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[ JBEM Index / Volume 4 / Number 2 ]

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The Biblical Ethics of Transsexual Operations

Mr. Scipione is the director of the Christian Counseling & Educational Foundation in Laverock, PA, and Sandiego, CA. He Holds an A.B. and M.A. from Temple university and B.D. and Th.M. from Westminster Theological Seminary.

Most often people's problems do not bother you until you are involved with them. This happened to me when a very fine Christian woman came to me for some Biblical advice.1 She was pleasant, godly and deeply concerned about God, His honor, and His direction for her. Her life story was intriguing. Born and raised as a female, in early adulthood she had several operations in order to become a "male". She then "married" and lived this way for several years. Later, Christ found her and she became His follower. Finally, she was convinced that the Scriptures required her to return to her God-given identity; she had another operation resuming her God-created female gender. Now she lives as a single woman.

This friendship has led to many questions concerning transsexualism. I want to examine the biblical data that relate to this issue. As a physician or medical health care provider (or pastor) who works with people, you must understand God's mind on this phenomenon. There are biblical principles that speak to transsexualism. These will help you counsel transsexuals. The purpose of this article is to find and apply these principles.

I will not try to convince you that you must have biblical ethics rule your life and medical practice.2 I will assume you agree.3 People need direction and guidance from you as well as precise, competent medical technology. You need to speak God's truth and not allow them to live in the dream world of the lie. God's Word sheds light upon transsexualism. First, we will deal with the biblical view of the body, sexual gender and role identification, and sexual gratification as they relate to human sexuality in general, and to transsexualism in particular. Second, we will apply these principles to medical practice and its involvement with transsexual operations. Finally, we will see how my friend benefited from sound biblical counsel from a godly pastor. She is a real person, much like those who come to you seeking help. May God use you to help those you serve escape this painful delusion.

I. THE BIBLICAL VIEW OF THE BODY

1. The body is good.

We teach our children, "God created the body of Adam out of the ground", Gen. 2:7; He then "formed the body of Eve out of Adam", Gen. 1:31. God's care over and evaluation of creation show that the physical universe is good and is a sufficient environment for man. Jesus Christ had a physical body, Col. 2:9. Clearly, then, the body is good. Biblical anthropology knows nothing of the pagan greek dualism that pits the body against the spirit with the former being evil and the latter good Bodily concerns and health are valid human concerns.

2. The body is cursed.

However, it is also clear that the body is cursed, Gen. 3:16-19. Man's rebellion brings down God's wrath, Rom. 1:18-19. Work, childbirth, and other activities are made painfully difficult due to His curse. Bodies do experience degenerative processes. Ultimately, they die. Genetically, we suffer the effects of the fall. Diabetes and other diseases are the result of our rebellion. Genetic failures result in bodily problems that influence sexuality. For example, the morphological differentiation of the genitalia, due to X-Y chromosomal defects, does not always progress according to the normal God-ordained pattern .4 Medicine is one way to minister to people who are under the curse of and the rule of sin and death. God in His common mercy to all men allows the development of medical technology to alleviate some of the brunt of the curse. Complete reversal of the curse can only come in the new heavens and new earth, Rom. 8:18-25.

3. The body is redeemable.

If the incarnation of Jesus proves that the body is good and not evil, then His resurrection shows that the body is redeemable. The resurrection is an integral part of His salvation from sin. Praise goes to God for the kindness of the resurrection, I Cor. 15. Any practice that counters this truth, e.g., cremation, is to be mistrusted, if not rejected outright.

These general biblical facts concerning the body are necessary background for considering transsexualism. You can not have a proper approach to the subject unless you have God's view of the human body.

B. The Biblical View of Sexual Gender5

1. Sexual gender is part of being the image of God and is, therefore, good.

Man is unique. In creation he stands alone as the image of God, Gen. 1:26-7. God made man in His image,6 His likeness.7 Man does not have this image as part of His makeup, he is the image. The image is his makeup. This is what makes man, man. Nothing else in creation bears this relationship to the Creator. Man is not a higher form of animal life. He is not a creature that evolved into or was made the image bearer of the Creator. Man is different. This was true from the moment he was created, Gen. 2:7. God made man, male and female. The Maleness and Femaleness are part of being the image of God.8 While some of the physiological aspects of human gender are similar to or identical with animal sexuality, man's gender and sexuality are not the same. Adam could not find a helper and mate suitable for him, Gen. 2:18-20; God then makes Eve. Both facts show that human gender is related to image bearing and to dominion as well as reproduction. Human maleness and femaleness are related to being the reflection of God as prophets, priests, and kings. Dominion, and companionship in that task are the focus of human sexual gender. As such, it is part of the basic identity of the individual not a temporary role or function.9 Part of godliness is to be comfortably content with one's creaturely identity, Gen. 3:22-3, and to be compatible with one's counterpart, Gen. 2:25. Being a man or a woman is a good thing, in fact, very good, Gen. 1:31.

