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The difficult path to understanding and ministering to trans youth

A new book by two Christian psychologists offers an integrated approach to a complex and often divisive issue.

(Image: Gaelle Marcel | Unsplash.com)

Transgenderism is currently among society’s most controversial topics. Especially in Christian circles, the moral and theological implications of this phenomenon have been a major point of contention. But the distinction between transgenderism (and gender theory) and the person who has or wishes to transition is, according to Drs. Mark Yarhouse and Julia Sadusky, not given enough attention. As much as those with a teaching vocation ought to critique the theoretical errors of gender theory, to assume that this is an adequate means to minister to trans people is naive and likely to be ineffective.

In their new study Emerging Gender Identities: Understanding the Diverse Experiences of Today’s Youth, Drs. Yarhouse and Sadusky—both Evangelical clinical psychologists—offer a wide array of clarifications, distinctions, and pastoral insights based largely on their clinical experience with gender atypical teens. The book begins with the warning to parents and pastors to avoid responding defensively when a teen confides to them that they are gender atypical. A lesson in theological anthropology is not likely to help them get to the root of their discomfort with their identity.

In order to be able to listen, understand, and help the teen, they suggest first learning about the language that the teen is using to describe what he or she is experiencing. They begin with the distinction between gender dysphoria and “emerging gender identities.” Gender dysphoria, to which Yarhouse dedicated his previous book, is a neurological condition in which a male perceives himself to be female, or vice versa. Variations of this phenomenon “have existed throughout history,” and is what most people think of when they hear the word “transgender”. They emphasize gender dysphoria’s neurological basis, and that it ought not be equated with willful rebelliousness or wanting to follow trends.

Emerging gender identities or gender diversity (which include genderfluid, genderqueer, agender, and bigender) are fairly new concepts which express something beyond feeling one’s body to be incongruous with his or her identity. These identities construe gender to be more broad than male and female, and thus perceive the male/female binary to be a source of oppression. These identities find much of their origin in the writings of gender theorists like Judith Butler.

Yarhouse and Sadusky’s historical genealogy of transgenderism provides further clarification, tracing the line from when it was understood to be a result of moral depravity, to a pathological condition, and then more recently to a politically charged identity. From this historical view they zero in on what they deem a false dichotomy that has emerged in contemporary debates: the increased awareness vs. social contagion theories. The former holds that one’s gender identity, be it cisgender, trans, or gender diverse, is essential to who you are, and that the recent surge of people identifying as non-cisgender is due to growing awareness and cultural acceptance of non-cisgender experiences. The social contagion view sees this surge of people “falsely” perceiving their gender identities to be distinct from their bodies as the result of the popularization of trans narratives in the media.

Yarhouse and Sadusky suggest instead taking into account the multiple layers and factors behind a person’s trans identity. To do so, they point to philosopher Ian Hacking’s framework, known as the “looping effect,” which considers how “changing ideas change people, and how changed people necessitate further changes in ideas.” “People’s behaviors change in response to how they are categorized…reactions may be behavioral or conceptual or affect identity insofar as assumptions about the self and the condition are shaped by mental health nomenclatures. This shaping can come from many sources, including mental health experts, broader societal views, and taken-for-granted realities.”

Hacking accounts for five factors within a given looping effect: classification, people, institutions, knowledge, and experts. Yarhouse and Sadusky insist that this kind of framework allows parents, pastors, and counselors to appreciate the way a teen construes his or her experience, while also being better able to identify the root cause of the gender incongruity (be it actual dysphoria or other issues).

This framework also allows important questions to be raised about the authority afforded medical experts in these matters. Why are so many doctors prescribing gender blocking hormones and sex-change surgeries? “Something like crowd curation is happening in response to young people navigating gender identity questions today.” Yarhouse and Sadusky point to the rapid change in narratives, first distinguishing cisgender from trans identity, and now from trans to emerging gender identities. “Experts who might ordinarily be relied on as curators have turned to children with transgender and gender diverse experiences for guidance, making these children the curators of their own gender possibilities.” Rather than helping young people to sort through and possibly resolve the lack of congruence between their bodies and perceived identities, doctors are now responding to demands of patients as if these were transactions between retailers and customers.

