Available in Audio Format:

Who am I?

This question dominates our society. Everywhere we look, we see examples of people trying to discover themselves, to redefine themselves, to find their identity.

Consider some popular movie characters. In Disney movies, we have Mulan, Elsa, and Rapunzel who struggle to overcome family expectations or cultural stereotypes to discover their true selves. Or consider the whole superhero genre. Spiderman, Batman, and Superman all wrestle with their superhuman qualities and their civilian alter egos. 

The point is not to show that the ARPA staff watch too many movies. (In fact, some of us haven’t seen any of these movies.) Our point is to show our modern world’s infatuation with the question of identity.

This struggle to answer the question, ‘Who am I?’ plays out in the real world too. We see this especially clearly in the recent transgender movement and its identity-focused narrative. Michelle’s story illustrates this. She didn’t have an easy childhood. She had trouble making friends at school and was often bullied. She started harming herself at the age of eleven and attempted suicide at 20. Michelle was treated for social anxiety and clinical depression, but these treatments didn’t improve her well-being. A year into therapy, an online community suggested that something else was causing her angst: that she was actually transgender and that she needed to socially, medically, and surgically transition for her to fully express her true identity.

Who am I? The answer from many movies, from Michelle’s online community, and from our culture is clear: your identity is something you discover for yourself. Whether that identity is around gender, family ties, or our place in the world, our culture tells us that our identity is received by God but achieved through our own effort.

Rather than confessing with Scripture, as summarized in the Heidelberg catechism, that “I am not my own but belong body and soul, in life and death, to my faithful saviour Jesus Christ,” the creed of our culture is that “I am my own and belong, body and soul, in life and death, to myself” and maybe, just maybe, to the people around me that I like.

This is seen perhaps most clearly in modern gender theory. It says that gender is entirely socially constructed, meaning that it isn’t objectively real. Human beings invented it. All the expectations placed on men and women aren’t valid. But it gets more radical than that. For gender theorists today, biological sex itself is socially constructed. We aren’t born with a sex. We are simply assigned a sex at birth. That’s “the way you are,” they say.

In this paradigm, human beings and human choices are elevated to the status of a god. This is the idol of our day: that autonomy (self-law) is supreme.

Gender Identity and Gender Dysphoria

This is why our modern world has invented the concept of gender identity. With gender identity, rather than accepting the sex and the gender that God has given you, you can pick your gender. And if you don’t want to be a man or a woman, you can invent your own gender. We can create our own meaning and identities and do whatever we want with our bodies.

That’s what Michelle’s online community was telling her – that she didn’t have to accept the fact that she was a woman. If identifying as a man – as identifying as transgender – made her feel better, then she should identify as a man. It is the way you are, they would say.

Now, worldview is certainly a big part of this concept of gender identity. But there is also something else at play here: gender dysphoria. Gender dysphoria is confusion about your gender and distress with your physical body and it is a diagnosable mental health condition.

We don’t know what causes this gender dysphoria in every case. But here are four things we do know.

First, gender dysphoria often goes away naturally. About 80% of children who experience gender dysphoria before puberty will outgrow it after puberty. When it is present before puberty, it doesn’t need medical treatment. It needs time. That’s why it is important to let kids be. They are made in the image of God as male or female, as a boy or girl.

Second, gender dysphoria is often socially contagious. In 2018, a study found that girls with a friend who identifies as trans are more likely to identify as trans themselves. Even more surprisingly, entire friend groups of girls sometimes identify as trans together. We see this reflected in the number of referrals to gender clinics.In the United Kingdom, referrals to the country’s sole gender clinic increased from under 100 per year to over 5000 per year in little over a decade. These changes in gender identity among teenage girls happen so suddenly and so often that researcher Lisa Littman came up with a new term to describe it: rapid onset gender dysphoria.

Third, medical and surgical transitioning are anything but caring. The medical community calls this treatment “gender-affirming care” but there is nothing caring about these treatments and so we don’t think that it is accurate to use that term. The goal of medical and surgical transitioning is to reshape the body rather than letting kids be.

