Sex, Gender, and Transgender Experiences: Part 2—Biological Sex and Gender Role

Sex, Gender, and Transgender Experiences: Part 2—Biological Sex and Gender Role
July 29, 2019

This is part 2 in an ongoing series on gender by Dr. Preston Sprinkle. Click here to see the first post. 


What is gender, and how is it related to sex?


In my previous post, we saw that the definition of biological sex is widely agreed upon, the same is not true of gender. The term gender can be used with bewildering variety and stunning inconsistency. However, there are at least two different aspects of gender that are typically emphasized when people talk about gender: “gender role” and “gender identity.” 


According to Robert Stoller, the scholar who coined the term “gender identity:”


The term gender identityrefers to the mix of masculinity and femininity in an individual, implying that both masculinity and femininity are found in everyone, but in different forms and different degrees.[i] 


Today, gender identity is typically glossed as one’s internal sense of self, which we’ll cover in the next two posts. For this post, I want to consider the relationship between biological sex and gender role.


The idea of gender role was developed by sexologist and gender guru, John Money, who said that “gender role…is defined as everything that one says and does to indicate that one is either male or female, or androgyne,” which is similar to how people describe it today.[ii]  Basically, “gender identity is the private experience of gender role, and gender role is the public manifestation of gender identity.” Gender identity is the inside stuff; gender role is the social manifestation of what’s going on inside.


So, to sum up our definitions thus far:


  • Biological sex is one’s state of being male or female based on their reproductive structures
  • Gender roles are how males and females are expected to behave in any given society; i.e. masculinity and femininity
  • Gender identity is one’s internal sense of who they are as male, female, both, or neither


For this post I want to wrestle with the relationship between biological sex and gender role. In the next couple posts, we’ll consider biological sex and gender identity. 



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Gender Roles and the Nature Versus Nurture Debate


Several questions surround the sex and gender role relationship. Probably the most common is: Are gender roles (i.e. masculinity and femininity) based on biology? That is, are men masculine and women feminine because they are biologically hardwired to be masculine and feminine? Or is masculinity and femininity—gender roles—social constructs thrust back upon biology? Or are gender roles formed by some combination of both nature and nurture? And just so we don’t get too far down the rabbit hole, our main question is: could someone be a gender—in this case, occupy a gender role—that’s different from their biological sex? Or more pointedly: if a female is not feminine, is she still a woman?


Most would agree that gender roles are, on some level, based on stereotypes. Masculine men are those who love sports, are more aggressive, and, some would argue, are better at STEM fields than women are. Boys prefer blue over pink, jeans instead of dresses, and rough and tumble play more than sitting at the edges of the playground talking about all the rough and tumble boys. Women are more nurturing, compassionate, agreeable, and less aggressive as men. Women prefer pink over blue, talking over sports, and working in fields that involve people more than blueprints.


Stereotypes exist. But why do they exist?


Some will say that these stereotypes are purely social constructs. They are artificial expectations foisted upon males and females (scholars who hold this view are called “constructionists”). Others say that these stereotypes are based on biology. Boys love rough and tumble play because they have much more testosterone than girls and are therefore biologically hardwired for rough and tumble play (scholars who hold this view are called “essentialists”).


Take aggression, for instance. If you were to ask anyone on the streets, “are boys more aggressive than girls?” most people would say yes. (The smarter ones will ask you to define “aggression,” but we’ll leave that alone for now.) And there are plenty of studies to back this up.[iii]  In utero, most males receive a wash of testosterone during the third trimester that is believed to masculinize the brain. Although the implications of this wash are widely disputed,[iv] many believe that a brain marinated in T is what predisposes males to engaged in masculine behaviors like rough and tumble play. So, when boys are given different options of toys to play with, even at a very young age—say, 2-4 years old—they will more often than not, chose airplanes and action figures over Barbie dolls or magic markers. Females typically don’t receive the same wash of testosterone in utero and as it turns out they also tend to prefer Barbie dolls and magic markers over airplanes and action figures.[v] 


Interestingly, one of the ways in which parents and counselors are told to determine if a child is transgender is if they prefer boy toys or girl toys. Regardless of biology, if they act like a boy, play like a boy, prefer blue over pink, jeans over dresses, rough and tumble play with the boys instead of drinking pretend tea with all the chatty little girls, then this means they might really be a boy. According to the U.K.’s National Health Service, a child might be trans, for instance, if they “dislike or refuse to take part in activities and games that are typically associated with their sex, and want to take part in activities and games typically associated with the opposite sex” or “prefer to play with children of the opposite biological sex.”[vi] Right or wrong, this way of determining whether a child really is a boy or girl is partially based on gender stereotypes.