2. Sexual gender is cursed.

However, the fall changed this marvelous situation. Sin opened the door to guilt and shame before God, Gen. 3:8-10,21, and before one's spouse, Gen. 2:25; 3:7. In cursing man, God said there would be abuse and conflict in the male-female, husband-wife relationship, Gen. 3:16.10 Confusion, discomfort, and incompatibility exist where harmony reigned. Confusion about gender and gender roles became the norm. God highlighted this issue in His curse on man's rebellion.

Later, God had Moses teach:

A woman shall not wear a man's clothing, nor shall a man put on a woman's clothing, for whoever does these things is an abomination to the Lord your God.

Dev. 22:5.

Destruction of sexual gender is serious. God says it is an abomination.11 The confusion or blurring of the distinction between the sexes shocks and sickens God. This is one of a list of wicked, repugnant things that God righteously puts under the sentence of the ban. Apparently, the Amorites' degeneracy included gender confusion as well as homosexuality, bestiality, and the sacrifice of children to the idol Molech. God declares this to be moral perversion and worthy of severe punishment. Man's imaging of God is marred. This blurring and confusion of the sexes is part of God's punishment as well as a cause of it, Rom. 1:18-32.

3. Sexual gender is redeemable.

Paul teaches about the tradition of the church in 1 Cor. 11:2-16.12 He argues that Christ's redemption has implications for male-female relationships. The gospel breaks down religious (Eph. 2:11-22), national or cultural (Col. 3:11), economic, and sexual (Gal. 3:26-29) distinctions based on sinful prejudices. Nevertheless, the gospel does not obliterate righteous creational norms. Good and necessary creational differences between men and women, which are marred in the fall, are redeemed in Christ, vs. 7-9, 11-12. In the Lord, men and women are not independent but interdependent. Therefore, Christ's work redeems and protects marriage and its role distinctions from fallen abuse on the one hand, and foolish abandonment on the other. In fact, He raises them to new heights, Eph. 5:22-23. Jesus Christ-by His perfect life, His substitutionary death, His ascended glorified seating at the Father's right hand, His power, and His intercession-guarantees that any curse on and confusion about sexual gender and roles can be overcome in Him.

C. The Biblical View of Sexual Gratification

1. Sexual gratification is good.

God created man and woman to become one flesh, Gen. 2:24. While this union can not be limited to sexual oneness, sexual union is included and is a major emphasis. The instruction to multiply came before the fall. In 1 Cor. 7 Paul says that the sexual union of couples should be regular and not interrupted except by agreement for the purpose of prayer, vs. 5. In fact, sexual union is a duty to one's spouse that is under his or her authority, vs. 3-4. Creation norms require that sexual gratification be realized between one man and one woman within the covenantal bonds of marriage.13; Marriage is more than, but includes, sexual union and gratification. The marriage bed is to be honored as well as kept pure, Heb. 13:4.

2. Sexual gratification is cursed.

Sexual impurity is a given in our culture. In the Levitical law, God prohibits homosexuality and bestiality." This proves sexual gratification had been perverted even by Moses' day. the fact that many people direct their sexual desires towards people or objects other than their spouse, and do not control these desires is evidence of the depravity of man. This depravity is part of the process of God giving people over to their evil desires, Rom. 1:18-32. Since this is part of God's judgment against rebellious idolatry, we have a clue to some of the issues underlying sexual perversions in general and transsexuality in particular.

In many sexual perversions, such as pornography, bisexuality, homosexuality, bestiality, and even more depraved things of which it is disgraceful even to speak", the questions arise: are these patterns genetically-physiologically engendered or are they learned? Romans 1 and 2 Corinthians 6 clearly prove that patterns of sexual gratification must be learned. Homosexuality is an example. Some secularists, and Christians who follow their reasoning, speculate about genetic factors in the etiology of homosexuality. Romans 1 speaks of leaving the natural function for the unnatural. 2 Corinthians 6 talks about Christian conversion as changing homosexuality. Being washed, set apart, and justified by the blood of Jesus and the Holy Spirit's power, the homosexual is changed. Interestingly, fornicators and adulterers are included in the list of converted sinners. Conversion changes them. Does conversion change one's genetic makeup? No! Are these sins hereditary?

