A Current Position1
The rise of transgender issues to social prominence raises important questions for the Seventh-day Adventist Church. In particular, the question of sex-change surgery (also called sex reassignment surgery) challenges the Church with sensitive questions. Although the transgender question is important, the scope of this document is limited to providing some guidance regarding sex-change surgery. We acknowledge that questions related to sex-change surgery are not merely clinical, but involve human beings who are experiencing deep emotional distress as they try to grapple with their personal gender identity. These people need our love, prayers, support, and guidance.
There are two areas of questions for believers in reference to sex-change surgery. The first is whether those who are already members of the church but experience gender identity tensions should have sex-change surgery. The second regards those who first have had sex-change surgery and then come to Christ and the Church.
Gender identification usually aligns with one’s birth sex. Sometimes, however, genetic, chromosomal, hormonal, and intrauterine influences may result in ambiguity of anatomical sexual differentiation. In these situations anatomical development of genitalia can result in a spectrum of disorders spanning the gamut from definitely female to overtly male. Those born with ambiguous genitalia may well benefit from corrective surgical treatment.
There is another group of persons whose anatomical gender identity is clearly male or female but who identify with the opposite gender of their biological sex. Such individuals sometimes request surgical intervention to change their genitalia into that approximating the opposite sex. They are the focus of the following considerations.
(1) While the struggles and challenges of those identifying as transgender have some elements in common with the struggles of all human beings, we recognize the uniqueness of their existential situation and the limitation of our knowledge in such issues.
(2) As Christians we look to the Word of God for guidance. First, from a biblical perspective the human being is a psychosomatic unity. This means that sexual identity cannot be entirely independent from one’s body as is frequently asserted. In fact, in Scripture, our gender identity is, to a significant extent, determined by our birth sex with God being the author of gender identity (Gen 1:27; 5:1, 2; Mark 10:6; Ps 139:13, 14). Second, the Bible reminds us that each person with his/her mind and psyche is part of the creation that is corrupted by sin (Rom 3:9; 7:17; 8:20–23; Jer 17:9; Gal 5:17) and needs to be renewed by God (Rom 12:2). Our emotions, feelings, and perceptions are not fully reliable indicators of God’s designs, ideals, and truth (Prov 14:12; 16:25). We need guidance from God, through Scripture, to determine what is in our best interest (2 Tim 3:16).
(3) A human is meant to be an undivided sexual entity. The claim that some individuals experience a psychological sexual identity incompatible with their biological sex reveals a serious type of psychological dichotomy. Such psychological disturbance or brokenness is an expression of the damaging effects of sin on humans. It remains unclear, however, if this disturbance or brokenness can be overcome through sex- change surgery. Such treatment may disturb the patient even more.
(4) So far, sex-change surgeries are irreversible. Persons undergoing these procedures have to use hormones for the rest of their lives, which indicates that an integrated sexual identity is not achieved through surgery. Surgery does not solve the problem completely. What aggravates the situation is that while surgery is irreversible, people may change psychologically as they grow and mature, seeking again a new identity.
(5) In some cases, sex-change surgery may be motivated by a sophisticated desire for homosexual activity. Undergoing sex-change surgery in order to satisfy the homosexual urge to have sex with a person of the same sex would violate the ethical and moral biblical principle of sexual activity being limited to heterosexual marriage.
(6) The Scriptures call humans to manage their emotions and passions by bringing them under the lordship of Christ (Gal 5:24; Jas 4:7). Sexual drives and identities are not to be satisfied on the grounds that, since they are considered to be normal or natural, we should let nature run its course. Sin and evil have corrupted human nature, including gender identity and sexuality. While self-discipline is indispensable in bringing both into harmony with biblical values and principles, God has promised the Holy Spirit to help us face our sinful impulses and our attraction to sin.
(7) Since surgery does not solve the situation, a person is more likely to find wholeness and healing by learning to live with his or her sexual condition of a real or perceived dichotomy in sexual identity while leaning on the Lord for constant help.
For these reasons the BRI Ethics Committee strongly cautions against such a radical and irreversible procedure and urges pastors and church members to demonstrate care and regard toward those who struggle with this challenging issue. Should individuals seek to use sex-change surgery as a way of circumventing biblical principles addressing human sexuality and the proper way to satisfy such desires, they would be acting against God’s revealed will. The Church must remain loyal to its commitment to the will of the risen Lord as revealed in the Scriptures and therefore display love for all.
The situation becomes even more complex in the case of persons who underwent sex-change surgery before coming to know Jesus as their personal Savior and Lord. How should the Church deal with them when they ask to become members of the community of believers? To answer this crucial question we make the following recommendations:
(1) That we treat these persons with love and respect, demonstrating our serious interest in their wellbeing. Those involved in the conversation should do their utmost to avoid aggravating the new converts’ emotional condition. Adding pain to persons who have been hurting most of their lives is not an expression of Christian love.
(2) That we recognize that God called them to salvation in the state in which they were found by Him, lacking wholeness, and that they accepted the call to salvation.