But are the essentialists right? Are males biologically hardwired to be masculine?


“Correlation doesn’t equal causation!” protest the constructionists. Just because males act more masculine doesn’t mean that nature (or God) caused them to act this way. It’s just as possible that society has nurtured them into this role. Perhaps boys act more masculine because our society expects them to be more masculine. We reward girls who “act like girls” and reward boys who do the same. We punish girls who act “masculine” and especially boys who act “feminine” (tomboyish girls are typically more socially accepted than girly boys). You may not think you do this, and you may not do it consciously, but from the time a baby is born, we nurture them into the gender roles we think they should fit into.


Pink and blue are classic examples of this. Did you know that 100 years ago, pink was considered a boy color while blue was considered girly? According to the Ladies Home Journal in a 1918 article: “The reason is that pink, being a more decided and stronger color, is more suitable for the boy, while blue, which is more delicate and dainty, is prettier for the girl.”[vii] (Prior to the 20th century, all babies were stuffed into white frilly dresses.) And yet today—in the west, at least—boys prefer blue and girls prefer pink. Why? Because we’ve nurtured girls to like pink and boys to like blue. There’s nothing in our genes that hardwires boys to like blue and girls pink. Pink and blue are cultural constructs.


What about aggression? Most people assume that boys are more aggressive because they’ve been juiced up on T in utero. And this might be at least part of the reason why boys are, on average, more aggressive than girls. But some studies show that boys are more aggressive at least partly because they are rewarded when they are aggressive, while girls are not.[viii] In fact, some cross-cultural studies show that levels of male and female aggression are based on how society rewards or discourages aggression.[ix] Male and female aggression levels vary from culture to culture based on how strongly aggression is rewarded or punished. For a behavior to be rigidly hardwired in our sex-differences, it should ring true across all cultures. But this doesn’t appear to be the case with at least some behavioral differences among males and females. And, of course, we must define aggression. Because even in the west where boys turn out to be more physically aggressive than girls, girls are more relationally aggressive than boys, as we’re seeing with the recent epidemic of cyberbullying, which is more common among females than males.[x]


But the social constructionists were dealt a heavy blow in the infamous case of David Reimer. At 8 months old, David was the victim of a botched circumcision that cut off his penis. Since it’s easier to make a hole than a pole, and since—according to John Money, who advised the parents—gender is a social construct, it’d be easier to surgically transition David to a female and raise him as girl, which is what the parents did. David became Brenda, and she lived happily ever after.


Actually, she didn’t. Despite the parents’ best efforts, Brenda couldn’t be socialized into a girl, despite believing she was one. While the media reported that Brenda was getting along just fine as a girl, he later revealed that he has always felt like a boy trapped in a girl’s body (sorry, the pronouns are particularly tough with this story, so I’ll keep flip-flopping around). In fact, this is exactly the case. “She ripped off frilly dresses, rejected dolls in favor of guns, preferred to play with boys, and even insisted on urinating standing up.”[xi] Finally, at 14, Brenda couldn’t take it any longer and said she wanted to transition to a boy. It’s then that his parents told him that she really was a boy. Brenda then become David once again.[xii]


That’s just one example, you may think. Not quite. One study looked at a very similar case where a male had his penis severed at an even younger age and was surgically changed to a girl and raised as such, and the results were very similar to Reimer’s.[xiii] Another study looked at 25 males who were born without a penis and were surgically changed into, and raised as, females. All 25 echoed the behavioral patterns of David Reimer: they engaged in male-typical behaviors; some even declared themselves to be boys from a very early age, despite looking like and being raised as females.[xiv]


Nature or nurture? Are gender roles social constructed or biologically hardwired?


While the above cases might cause one to question the scientific validity of gender-neutral parenting, my primary concern is not to solve the nature/nurture debate. For what it’s worth, I do find attractive certain biosocial (or “interactionist”) models, where nature and nurture both interact with each other to form our conceptions of masculinity and femininity. The weight of evidence seems to suggest that the testosterone most males receive in utero has at least some influence on behavior in general, even if some popular assumptions about testosterone might be overplayed.[xv] We can affirm some level of essentialism while also affirming that society plays a role in nurturing such behavior. For instance, what if higher levels of testosterone made males generally more aggressive? And what if they are also generally nurtured and shaped by a society that expects males to be more aggressive? If you had a gun to my head, I’d probably say that both nature and nurture shapes males to generally act more aggressively.