No. Therefore, it is clear that these sexual perversions, as well as others, are learned patterns of thinking, desiring, and acting. Each sinner develops his or her "sinful preference" out of the deceitful desires of the heart. Addictively and compulsively, people become involved, Eph. 4:17-23. For those who so pervert themselves, judgment waits, Heb. 13:4.

3. Sexual gratification is redeemable.

The above teaching on sexuality and marriage as well as 1 Cor. 7 show that Christ redeems marital sexual gratification. For now it is to be enjoyed since it is limited to this age and is not for the age to come, Mt. 22:29-30.

D. The Effects of Sin on Sexuality

We have already examined some of the effects of God's curse against man's sin and how it affects the body, sexual gender identity, and sexual gratification. But you need to grasp some of the wider effects of sin on sexuality. First, man's rebellion stems from his belief of and desire for Satan's lie. The temptation was "to be as God". Man wanted to control his fate instead of continuing in faithful covenantal servant-hood under God.

Man, therefore, now finds himself in the position of wanting absolute definitional and directional control over his body, sexual gender, and sexual gratification. He refuses to accept God's definitions and direction. History gives grim testimony to this rebellious attempt to usurp God's throne. Lamach's arrogant pride and polygamy, Gen. 4:19-24; the pre-flood violence, Gen. 6:1-7; Babel's self-centered seeking of a place and a self-esteeming name, Gen. 11:1-9; the Amorites' abominations, Gen. 15:16, Lev. 18:24-30, all show the fruit of antinomian anarchy. Talk of ecological pollution! The land vomits out such people. Right in the middle of this insurgency is the perversion of the proper use of the body, gender, and sexual gratification. The results? Addiction. Yet, today many confuse this slavery with freedom and maturity.

II. THE MODERN PSYCHO LOGICAL-MEDICAL VIEW OF SEXUALITY

While I will not take the time to build the case that popular ideas of sexuality are watered-down psychological pablum cut with pseudoscientific froth, I believe most biblically astute observers will agree, Heb. 5:12-14.

A. The View of Sexuality.

1. The Body

Today is a day of biological reductionism. While new age spiritism reacts against it, in academic scientific circles, by and large, biological reductionism reigns. There is a general indulgence of fleshly desires and an almost idolatrous worship of the body. Aerobic dance classes, cosmetic surgery, fat removal by lipo-suction, athletic use of anabolic steroids are all evidence of the worship of the body. Except for some anorexia nervosa and bulimia, asceticism is definitely not the "in" thing!

2. Sexual gender.

Need I say much! You have a choice between the old perverse macho chauvinism or modem feminism. No wonder so many people are confused about their gender. The former is a sinful perversion of true male headship; the latter is a revolutionary reaction to the former. Revolutions that bypass the humble holy life of Jesus, that bypass the cross of Jesus, and that exclude His resurrection and ascension to glory have no power to change individuals or society. The Bolsheviks turned into murdering little czars. Black Nationalists turned into cruel masters as bad as any slave master. Feminists turned into female chauvinist pigs worse than any corporate male chauvinist. Feminist unisex ideas only manufacture uniformly bland rebels. Paganized female deities storm against God and His authority structure. Psychologists were to lead us into a self-actualized sexuality that would lead to deification through orgasmicly heightened self awareness and freedom. The fruit of the sexual revolution is bitter indeed. The sexual revolution is revolting, a true abomination.

3. Sexual gratification.

Typical of modem psychological-medical ideas is the following quote from a prominent text on human sexuality:

"In medicine generally, and in sexology in particular, there are many occasions when one is confronted with the issue of how to establish criteria of pathology . . . The criterion point adopted in answer to such questions may have great practical significance . . . There is always something arbitrary about the choice of a criterion of normalcy. It is arbitrary even to choose the statistical norm . . . The criterion of health versus pathology involves a choice of logical reasoning that sooner or later brings one into direct confrontation with a value judgment . . . The mood of society today is toward the greater tolerance of the principle of live and let live sexually, provided both partners are consenting adults or, if young, of like age. There is no fixed dividing line between the tolerable and the intolerable, socially, and no criterion for establishing one. A workable criterion, which is both expedient and pragmatic is the criterion of mutual consent between erotic partners, up to the point of noxious injury to health and well-being."16

4. Relativism Reigns.

This subjectivism or individualism is a cultural "norm". Obviously, from this quick overview of "scientific" thinking on sexuality you can infer the view of the permissibility of transsexuality.