They propose that many young people who don’t perceive themselves to be like other boys or girls are now identifying as trans because it’s one of the only narratives made available to them to make sense of their experience. Whereas the boy who played with dolls used to be deemed more sensitive than other boys, and the girl who like rough and tumble play was told she was a tomboy, they now are more likely to hear that they are not a boy or a girl, but perhaps are really trans or non-binary. Though these could indeed be signs of gender dysphoria, it’s possible that they just may happen to have different personalities from the dominant stereotypes of masculinity and femininity. They note that this lack of identification with dominant gender stereotypes can be a source of enrichment for others, for it forces us to question the basis and real value of those stereotypes.

They also point to the sense of identity and community that come along with calling oneself trans. It’s likely that many of these young people lack the resources to answer questions like “who am I?” and “where do I belong?” Identifying as trans or gender diverse provides one with almost built in answers, especially considering the wide array of resources made available through the internet and social media.

The second part of the book offers practical advice revolving around the theme of pastoral accompaniment. “This posture signifies that we want to understand where a person is, enter into their present experience with them, and commit to journey with them regardless of where they go from here.” Yarhouse and Sadusky offer several examples from the lives of their own clients, and categorize the typical responses of parents and pastors into three theological frameworks. The “ultra conservative/fundamentalist” position “prioritizes a theoretical theology of gender grounded in Scripture without considering the impact and costliness of this theology for those on the fringes.” The “liberal” position “emphasizes so highly the importance of walking with people that it might treat as irrelevant the moral and ethical implications of a person’s decisions for fear of casting judgement.” And lastly the “orthodox” position, which the authors are partial to, “says we need not throw out theological considerations but that we must not exert all of our energy into categorizing the morality of gender identity.” They continue, “even if you think you have all the theological and ethical answers,” they recommend pausing to reflect on “the ‘how-to’ of sharing them.” They turn to the example of Jesus himself, who “struck a balance between asserting moral truths and inviting to relationship with those who question or even rejected these moral truths.”

Their image of accompaniment upholds the forging of an intimate, trusting relationship, rather than articulating and engendering obedience to moral rules, as its ideal. They assert that this reflects the ideal of Christianity more broadly—entering into relationship with Christ and coming to recognize the truth of one’s identity in Him, rather than abstractly applying a set of rules to one’s behavior. This begins with listening. Half of the struggle of gender incongruity is feeling that no one understands or wants to hear about what you’re feeling.

Being able to listen to someone’s experience doesn’t necessarily preclude challenging the conclusions they come to, nor refraining from condemning false doctrines. It’s a matter of what, how, and when it is said. For example, a pastor who is working one-on-one with a trans teen will want to first establish a foundation of trust before questioning why he or she has chosen to identify that way. Whereas a professor teaching in a theology class is in more of a position to critique the false foundation of gender theory, while still maintaining a sense of sensitivity and respect for those who identify as trans. That being said, the anthropological vision provided by Genesis and the rest of Scripture indicates that the gender binary ought not only be culturally normative, but is a rich source of meaning and beauty within the broader context of God’s creation.

When it comes down to the decision of whether or not to cross identify, Yarhouse and Sadusky recommend counseling teens to wait until young adulthood, since most cases of adolescent gender dysphoria eventually resolve themselves. If the dysphoria is not resolved on its own or through counseling, they recommend the least invasive decisions possible, starting from cross-dressing, and if needed, hormone therapy. They draw the line at surgical changes in light of such a decision’s ethical implications, as well as the research indicating that numerous people who transition eventually will want to identify with their biological sex again.

The last and most compelling suggestion offered is developing “a robust  theology of suffering.” Christian anthropology recognizes the inherent unity between body and soul. The rupture of unity brought on by gender dysphoria is a source of deep pain and suffering. They lament how the ultraconservative and liberal approaches downplay one of the most essential aspects of Christianity: the Cross. These attempts to cover over the messiness of suffering lose sight of Christ himself, “who is certainly not alien to suffering and to the human feeling of being forsaken by God.” The Christian community ought not only pray for, but with those experiencing dysphoria. Carrying the cross together can become a source of enrichment for everyone in the community. Identifying with Christ’s suffering body and sharing the cross with Him and the rest of the Christian community can become “an entryway into some of the elements of identity and community” that draw teens to the trans community in the first place.

They also note that service to others can be “an outlet to cope with the ache of distress.” The corporal works of mercy can be a meaningful way for people who experience suffering in the body to begin to discover their true identity in Christ. “Many of us find,” they continue, “that when we wrestle with God, we can enter more fully into the wrestling of others that is inherent to the spiritual life, becoming more driven to serve them and to find transcendent meaning in the process.”

