less important, if not absent. In both sexes however, there is an obsessive striving to change appearance and behavior to mimic that of the opposite sex.

Are transsexuals born that way?

Over 99.98% of the individuals are, obvious at birth, either male or female sex (Sax, 2002) if defined by physical characteristics (the presence of a vagina or a penis). In a very small number, sex may be unclear due to ambiguous genitalia as a result of medication conditions, e.g. adrenal virilization syndrome (in which girls are born with a masculinized clitoris) or hermaphroditism .

Different explanations on transsexuality have been offered, with the debate centering on ‘nature vs. nurture.' Recently, Dr Mohd Ismail Mohd Tambi, a consultant clinical andrologist, disclosed to the media that one of the reasons for transsexuality was biological (The Star, 2005-11-28). Yet studies on biological causes remain inconclusive, for differences in brain structure could have been caused by hormonal medications. In other words, the strength of studies on brain structure is still very limited. Research has also not been able to confirm the suggestion of differences in hormone levels nor demonstrate genetic cause. There is still a general lack of good replicated research. The debate continues.

According to a report by the Evangelical Alliance Policy Commission (EAPC) in Britain , the body of evidence for transsexuals having psychological causes is greater and more long-standing compared to evidence for biological causes. "Published academic literature that indicates transsexual people as children have experienced much greater psychological harm than non-transsexuals remains largely undisputed."

Some examples of psychological factors are: parental rejection, absence of father during childhood, having emotionally-distant father, peer pressure, perfectionism, media images, self-rejection and poor self-esteem which may be reinforced by hostile reception from society.

In some cases, transsexual behavior ceased when a concurrent psychiatric condition was treated with medication (e.g. a 1997 case report: ‘Four year remission of transsexualism after comorbid obsessive-compulsive disorder improved with self-exposure therapy'). In other words, transsexual can and do change their gender identity and preference.

In sum, the precise etiology (study of causes) of transsexuality is still an open question.

TREATMENT 

Gender reassignment surgery (GRS) as solution

Most transsexuals suffer from great psychological and emotional pain due to the conflict between their identity and their original gender role and anatomy. Although GRS meets many of their wishes and affords them a measure of increased comfort, it nevertheless does not deal with root psychological causes. The question to ask is whether a treatment tackles the illness or manages the symptom.

EAPC believes that GRS allows the deep psychological confusion and hurt suffered by transsexual people, and thereby "increasing the prospect of future emotional damage." Further, the post-operative transsexual lifestyle requires regular assistance of hormone therapy throughout its lifetime. A difficulty with transsexuality is that it is largely concerned with a state of mind.

THE MALAYSIAN CONTEXT

In Malaysia , the local term for male transsexuals is mak nyah , and pak nyah for females. In1983, the Conference of Rulers in Malaysia decided that a fatwa prohibiting sex change operation should be imposed on all Muslims, except in the case of a hermaphrodite. Although there are no official religious rulings from other faith communities, the groups have staunchly opposed sex-change.

In November 2004, a judge dismissed an application by a 33-year-old who wanted to become legally male after a sex-change surgery, and ruled that biological characteristics were set at birth and that biological, rather than psychological tests, determined gender identity (BBC, 2004-11-5). Currently there is no law covering gender reassignment in Malaysia .

Responding to a recent transsexual marriage in Kuching, Home Affairs Minister Datuk Seri Azmi Khalid said that Malaysia laws do not allow its citizens to change their gender in their identity card despite a sex-change operation (The Star, 2005-11-15). His deputy Datuk Tan Chai Ho told Bernama that the marriage was "invalid" as the Marriage and Divorce Reform Act 1976 does not allow marriage between two people of the same sex, even if one of them has undergone sex change surgery (2005-11-14). Prime Minister Dato' Seri Abdullah Ahmad Badawi stressed that the government does not condone same-sex marriages (The Sun, 2005-11-23).

CHRISTIAN RESPONSE

From the perspective of many transsexuals, the Church may have appeared to be strong on condemnation and weak on compassion. While resting on the conviction that God has revealed His intentions for human life in the Bible, the evangelical churches still have much to offer.

Simply highlighting Deut 22:5 (prohibition on cross-dressing), 23:1 (prohibition on emasculation) or 1 Cor 6:9-11 (in regards to effeminate behavior), and applying them on transsexuals can result in a failure to do justice to a responsible exegesis, reasonable hermeneutics and application.