B. The View of Transsexuality.

Dr. Daniel G. Brown, a clinical psychologist, U.S.A.F. and former Associate professor of Psychology U.S.A.F Academy, writes, "in view of popular notions to contrary, it should be added that neither transvestism nor inversion involves a condition of depravity or moral degeneration"." Brown notes that the Hebrews knew of this and quotes Deut. 22:5. He admits that "it is evident from this passage that transvestism was looked upon as morally reprehensible behavior and, hence, subject to punishment and divine wrath . . . Among some modem-day "moralists" and much of the general public, transvestites are considered degenerative perverts and affronts both to Providence and to nature".18 Obviously, Dr. Brown thinks God is incorrect. This modern man. I've found no exceptions to this amoral view among psychologists although they may exist.

There is almost total agreement among secular writers that transvestism and transsexualism have no biological basis." The fact that hermaphrodites have few, if any, problems with transsexualism, when one might expect them to have problems if any group of people would, proves that there is no physiological cause. As a group they prove that once a sex gender role have been assigned, children adjust well and experience few problems." Thus, sexual gender roles are largely learned." Developmental problems are usually assigned to the family. "The causative factors in transsexuality appear to be the same as those in transvestism and homosexuality. The transsexualist's mother is typically an unhappy woman, who clutches her son to her bosom - literally or figuratively - entering into an intensely close relationship with him from which the father and other children of the family are excluded".22

In the area of sexual gratification, there is agreement that since sexual arousal can be attacked to different objects; this arousal, though physical, is triggered by learned responses. Money and Wiedeking say:

The actual image that is erotically stimulating is not phyletically programmed so as to be identical in all human males. If it were, any two males and females could pair-bond, that is, fall in love with each other. But nature, in its own wisdom, has designed us as a species rich in the diversity of individual differences, erotic individual differences included. Thus, the image of erotic arousal is no more innate than is native language. Like native language, the image of erotic arousal is established in response to early life experience, and it becomes ingrained or imprinted. The so-called errors of imagery, manifested as transposition of gender identity/role, or as the intrusion of displacement paraphilias, also become ingrained or imprinted.23

Thus, sexual gratification may or may not play a part in transsexualism. It may not be attached to homosexuality. Obviously, from a biblical standpoint transsexualism always ends up being homosexuality in spite of all surgical anatomical changes. This leads to the question: what generally is the secular view of this mutilation of the body?

While some voice concern over the excessive surgery involved in these operations, we typically read:

Many doctors shrink from what is to them a mutilation of the human body. But as Benjamin (1967) has pointed out, all forms of psychotherapy have been singularly unsuccessful in helping these people who, in the company with the transvestite and homosexual, are notably resistant to change. Since the transsexual's mind cannot be made to adjust to his body, Benjamin contends, the only sensible and humane course is to make to body adjust to the mind.24

Transsexualism and similar problems are viewed as addictions.25 Therefore, as psychological problems they do not respond well. Depression that often accompanies this problem can not be changed by operations.26 Money and Wiedeking describe the typical process of sex reassignment which usually includes hormonal reassignment, electrolysis, voice training, etc. After two years, the final legal decisions are made, then comes the radical surgeries, castration, mastectomy, etc.27 Money and Weideking say that the male-female surgery has been reasonably well perfected, but not the female-male.28,29

In spite of the destructiveness to the body and often to the family life of the transsexual, the world's view is that the individual's desires and rights are paramount. Since the technology is available surgery is, therefore, permissible, advisable or some even suggest necessary. The idea that such operations be avoided or that the transsexual can change his orientation is met with disinterested disbelief

III. THE BIBLICAL VIEW OF TRANSSEXUAL OPERATIONS.

A. The Mutilation of the Body is Wrong.

The Bible views damage to the body as bad and deliberate mutilation as an insult of great magnitude.30 Paul teaches that the body is the temple of the Holy Spirit and should be protected, 1 Cor. 6:12-20. The extreme hormonal manipulation and surgical mutilations involved in transsexual operations are not justifiable unless the health of the homosexual were at stake; and it is not. The psychological well being of the individual is as specious an argument here as it is in the defense of abortion upon demand for the physical well being of the mother.