Yarhouse and Sadusky’s extensive clinical research, fidelity to the doctrines of their faith, and profound sensitivity to the experiences of trans and gender diverse people have allowed for them to offer this integrated approach to a complex and often divisive issue. Compromising neither their beliefs nor their professionalism and commitment to the person, their study distinguishes itself from others that fall into simplistic reductionism. Further, this study offers something for everyone, be it for those more sympathetic to the transgender cause who are looking to make sense of the apparent clash between trans experience and orthodox Christianity, or those whose mission it is to uphold truth who are unsure of how to share it with those who feel confused or alienated by Christian doctrine. Their nuanced and practical insights based on wisdom from theology, psychology, popular culture, and lived experience will prove to be a valuable resource for parents, pastors, and counselors.

Emerging Gender Identities: Understanding the Diverse Experiences of Today’s Youth 
by Drs. Mark Yarhouse and Julia Sadusky
Brazos Press, 2020
Paperback, 256 pages


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About Stephen G. Adubato 2 Articles
Stephen G. Adubato studied moral theology at Seton Hall University and currently teaches religion and philosophy at St. Benedict’s Prep in Newark, N.J. He also blogs at the "Cracks in Postmodernity" at the Patheos Catholic Channel.

7 Comments

  1. The authors of a 2019 study which claimed so-called gender-transition surgery may improve the long-term mental health of recipients have issued a CORRECTION, nearly a year after publication. The authors of the study—Richard Bränström, Ph.D., and John E. Pachankis, Ph.D.—now report that: “the results demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care.”

    https://www.catholicworldreport.com/2020/08/04/researchers-reverse-gender-surgery-offers-no-advantage-to-mental-health/

    Perhaps the American Psychiatry Association (APA) and the American Medical Association (AMA) will:
    (1) Revise any past testimony related to state laws that now prohibit non-abusive restorative therapy and counseling for young people suffering from gender dysphoria.
    (2) Pay damages for those patients who have been misled into being physically mutilated, permanently, based on previous, credentialed and politically-correct APA and AMA scribblings;
    (3) More generally, adopt a more circumspect attitude toward the LGBTQ and gender-theory “community” construct, and then,
    (4) Clear affirm the benefits—and truth content—of binary/complementary human sexuality and marriage, together with a news alert also affirming (to those suffering from geographic dysphoria) that the earth is indeed round instead of flat (another binary decision).

    • Its actually very simple. You academics put it in a philosophical realm. When its spiritual. A dominant female spirit due to weak fathers making sons femine. Daughters like moms compensating a male spirit becoming masculine. These kids need exorcists. Not professional doctors.

    • Peter,
      Yes. I think when the current hysteria dies down and the young people who have been sterilized and mutilated begin filing lawsuits, things may change for the better.
      That’s part of the history of eugenics also.

  2. The first step in ministering to and counseling “transgender” youth is to stop referring to them as “transgender” youth. Are you helping David Allen Bawden if you address him as “Your Holiness” while trying to explain to him that he is not Pope Michael? People who suffer from gender dysphoria are no different than those who disfigure or mutilate themselves because they feel that sone organ or limb is foreign to their body.

    • Exactly.

      In reading the article I was disgusted by the parade of nonsensical words and phrases. Anyone who uses them is playing along with a denial of reality, and is promoting evil.

      “In order to be able to listen, understand, and help the teen, they suggest first learning about the language that the teen is using to describe what he or she is experiencing.” “Emerging gender identities or gender diversity (which include genderfluid, genderqueer, agender, and bigender)”

      How about skipping the language that the teen is using, which is almost certainly parroted from the people who are pushing this evil, and just telling them the plain truth: There are two sexes, male and female (with a vanishingly small number of aberrations). Your feelings have nothing to do with the fact that you are a boy or a girl.

      “These identities construe gender to be more broad than male and female, and thus perceive the male/female binary to be a source of oppression.”

      Then they need to have the truth pointed out to them.

      “These identities find much of their origin in the writings of gender theorists like Judith Butler.”

      Who must be either evil or willfully ignorant.

      Next we will have to be playing along with boys and girls who think they are unicorns or leprechauns. No, thank you.

