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.

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. 

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.

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