B. Transsexuality is living a lie, a foolish fantasy.

Neither biblical exegesis nor research science gives credibility to the transsexual's insistence that he or she is the opposite sex caught in an opposite sex body. The transsexual thoughts, desires, feelings amount to nothing more than an elaborate, expensive, moral-mental delusion. That a lie can be so addictive should not surprise the Christian ethicist. Romans 1 and 6:12-18 clearly teach the addictive nature and power of sin. Eph. 4:17-19,22 teach that the deceitful desires which lead to a greedy lust for more impurity have a progressive quality. Not to call this sin "sin", especially when it is within yourself, is to be caught in the web of self-deception. Medical science has helped raise this delusion to new heights. Now surgery renders a body outwardly closer to this moral-mental delusion. Yet, the genetic witness remains! If transvestism is abhorrent to God, then a radical surgical "dressing up" is far worse. If the lesser sin of transvestism is an abomination, then transsexual operations must be super abomination.

The following statements prove that lies are involved:

Almost all transvestites have a female name to go with the female wardrobe. There is also a female personality.31

No where is the difference between the sex assigned by nature and the gender identity acquired through social conditioning (discussed in the next section) more dramatically demonstrated than in the transsexual. The man knows he is a male and yet rejects his maleness . . . Typically a man will undergo transsexual surgery because he wants to be perceived as and/or loved as a woman by a "straight" man. He does not wish to be loved by a homosexual whose love-sex object is another man. The transsexual is firmly convinced that some cruel caprice of nature has imposed upon him the body of a male and the emotionality and mentality of a woman.32

You and I should scream "no", while at the same time weeping over such delusion. Satan blinds and binds transsexuals through such lies. Few transsexuals ever go back to their God-given gender.33

The pastoral counselor or physician cannot in good conscience encourage such bondage. The universal response to transsexual operations must be "no", "never". The only God-given place to exercise companionship, complimentary gender identity, and bodily sexual gratification is within the bonds of marriage, 1 Cor. 7:2,9.

IV GOD'S ANSWER TO TRANSSEXUALISM.

A. Christian Conversion.

1 Cor. 6:9-11 triumphantly declares that the blood of Jesus Christ and the power of the Holy Spirit are sufficient to handle sins that bind both body and spirit. This supernatural washing, setting apart, and justification are sufficient to put these sinful lifestyles in the past. My friend is evidence of this truth. Perry Desmond is a man who had two sex-reassignments. God's grace truly transforms.34 Surely it is sufficient.

B. Accepting one's gender as part of Christ-likeness.

A person must accept his or her God-given gender and learn its role, 1 Cor. 7:20-24. Contentedness and submission are foreign to the world, but Christians accept and submit to God's will. This means that everything possible should be done to help the person assume and exercise his or her true identity; this includes surgery where possible, physically and financially. There will be literal scars and total restoration is impossible. Perry called himself "a eunuch for the Lord" and worked within his limitations. The person must make a dedicated effort to learn and practice the proper gender role. Biblical counseling on identity in Christ, gender role, etc. will be necessary. The church should envelope such a person so Satan cannot ravage him or her with despair, 1 Cor. 2:5-11.

C. Meeting Companionship Desire.

Even though severe problems may be involved, if the person is not gifted to be single, marriage is God's answer, Mt. 19:12; 1 Cor. 7:2,9. People can be be happily married in spite of severe physical limitations. I know couples where one has severe handicaps, yet genuine love and even limited physical joy exist.

There are many more things that could be said about these issues, especially how to counsel them from a biblical perspective. However, that is beyond the limited scope of this article. I want to close by drawing a few direct applications to your medical practice or pastoral care.

V MEDICAL DECISIONS

A. Direct Medical Treatment.

1. Hermaphrodites.

While these individuals are not the direct concern of this article, a brief word is necessary. Ethically, you should help the parents take responsibility for surgical-hormonal treatment. As much as is possible, the external genitalia should be brought into conformity with the genetic gender of the child.35

2. Transsexual operations.

You should not support transsexual operations nor firms that do. I think it is analogous to referring for an abortion. If it is ethically wrong to perform such operations, it would also be wrong to refer to someone who does these immoral operations. You should do everything ethically permissible to influence others not to perform such procedures, or be involved with those who do.