      • Leslie,
        I understand what you’re saying, but you might be missing the point.

        My take on the central theme of the article is:

        1) Listen to how they describe their predicament,
        2) for the purpose of developing trust and to formulate the remedy.
        3) Ask probing questions that might lead them to see their folly.
        4) After listening, probing, and developing trust, provide the truthful remedy.

    • This article does not pass the smell test.

      1) ¨In order to be able to listen, understand, and help the teen, they suggest first learning about the language that the teen is using to describe what he or she is experiencing.¨

      We can and should ¨listen¨ and ¨understand¨ where a teen is coming from – but then somewhere down the line, there also needs to be a gentle critiquing of dubious ¨identities¨, made-up terminology and / or copied ´language´, – for example, see the sort of stuff being sought to be legitimized at https://uwm.edu/lgbtrc/support/gender-pronouns/

      2) Regarding an *alleged* (peer-reviewed? broad scientific consensus?) ¨neurological basis¨ for ¨gender dysphoria¨, perhaps the voices of others also should be heard – chances are, they would disagree with some, if not most of what Mark Yarhouse and Julia Sadusky *opine*. In the spirit of ¨dialogue¨ (you know – the same spirit with which the author of this article wrote https://www.patheos.com/blogs/cracksinpomo/2020/02/beyond-critiquing-fr-martin/ ) and *for starters*, perhaps they and the author of this article should also have a public chat with folks such as https://segm.org/about_us and https://www.youtube.com/watch?v=QPVNxYkawao and https://www.youtube.com/watch?v=GOniPhuyXeY and https://www.youtube.com/watch?v=rYtGPLpW-g8 and https://www.youtube.com/watch?v=Rt9DW4e1Cvw and https://www.youtube.com/watch?v=7DwKS1QPh1k etc.

      3) ¨…The social contagion view sees this surge of people “falsely” perceiving their gender identities to be distinct from their bodies as the result of the popularization of trans narratives in the media…¨

      That there has indeed been a popularization of ¨trans¨ narratives in the media is evident. And that a ´social contagion´ has indeed spread in some cases cannot be ruled out. Whether people are falsely or actually *perceiving* their gender identities to be distinct from their bodies misses the more important point – which is, whether the toleration…normalization…legitimization…approbation…¨pride¨ celebration…of such ´perception´ is good for both the individual and for society. And once society gets used to the opening of that Pandora´s box, why stop with ¨gender identities¨? How about ¨sexual identities¨ of the next frontier, – for example: ¨virtuous pedophiles¨ (https://www.youtube.com/watch?v=k-Fx6P7d21o ) and ¨non offending pedophiles¨ (https://www.youtube.com/watch?v=5yWklRbXDOY )?

      4) ¨…People’s behaviors change in response to how they are categorized…reactions may be behavioral or conceptual or affect identity insofar as assumptions about the self and the condition are shaped by mental health nomenclatures. This shaping can come from many sources, including mental health experts, broader societal views, and taken-for-granted realities…¨

      https://www.catholicworldreport.com/2012/09/27/redefining-deviance/

      5) Re the sense of identity and community that come along with calling oneself ¨trans¨, although not green-lighting, are Yarhouse and Sadusky ¨neutral¨ about such ¨identities¨ and ¨communities¨? [If not an open embrace, is there a hint of the ´whatever-makes-you-happy´, relativistic, ´Justice´ Anthony ´you-can-make-up-the-meaning-of-your-own-existence´ Kennedy mindset?]

      6) ¨pastoral accompaniment…we want to understand where a person is, enter into their present experience with them, and commit to journey with them regardless of where they go from here.¨

      Regardless? So if someone decides after all the ´gaining trust´ and conversations, to stick to the path of a full-on embrace of the ¨transgender¨ ¨identity¨, are we to continue ´pastoral accompaniment´? Perhaps we can ¨update¨ the parable of the prodigal son and have the father ¨accompany¨ the younger son into the pigsty – you know, not to eat along with his son and the pigs but just to ¨accompany¨ and ¨be present¨?
      If yes, why stop there? How about accompanying the likes of https://www.youtube.com/watch?v=JfyxUO4ZsDo and https://www.youtube.com/watch?v=RdK0neywYOc ?