Plus, general differences in the way that males and females smell, hear, and see are much more likely to be biologically rooted than environmentally caused. Females, for instance, have a much more sensitive sense of smell.[xvi] Is this because they’ve been nurtured to have a more sensitive sense of smell? Call me a cynic, but that’s a much harder pill to swallow. Are males really nurtured to have a less sensitive nose?


For the rest of my posts, I’m going to assume that both nature and nurture play some role in forming our concepts of masculinity and femininity and the general patterns of behavior that form and reinforce those expectations. My main concern isn’t to untangle the forever tangled web of nature and nurture. That’s far above my pay-grade and far beyond my focus here. My main concern has to do with the bolded words above: the words “general” or “generally.”


Both essentialists and constructionists agree: Whatever the cause(s), gender roles (masculinity and femininity) are based on generalities not absolutes.


Even hardcore essentialists agree with this. When we say things like males are more aggressive than females, statistically we mean most males are more aggressive than most females. The differences are based on averages, not absolutes. And there’s usually a wide variation among males (and females) within virtually every behavioral trait.


To illustrate this, let’s look at something as indisputable as height. Males are taller than females. The average height of American males is 5 feet 9 inches tall, while the average height of females is 5 feet 4 inches tall. But this doesn’t mean every male is taller than every female. Some women are 6 feet tall and yet no one would say that they are not female because they fall outside the general pattern. There’s a clear difference in average, and yet much variation among each sex.


Same with masculinity and femininity. Most males are more aggressive than most females, giving rise to the stereotype that aggression is associated with masculinity. But—some females are more aggressive than some males. This doesn’t mean aggressive females aren’t females. These behaviors are generalities. We don’t run horses behind carts and we also determine one’s status as male or female based on whether they fit neatly within the general pattern of size or behavior of that class. If you are an aggressive female or a passive male, this certainly doesn’t determine whether you are a male or a female any more than being 5 foot 2 rules you out from being a male.


If you are a male who likes pink and hates blue, this doesn’t mean you are female. (It would actually mean you are incredibly masculine 100 years ago.)


If you are a female who likes sports more than shopping, this doesn’t affect your status as a female.


If you are a 5 foot 2 male who hates sports and loves shopping, you are just as male as Dwayne Johnson, even though only one of you fits the masculine stereotype. (Sorry, I don’t care who you are—Dwayne wins on this one.)



Biological Sex, Gender Roles, and Men’s Retreats


Gender roles are stereotypes based on how males and females generally behave—behaviors that are both biologically influenced and culturally shaped. But biological sex for non-intersex humans is not based on generalities but absolutes. Sure, males and females have many things in common based on their shared humanity, but the very things (chromosomes and reproductive systems) that make non-intersex humans sexually dimorphic are not based on generalities or stereotypes but on black and white absolutes. It would make no sense to flip the whole thing on its head and use the stereotypes to determine one’s status as a man or a woman. Such a move would be both scientifically naïve and socially oppressive.


And yet that’s what people often do. We begin with preconceived categories of how males and females should behave, and when some don’t fit our stereotypes, we make them feel like they aren’t really a man or really a woman.


The church can be particularly guilty of this. I know, because I’ve been to men’s retreats. Men’s retreats don’t tend to be very inclusive of all males (biological sex) but geared much more toward masculinity (gender roles). We don’t say it, but men’s retreats (and I’m going to assume, women’s retreats as well) prioritize gender roles over biological sex. They typically appeal to males and females who fit the stereotype, who conform to the majority. As a result, they tend to (often unintentionally) exclude the minority—those whose biological sex qualifies them to attend, but who’s interests and behaviors fall outside the gender club.



Our original two questions were: Is it possible for someone to be a gender that’s different from their biological sex? And, if it is possible then which one (sex or gender) should determine one’s identity and status as man or woman.


If by gender we mean “gender role,” then yes of course it’s possible—I just don’t think it’s particularly helpful. A female might not act in stereotypically feminine ways. Her biological sex might not be easily stuffed into the gender role implicitly assigned to her. But I would argue, and passionately so, that whether or not she can be neatly stuffed into a particular gender role, this shouldn’t determine her status as a woman.