The context of Deut. 22:5 intends to maintain the sanctity of the distinctiveness between the two created sexes, while the context of 23:1 supports and affirms the positive value of sex and that sexuality and spirituality are not in opposite to one another. Regardless, all these verses cannot be read in isolation from the rest of the Scripture. To consider the issue of transsexuality wholistically, Christians need to view the whole Scripture in light of creation, fall, redemption and final restoration.

The doctrine of creation shows that our sexual identity is given by God. It also emphasizes the basic and clear distinction between men and women. It sets out the foundation for Christian understanding of marriage as one of God's gracious gifts to humanity and that relationships are heterosexual, monogamous and open to the possibility of procreation.

The doctrine of fall tells us about the effects of sin on creation as a whole. Adam and Eve's willful disobedience had resulted in the distortion in God's pattern for living, including biological abnormalities and psychological disorders. We recognize and acknowledge these aspects of our fallen condition and seek to bring our tarnished lives in line with God's will and purpose.

We believe that putting things right is central to how God is involved in His creation after the fall. Therefore the doctrine of redemption is important in that those who suffer the effects of sin may find hope, a hope that is based on the healing work of Jesus Christ and His offer of abundant life (John 10:10).

The doctrine of final restoration warns us that our present experience of God's healing work is often necessarily partial and incomplete. The fulfillment of our redemption is in store in the future existence beyond the present world.

For Christians, transsexuality poses significant challenges, both moral and theological. In practice, it is difficult to maintain a balanced approach that maintains scriptural convictions with a compassionate response. Yet, it is important to stress that insensitive and ill-advised treatment of transsexuals can prove devastating and dangerous. There is no general formula for dealing with transsexuals, for each person is an individual with a unique personality and history.

"The need for patience, long-term commitment and the active seeking of God for wisdom by all concerned cannot be over emphasized" (EAPC). For Christians, "the emphasis is on both psychological and physical wholeness in the hope that the transsexual people will of themselves produce the desired psychosomatic unity, more truly reflects a biblical view of holistic health" (EAPC). Redemption and restoration begin within the church community and the challenge demands compassion, knowledge and wisdom.

AFFRIMATION & RECOMMENDATIONS (adapted from EAPC 2000 report)

NECF Malaysia respects individual rights and diverse perspectives on transsexuality, but remains steadfast in Biblical principles. We affirm God's love and concern for all humanity, and believe that God creates human beings as either male or female. Authentic change from a person's birth sex is not possible and an ongoing transsexual lifestyle is incompatible with God's will as revealed in Scripture and in creation. After careful consideration, we affirm and recommend the following:

  1. We recognise that all of us are sinners, and that the only real hope for sinful people, whether heterosexual, homosexual or transsexual, is for wholeness that is found only in Jesus Christ.
  2. We deeply regret any hurt caused to transsexuals by any unwelcoming or rejecting attitudes on the part of the Church. We call upon evangelical congregations to genuinely welcome and accept transsexuals, while acknowledging the need for parallel teaching, wisdom and discernment.
  3. We affirm that monogamous heterosexual marriage is the form of partnership uniquely intended by God for sexual relationship between men and women. We would resist church service for the marriage or blessing of transsexual partnerships on scriptural grounds.
  4. We appeal to the medical and psychiatric professions to prioritize research into the root psychological, social, spiritual and physical causes of ‘transsexuality' for the purpose of holistic treatment
  5. We commend and encourage transsexuals who have determined to restore their birth sex identity as a result of biblical conviction, and/or who have decided to resist gender reassignment surgery. We would seek prayerfully to support their reorientation through the grace of God.
  6. We prayerfully affirm and encourage those family members who are subjected to the impact of transsexuality and would seek to support them pastorally.
  7. We commend the work of those organisations, pastoral workers and churches that seek to help and support transsexuals.
  8. We in principle are opposed to civil discrimination against transsexuals, for example in respect of human rights and employment.

References

  1. A report by the Evangelical Alliance Policy Commission. Transsexuality . London : Evangelical Alliance , 2000.
  2. Leonard Sax. "How common is intersex? A response to Anne Fausto-Sterling." Journal of Sex Research , August 2002.

Posted Dec 1, 2005



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