B. Transsexual Reversals.

You need, also, to point the transsexual to Christ. Once a transsexual is converted, medical care should be given. Since the believer must live according to God's will, he or she must resume his or her created gender. Not to do so is to refuse repentance, just as a homosexual would by refusing to renounce his or her sinful delusion. This may mean more surgery. I found no information on surgical reversal and/or hormonal treatment for returnees from the scars of transsexualism. As a physician you need to give the proper advice and direct your patient to competent surgeons. Perhaps you may need to volunteer some care due to the high costs that presumably are involved in such a reversal process. You may have to help him or her get help from other medical personnel.

You also must counsel this new convert or direct him to a competent biblical counselor.36 The person needs directions in godly living, in assuming a gender role, in reconciliation to family, and in biblical changes in business life, social life, etc. All must be done to God's glory, 1 Cor. 10:31.

The new brother or sister will need total restructuring of his or her thoughts, desires, actions, etc., from God's perspective.37 In short, more than surgery and hormonal therapy is indicated.

To help your patient properly realign his or her life, a godly pastor and congregation are a must. The body of Christ is the only place that one's identity as an adopted son or daughter of God can develop properly. These are necessary adjuncts to a good medical practice just as a competent physician is a necessary adjunct to a biblical counseling ministry. Word and deed evangelism, including the Word of God and medical care, is a necessity for God's glory.38 Nothing can replace the body life of a local congregation.

This is the type of total, whole-person ministry needed by transsexuals if they are to become what God wants them to be.

VI. Personal Postscript

One last note needs to be appended to this brief overview of the ethics of transsexual operations: a personal postscript. May God use this article to encourage you to minister loving, Christlike, biblical medical help to transsexuals. Remember, my friend was converted by the power of God the Holy Spirit through the Word. A godly, faithful pastor using God's Word helped her to find her gender and identity in Christ through the Word. That same Spirit and Word are yours. If you knew the passages of Scripture and worked at ministering that Word to your patients or parishioners you would see the beauty of Christ being formed in them as it is in her. Trust in the Spirit and use His word; you will see the hand of God and He will get the glory.

Endnotes

1. The author is the director of the Christian Counseling and Educational Foundation in San Diego. The foundation trains pastors, church leaders, and laymen, including professionals such as physicians and lawyers, to counsel people from God's Word. While mainly pastoral in emphasis, the foundation's training is valuable to medical practitioners and personnel.

Christian Counseling and Educational Foundation
3495 College Avenue
San Diego, CA 92115

2. Payne, F.E., Jr. Biblical Medical Ethics. (Milford: Mott Media, 1985).
Dr. Payne has done an excellent job of arguing this issue.

3. If you are a Christian and you do not, you must respond to the issues raised in Payne's book. If you are not a Christian, you need to fact the claims of Jesus Christ as God and Lord. J. Blanchard, Right with God (Chicago: Moody Press, 1978) is an excellent presentation of the good news about Jesus.

4. Wolman, BB; Money, J. eds. Handbook of Human Sexuality (Englewood Cliffs: Prentice-Hall Inc., 1980) See Chapter one which covers this area.

4. Children may have chromosomal defects that lead to problems in their gender differentiation, commonly called hermaphroditism of intersexuality. Genetics determine whether or not the child will be a female or a male. The child will become a female unless the Y -linked histocompatibility (H-Y) antigen is present. If the "male" (X-Y) child's development is inhibited, i.e., the androgen-insensibility syndrome, due to insufficient levels of mullerian inhibiting substance (MIS) and/or androgen, his internal and external genitalia fail to masculinize. If the "female" (X-Y) child's development lacks adrenal production of the hormone cortisol, she will have too much androgen, i.e., the adrenogenital syndrome. This will result is some masculinization of the external genitalia.

5. This is not the place to address fully the modem pagan feminist views nor the incorrect assimilations of them by Christians. However, this is an important ethical battlefield. For a defense of the feminist position by "evangelicals" see:
- Scanzoni, L.D. and Hardesty, N. All We're Meant to Be. (Waco: Word Books, 1974).
- Mollenkott, V.R. Women Men and the Bible. (Nashville: Abingdon, 1977)
For two defenses of the traditiona historic Christian position by Christian women see:
- Foh, S. Women and the Word of God_(Phillipsburg: Presbyterian and Reformed Pub. Co. 1979)
- Pride, M. The Way Home: Beyond Feminism, Back to Reality. (Westchester: Crossway Books, 1985)

6. selem - can mean 1) shade, shadow; 2) image, likeness. It comes from a verb that means to be shady or dark. Image is a shadow or shape of the original as light is cast across the object.

