correction
An earlier version of this column misstated the name of the Endocrine Society. This version has been corrected.
I attended church faithfully and read the Bible that refers to homosexuality as an abomination in Leviticus 18:22, a sin, a condemnation to hell. Only a few biblical verses refer to same-sex attraction and behavior — for instance, the destruction of Sodom and Gomorrah in Genesis 19, and the justification of its destruction in Jude 7. But none are reflective of how we understand sexuality today, a misinterpretation that has led to faith-based defenses of homophobia and transphobia.
The recent increase in anti-transgender legislation is troubling for me as a Christian, cisgender gay man and pediatrician who provides gender-affirming care to adolescents. According to the Human Rights Campaign, as of March 13, a record 82 anti-transgender bills had been introduced in state legislative sessions this year. One such bill — which was signed into law on April 6 and takes effect in July — makes Arkansas the first state to ban physicians from providing gender-affirming health care to transgender youth under age 18.
Homophobia and transphobia — which are not Christian values — are at the root of these hateful, harmful legislative efforts. The proposed laws set a disturbing precedent of discrimination in the name of Christianity. And they’re not what Jesus would do. Jesus would not deter transgender youth from seeking lifesaving care.
Did Jesus withhold his curative power from the paralyzed man deemed a “sinner” (John 5:1-15)? No. Did Jesus deny healing to a man with a deformed hand on the Sabbath, one of the holiest days in Judaism (Mark 3:1-5)? No. Did he refuse to heal a man with leprosy, when lepers were considered unclean (Matthew 8:1-4)? He did not. And Jesus did not refuse to heal children. He healed Jairus’s daughter, who was thought to be dead (Mark 5: 35-43); a demon-possessed daughter of a Gentile woman (Matthew 15:21-28); and a boy with epilepsy (Luke 9:37-43).
When we allow state-sanctioned hatred by passing transphobic legislation, it damages youths. A lack of knowledge and empathy toward transgender youths can lead to negative health outcomes, causing harm to those who already face higher rates of depression, anxiety, suicide and marginalization. Jesus would not condone the denial of access to treatment determined to be the standard of care by the American Academy of Pediatrics, the American Psychiatric Association and the American Psychological Association.
Providing gender-affirming care to adolescents experiencing gender dysphoria is challenging. It often requires multiple appointments with health-care professionals before the initiation of medical treatment, during which professionals also educate parents and guardians about gender and sexuality, and provide emotional support and reassurance to both patients and their families. During these visits, doctors and mental health practitioners must ask intimate, sometimes difficult questions: How long have their patients experienced, and what worsens, their gender dysphoria? Were there, or do they anticipate, any difficulties coming out?
But physicians are guided by the highest professional standards set forth by the World Professional Association for Transgender Health and the Endocrine Society. Both groups publish clinical guidelines based on the best available scientific evidence for children experiencing gender dysphoria. These guidelines recommend that children receive affirmation; are ensured a safe social transition; and are offered supportive counseling from an affirming mental health professional combined with medical education regarding the role, side effects, risks and benefits of puberty blockers and gender-affirming hormones.
These standards of care also recommend shared decision-making with and consent from parents and guardians, as well as medical clearance before the initiation of age-appropriate medical transition. Gender-affirming surgery is considered the last step in the process and is recommended for those age 18 and older.
There are also transgender, gender-nonconforming and gender-expansive youth who do not want medical or surgical treatment, and instead desire only social transition — with support from medical and mental health professionals — via the use of different names or pronouns, or clothing that helps them to feel more like their authentic selves.
As a physician, I know this care saves lives. And as a Christian, I know I’m following my faith by providing such care. I ask myself: What would Jesus do? And I am confident that Jesus would stand in agreement with me. He would love his gender-nonconforming, gender-expansive and transgender adolescents, and support the assertion that children of all gender identities, expressions and sexual orientations deserve access to the affirming care they need.
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