(3) That we do not coerce these persons to reverse their surgery. It could be argued that although the Lord finds us in a state of fragmentation, He wants to transform and restore us, and that, therefore, new believers should begin a process of medical reversal that will take them back as close as possible to their pre-surgery physical condition. Such an attempt would create significant problems because complete surgical reversal remains impossible, and even a partial reversal may seriously endanger the health of the persons involved.
(4) That we do not deny church membership to persons who have undergone sex-change surgery but are committed to the Lord and His will. The only thing that we can biblically require is what the Bible requires from all of us: to allow the Spirit of the Lord to bring inner healing to us and to live a life of moral and sexual purity while looking forward to the moment when the Lord will restore wholeness to all of us.5
The irreversible nature of sex-change surgery, the fact that the Lord touches the hearts of transgender persons and accepts them as His children, as well as the recognition that all of our bodies have not yet been redeemed (Rom 8:23), makes us very cautious when interacting with them. Our respect and care for these persons follows Christ’s example of serving others while being fully committed to God and His revealed will.
A Current Position
The question of whether marriage should be considered by transgender people who have experienced sex- change surgery2 or whether it should be discouraged by the Adventist Church is a delicate question.3 Oftentimes the affected persons have suffered emotionally and spiritually because of their feelings of gender incongruity and rejection by others. So they need all our love and respect.
However, if marriage of transgender persons is being considered, a few considerations are in order.
(1) The Bible teaches clearly that according to God’s plan and design only one male and one female can be joined together in marriage. In strongest terms Jesus upheld heterosexual marriage and ruled out polygamy as well as homosexual relations. These biblical norms are binding for humanity at all times and under all circumstances. Therefore, they need to be adhered to when pondering marriage of transgender people.
(2) The Biblical Research Institute Ethics Committee currently works with the assumption that a male to female surgically-changed transgender person should be considered female and a female to male surgically-changed transgender person male, even though the new state is not perfect as constant dependence on hormone therapy indicates. If a transgender person has not had a sex-change surgery, the committee would consider that person to be male or female according to his/her biological sex, even if that person has adopted a first name associated with the sex opposite of his/her biological sex.
(3) This would mean that a marriage between a non-transgender male and a transgender male or between a non-transgender female and a transgender female would be understood as a homosexual relationship,4 prohibited by Scripture.
(4) A transgender person may be attracted to the same sex but may dislike sexual relations, for instance, as a male with another male and therefore may seek sex-change surgery, which would open the way to have sex with a male now as a female. Such behavior appears to be a sophisticated form of homosexual behavior that would also militate against the biblical perspective of homosexuality.
(5) Regarding the question of whether a surgically-changed transgender person should attempt to reverse the prior surgery, we do not expect persons who have undergone sex-change surgery to attempt to revert to their former state, because presently sex-change surgery is irreversible. Under this assumption it would theoretically be possible for a transgender female to marry a male and a transgender male a female, unless the sex-change surgery was undertaken for homosexual desires. Yet even if marriage would be potentially possible, we believe that transgender persons who have had a sex-change surgery should abstain from seeking it.
(6) A marriage between a transgender person and a non-transgender person can be a tremendous challenge, especially if total transparency is lacking. The non-transgender partner would need to know that the future spouse originally had the same biological sex that the other partner still has. Some partners might be able to live with such a situation, while others may find it challenging or impossible to live in a marriage relationship with a transgender person. In addition, the issues of sexual relations and having children would need to be raised between the partners that want to marry. For instance, a male to female transgender person cannot bear children naturally.
(7) Even if both partners were transgender persons, reasons for getting married, issues of sexuality, having children, forming a family, etc. would militate against such a marriage.
(8) As much as heterosexual marriage of non-transgender partners is a blessing, it also means work and adjustment of the partners to each other. This does not end after an initial period of a few months or even several years but continues for as long as a marriage exists. Today some heterosexual marriages are ending in divorce even after thirty or forty years because the spouses can no longer stand each other’s idiosyncrasies and standard behavioral attitudes. If this is true for marriages that are entered into by persons who have not had their gender identities compromised in any way, it is an even greater challenge for persons who come into a marriage relationship with strong psychological burdens as a consequence of feeling trapped in the body of the other sex. Marriage is not a way to bring psychological healing to individuals struggling with gender identity issues.
For these reasons we strongly caution transgender people against a transgender getting married. However, even if the Church would not approve of a couple’s choice to marry, the local pastor should still minister to those entrusted to his care.
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1 The BRI Ethics Committee is indebted to Ángel M. Rodríguez on whose work this statement is based, e.g., https://adventistbiblicalresearch.org/sites/default/files/pdf/sex-change%20surgery.pdf.
2 Other designations are sex reassignment surgery, gender reassignment surgery, sex affirmation surgery, gender confirmation surgery, or sex realignment surgery.
3 For the question of whether the BRI Ethics Committee would recommend or discourage sex change, see the statement on sex-change surgery.
4 See the two official statements of the Adventist Church on homosexuality: http://www.adventist.org/information/official-statements/statements/article/go/0/homosexuality/vitality/service/ and http://www.adventist.org/information/official-statements/statements/article/go/0/same-sex-unions/beliefs/en/.