7. demut - can mean 1) likeness, image; 2) model, pattern; 3) appearance, form shape. This is an example of Hebrew parallelism. Demur is another way of saying selem.

8. God is "a most pure spirit, invisible, without body, parts, or passions."
Westminster Confession of Faith 11,1. See Deut 4:15-16; Jn. 2:24; Acts 14:11; 1 Tim. 1:17. But His likeness, man, has a body. God does not have gender in a sexual sense even though we must use masculine terms of Him as does His Word. Both male and female as individuals are the image of God, not just the male, Gen. 1:26-7. Also, together they are the image of God. Man and woman in their one flesh unity reflect the mystery of God's character. This is very similar to the reflection this one flesh relationship gives of the mystical union between Christ and His bride, the church, Eph. 5:22-23.

9. The fact that Paul, 1 Cor. 11:8-9, 1 Tim.. 2:13, and Jesus, Mt. 19:4-5, both appeal to pre-fall creation norms to defend present ethical norms and behavior as they relate to gender related issues proves that gender roles are not merely indifferent, cultural, negotiable items. On the one hand, to make gender differences only physical is to reduce man to the level of a mere animal. On the other hand, to make gender differences only cultural is to reduce man to a mere environmental product. This is not to say that there are not some physiological or cultural influences in gender-related roles. This is simply to say that such reduction is wrong and "de-images" man.

10. This is not the place to examine the intricacies of this passage. (It is clear that the fall perverted this relationship.) Feminists have misexegeted this text. For a good rendering see the following.
- Calvin, J. Commentaries on the First Book of Moses called Genesis, Vol. 1. (Grand Rapids: Eerdmans Pub. Co., 1948), p. 172
- Keil and Delitzsh, Old Testament Commentaries, Vol. 1 (Grand Rapids: Associated Publishers and Authors, Inc. n.d.) pp. 79-80.

11. tocebah - means an abomination or something that causes loathing or abhorrence. Other things that God designates as abominations are: homosexuality, Lev. 18:22; 20:13; incest, Lev. 18:6-18, 24-30; bestiality, Lev. 18:23; idolatry Deut. 7:25-26; 12-2931; 13:12-18; 17:2-7; 27:15; 32:16; Is. 41:21-24; 44:18-20; unclean food, Deut. 14:3-20; defective sacrifices that amount to theft from God, Deut. 17:1; occult dealings, Deut. 18:9-22; sacrificing one's children, Jer. 32:35; male and female prostitution, Deut. 23:17-18; remarrying a former spouse after a subsequent marriage, Deut. 24:1-4; dishonest business practices, Deut. 25:13-16; Prov. 11:1; 20:10,23; giving sons and daughters in marriage to pagans, Ezra 9:1, 15; the crooked or perverted hearted man, Prov. 3:32, 11:20; the sinful seven: haughty eyes (Prov. 16:5); lying tongue (Prov. 12:22), hands that shed innocent blood, a heart that devises wicked plans (Prov. 15:26), feet that run rapidly to evil, a false witness, a spreader of strife among brothers, Prov. 6:16-19; wicked speech, Prov. 8:7; political perversity, Prov. 16:12; judicial wickedness, Prov. 17:15; a hateful, lying, wicked heart, Prov. 26:23-28; dishonest worship, Prov. 15:8-9; 21:27; 24:9; 28:9; Is. 1:10-15.
Such things, especially idolatry from which all the others flow are so detestable that God demands the death of those who practice such abominable things. The cities of Canaan, experts in such things, were put under the ban for total eradication, Deut. 18:24-30.
Their teaching these things to Israel was viewed as an infection to be destroyed, Deut. 20:11-18. These things were the reason for God's destruction of Judah and the temple, Jer. 2:7; 16:16-18; 32:34-35. The whole book of Ezekiel carries this theme. While such things should bring shame to the doers, Judah did not even blush, Jer. 3:3; 6:15; 8:12.