It starts with puberty blockers. As their name implies, these blockers prevent a child from going through puberty and developing as God intends. These drugs halt normal adolescent development by stopping the production of the male hormone testosterone or the female hormone estrogen. Puberty blockers might not necessarily lead to ugly consequences, but their intent still to prevent children from developing as God intended them to.

The next step is cross-sex hormones. Cross-sex hormones basically trigger puberty of the opposite sex. Soon after her online community suggested that she might be trans, Michelle was prescribed such cross-sex hormones after only 3 appointments with a doctor and without any diagnosis of gender dysphoria. These hormones – testosterone in Michelle’s case – deepened her voice and triggered the growth of more body hair and a more muscular body.

Because God did not design women to run on testosterone or men on estrogen, there is a stunningly long list of side effects with cross-sex hormones. Some of these risks are extremely serious themselves – cardiovascular disease, brain tumors, and osteoporosis for example. These conditions are almost never found in young people. Yet, this hormone therapy is starting at fourteen. Thirteen. Twelve.

But that’s not the end of the story.

The final stage in a gender transition is surgery. Surgical transitions remove healthy tissue and even entire organs. Michelle had one of these surgical procedures: a double mastectomy, the removal of both of her breasts, so that she could look more like a man.

The message of medical transitioning is clear. If you don’t like the body that God has given you, our society encourages you to forge a new one. Not happy with the way you are, well that’s easy. There’s a drug or a surgery for that.

All three of these interventions – puberty blockers, cross-sex hormones, and surgical interventions – are almost guaranteed to lead to infertility.

Fourth, there is no way that kids can consent to these procedures. In Canada you need to be 18 or 19 to adopt a pet, apply for a credit card, buy lottery tickets, cigarettes, or alcohol, watch R-rated movies, or vote. We recognize that these are activities that children and young people are not yet ready to have access to.

By contrast – unbelievably – there are no age requirements to consent to puberty blockers, cross-sex hormones, or a surgical transition. Kids as young as 8 or 9 (in the case of puberty blockers) are making these life-altering decisions about their bodies. Our society refuses to simply let kids be. Our society is at war with the way we are.

In light of these four facts – that gender dysphoria often resolves itself, that gender dysphoria today is socially contagious, that medical and surgical transitioning is anything but caring, and that kids can’t consent to these procedures – we are starting to see other countries around the world putting the brakes on medical and surgical transitioning. Finland, Norway, Sweden, France, the United Kingdom, and a growing number of American states are drastically curtailing these treatments or even banning them outright. They are all saying let kids be.

And yet, here in Canada, the generally accepted approach to gender dysphoria is to transition the child. We have no laws or clinical guidance about how doctors are to practice this gender-affirming care. We do whatever the international activists – the World Professional Association for Transgender Health – suggest.

Michelle followed this path. She never really thought of herself as a boy, much less as transgender. It was only when she encountered trans advocates online and only after they suggested that she might be trans did she start doubting the sex that God had given her. Back when she visited a counsellor, then a therapist, and then a doctor, none of them diagnosed her with gender dysphoria. And yet, they still referred her on for a medical and surgical transition. After extensive treatments, Michelle came to a realization. Medical transitioning wasn’t solving her underlying poor mental health. She realized she wasn’t transgender after all. She abruptly began the process of what is called “detransitioning.” She quit her hormone therapy, and she is presenting once again as a female.

After a proper examination of her mental health, Michelle received a full diagnosis of ADHD, borderline personality disorder, clinical depression, autism, and traits of PTSD. It was these mental health conditions – not gender dysphoria – that caused her distress.

Michelle still suffers from the irreversible effects of her medical transition. Her low voice, male-pattern balding, and facial hair are here to stay. She could have another surgery to give her the appearance of breasts, but she will never be able to breastfeed a child. And she will never be able to become pregnant.

Michelle was not a minor when she medically transitioned, but the same story has happened to Canadians at younger and younger ages. And if she as a full-grown adult made this terrible mistake, how can we expect children and adolescents to make the correct decision?

How we answer the question ‘Who am I?’ matters. Our culture tells us we create our own identity, but Christians know we are not the creators of our own identity – it is given to us by the Creator who made both male and female in His image and declared them good. It is the Christian perspective that brings true body-affirming care.