      Just as excommunication serves a medicinal purpose to protect both the excommunicated and the community, at some time we would have to gently but firmly say that we cannot and will not accompany people off a cliff. Thus far and no further. The door is always open. Sometimes the prodigal child needs to really eat with the swine before coming to the senses, and then choosing to get up and return. We of course long for him/her to do just that.

      7) ¨If the dysphoria is not resolved on its own or through counseling, they recommend the least invasive decisions possible, starting from cross-dressing, and if needed, hormone therapy.¨

      Good grief! By that ´logic´, we can, in time, ¨evolve¨ and potentially green-light even other types of ¨dressing¨ – such as the dog – https://www.youtube.com/watch?v=2rZ_sR3KS34 or the
      cat – https://www.youtube.com/watch?v=rLmwLcLikXQ

      Or how about the adult male who wants to dress as a 6 year old girl? https://www.youtube.com/watch?v=H4FSCqZcl8g

      And as part of ¨affirming¨ ¨therapy¨, perhaps even the ¨¨virtuous pedophiles¨ and ¨non offending pedophiles¨ of number 3 above can be ¨accompanied¨ and green-lighted to ¨enjoy¨ ¨virtuous¨ pleasures and dances by the likes of https://www.youtube.com/watch?v=cyzunkwrtTE

      A line is crossed when those in positions of authority are seen to tolerate, legitimize or green light that which involves or points to disorders, especially when there are knock-on effects in the moral realm.

      In this case, the scandal and harm is more because it involves ´Evangelical clinical psychologists.´

      8) ¨The Christian community ought not only pray for, but with those experiencing dysphoria. Carrying the cross together can become a source of enrichment for everyone in the community.¨

      Of course, but that is predicated in this case upon the acknowledgment at some time during the journey – (when there has been a ´return to the senses´) – that there is a disorder to be overcome; not some ¨identity¨ to be affirmed or celebrated in ¨pride¨.

      On a tangential note, see also Amoris Laetitia number 297 where we read: ¨…Naturally, if someone flaunts an objective sin as if it were part of the
      Christian ideal, or wants to impose something
      other than what the Church teaches, he or she
      can in no way presume to teach or preach to
      others; this is a case of something which separates from the community (cf. Mt 18:17). Such
      a person needs to listen once more to the Gospel message and its call to conversion…¨

      9) ¨…have allowed for them to offer this integrated approach to a complex and often divisive issue…¨

      A so-called ´integrated approach´ which can in some cases involve the recommending by those in positions of authority – (´Evangelical clinical psychologists´, at that!) – of decisions ¨starting from cross-dressing, and if needed, hormone therapy¨…. is that really an ¨integrated approach¨? Or a recipe that fosters disintegration?

      10) ´…Their nuanced and practical insights based on wisdom from theology, psychology, popular culture, and lived experience will prove to be a valuable resource for parents, pastors, and counselors…´

      ¨Wisdom from theology¨? Caveat emptor!

      11) Mark Yarhouse is into ¨LGBTQ+ studies¨ – see the frequent references to those terms at https://twitter.com/markyarhouse

      And the author of this article also uses such terminology – see for example https://www.americamagazine.org/arts-culture/2020/07/10/can-love-victor-defy-stereotypes-about-growing-gay [which reviews https://www.youtube.com/watch?v=uh-IaEaEdE0 ] and https://twitter.com/stephengadubato and https://www.ncronline.org/news/opinion/confessions-weird-catholic

      How is all this relevant? The use or embrace of such terms and the general drift / mentality seen in them brings to mind https://www.ncregister.com/blog/edward-pentin/archbishop-chaput-term-lgbtq-catholic-should-not-be-used-in-church-document
      and
      http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19861001_homosexual-persons_en.html

      In that latter document, see paragraph 3 in particular. Specifically, this: ¨In the discussion which followed the publication of the Declaration, however, an overly benign interpretation was given to the homosexual condition itself, some going so far as to call it neutral, or even good. Although the particular inclination of the homosexual person is not a sin, *it is a more or less strong tendency ordered toward an intrinsic moral evil*; and thus *the inclination itself must be seen as an objective disorder*.¨

      @ the editors of CWR: Be wary of giving the keys of the hen-house to the fox.

      None of the above is to say that those experiencing so-called ¨gender identity¨ issues or same-sex attraction should not be cared for and accompanied. Their dignity as persons created in the image of God is naturally affirmed. Not so their ¨identities¨ and terminology which are recipes for disaster.

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