12. See 1 Cor. 4:17; 7:17; 11:16; 14:33; 16:1; 2 Cor. 8:18; 11:28; 1 Thess. 2:14; 2 Thess. 1:4; 2:15; 3:6-15; Tit. 1:5. Apparently, the apostles had specific ways of doing things. This authoritative tradition is not man's ideas but God's word and therefore not relative as to its truthfulness or negotiable as to its obligatory nature. The idea of cultural specificity of this tradition is incompatible with Paul's situation. Many of the churches were in different subcultures even then. This tradition spanned all of the churches; the apostolic tradition is therefore, pan-cultural.

13. For a short but excellent exposition marriage and sexuality see Chapters 1-3 in Adams, Jay., Marriage, Divorce, and Remarriage in the Bible. (Phillipsburg: Presbyterian and Reformed Pub. Co., 1980)

14. See footnote 11.

15. Wolman and Money, Ibid. Chapter 14 "Gender Identity Role: Normal Differentiation and its Transpositions", by Money and Wiedeking. This is a nice euphemistic way of speaking of sinful perversions of God's divine law.

16. Ibid, p 272, 273.

17. Ellis, A. and Abarbanel, A. eds. Encyclopedia of Sexual Behavior (ICY: Jason Aronson, Inc., 1973), p. 1012. Note that the editors, especially Ellis, are well known clinical psychologists.

18. Idem

19. Ibid., p. 1018; Wolman and Money, Ibid, p. 275; McCary, J.L. and McCary, S.D., eds. McCary's Human Sexuality (Belmont: Wadsworth Pub. Co., 1982) 4th ed., p. 407

20. McCary and McCary, Ibid., p. 409;
Ellis and Abarbanel, Ibid., 1017.

21. Ellis and Abarbanel. Ibid., p. 1014;
Wolman and Money, Ibid., p. 275

22. McCary and McCary, Ibid., p. 409

23. Wolman and Money, Ibid., 273.

24. McCary and McCary, Idem.

25. Wolman and Money, Ibid., p. 279.

26. Ibid., p. 276

27. Ibid., p. 276-7.

28. Ibid., p. 277.

29. Matti, B.A., et al. "Phalloplasty using the free radial forearm flap.' British Journal of Plastic Surgery_41 (2): 160-164, March 1988.
- Davies, D.M., et al. "A method of phalloplasty using the deep inferior epigastric flap." British Journal of Plastic Surgery 41 (2): 165-168, March 1988.
- Gilbert, R.A., et al. "Transsexual surgery in the genetic female." Clinical Plastic Surgery 15 (3): 471-487, July 1988. (34 references). These were found for the author by Dr. T W. Ziegler, M.D., who is a urologist. Dr. Ziegler is an elder of the New Life Orthodox Presbyterian Church of San Diego, California.

30. Mutilating another person's body was an insult, 2 Sam. 10:4 (2 Chron. 19:4). The cutting of the hands and the head, even if the person is dead, is the supreme curse or desecration of the body, Jud. 1:6-7; 19:29; 20:6; 1 Sam. 5:4; 31:9; 2 Sam. 4:12; 16:9; 20:22; 1 Chron. 20:3. Self mutilation is part of pagan worship, 1 Kings 18:28.
Bodily defects had profound effects on one's relationship with God. Bodily deformity prohibited Levitical service, Lev. 21:16-21. Male genital defects prohibited personal participation in tabernacle or temple worship, Deut. 23:1

31. Wolman and Money, Ibid., p. 278.

32. McCary and McCary, Ibid., pp. 4089.

33. Wolman and Money, Ibid. p. 277.

34.  Desmond, P. and Hymers, R.L. Perry: A Transformed Transsexual (Ironton: Metmorphis Books, 1978).
This is the amazing story of a man who was a homosexual, a professional female impersonator, who had a transsexual operation, became a prostitute, was converted to Christ, went back to being a man after operations, and finally became an evangelist.

35. Wolman and Money Ibid., pp. 8-12.
Some suggested treatments are given.

36. See footnote 1.

37. Adams, J. The Christian Counselor's Manual. (Phillipsburg Presbyterian and Reformed Pub. Co., 1973), pp. 161-215.

38. Grant, G. Bringing in the Sheaves: Transforming Poverty into Productivity (Brentwood: Wolgemuth and Hyatt Pub. Co., 1988). See Chapter 4, "Authentic Christianity: Word and Deed."

[ JBEM Index / Volume 4 / Number 2 ]

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