If someone were to prioritize gender role over biological sex, they would have to depend upon old stereotypes of masculinity and femininity and give fodder to the oppressive notion that the majority should define (and often exclude) the minority.


You may wonder, well WHO’s actually prioritizing gender role over biological sex?


Yes, they are.






According to the World Health Organization (the WHO):


gender refers to the socially constructed roles, behaviours, activities, and attributes that a given society considers appropriate for men and women. To put it another way: “Male” and “female” are sex categories, while “masculine” and “feminine” are gender categories.[xvii]


Notice, the WHO (the org not the band) does not say gender role but gender as a whole. They say that gender refers to all the ways that society forms our understanding and expectations for how men and women should act, and they even us “masculine” and “feminine” to describe “gender categories.”


Call me a party pooper, but this seems to give life to masculine and feminine stereotypes, which could be unhelpful when we’re considering people who experience gender incongruence. For instance, the WHO follows the IDC’s (International Classification of Diseases) definition of gender incongruence as:


Characterized by a marked and persistent incongruence between an individual’s experienced gender and the assigned sex.


If you add the WHO’s definition of gender to the IDC’s definition of gender incongruence, what do you get? Males who aren’t stereotypically masculine and females aren’t stereotypically feminine.


Now, the WHO has updated their statement on sex and gender, but their definition of gender reflects their previous emphasis on societal expectations for males and females: “Gender refers to the socially constructed characteristics of women and men—such as the norms, roles and relationships that exist between them.”[xviii]


You can see why a good number of feminists are bewildered when otherwise liberal western societies prioritize gender over sex, especially when gender is described along the lines of gender role. Women have been fighting for decades to be liberated from outdated, narrow, and even oppressive constructs of femininity that have been largely maintained by men. “‘Gender’, in traditional patriarchal thinking, ascribes skirts, high heels and a love of unpaid domestic labour to those with female biology, and comfortable clothing, enterprise and initiative to those with male biology,” writes feminist scholar Sheila Jeffreys.[xix]


Is this critique valid? When gender overrules sex, does this resurrect old, male-dominated stereotypes that have been oppressive toward women? It depends, in part, on how we define gender, which is why it’s so important to be very clear about what we mean and don’t mean when we talk about gender and sex.


I don’t think gender role should determine who really is a man and who really is a woman.


But what about gender identity—one’s internal sense of self as male or female or both or neither? Could one’s gender identity be at odds with one’s biological sex? And if so, should gender identity overrule biological sex in determining whether one is a man/boy or woman/girl for non-intersex persons?


It’s already 5:30pm where I’m at, and probably near the same where you are. Let’s call it a day and tackle this one in the next post.




[i]  Robert Stoller, Presentations of Gender, 10,cited in Christina Beardsley and Michelle O’Brien (eds.), This is My Body, 12.

[ii] Gender role is the “adoptions of cultural expectations for maleness or femaleness” (Yarhouse, Understanding Gender Dysphoria, 17). “Gender roles govern the way we’re expected to act, depending on our gender” (Hartke, Transforming, 23). “Gender roles in society means how we’re expected to act, speak, dress, groom, and conduct ourselves based upon our assigned sex” (Planned Parenthood).

[iii] See especially M. Hines and F. R. Kaufman, “Androgen and the Development of Human Sex-Typical Behavior: Rough-and-Tumble Play and Sex of Preferred Playmates in Children with Congenital Adrenal-Hyperplasia (CAH),” Child Development 65 (1994): 1042-53. See also Tracy Collins-Stanley, et al. “Choice of Romantic, Violent, and Scary Fairy-Tale Books by Preschool Girls and Boys,” Child Study Journal 26 (1996): 279-302; Kai von Klitzing, et al.  “Gender-Specific Characteristics of 5-Year-Olds’ Play Narratives and Associations with Behavior Ratings,” Journal of the American Academy of Child and Adolescent Psychiatry 39 (2000): 1017-1023; Melissa Hines, “Sex-Related Variation in Human Behavior and the Brain,” Trends in Cognitive Science 10 (2010): 448-456. For an informed yet accessible summary and discussion, see Leonard Sax, Why Gender Matters (2nd ed.; New York: Harmony, 2017), 47-68.

[iv] See Fine, Delusions of Gender, 97-106 for good discussion of different views.

[v] I say “typically,” because some females with an intersex condition known as Congenital Adrenal Hyperplasia (CAH) overproduce the androgen hormone called androstenedione, which seems to have some kind of masculinizing effect on the brain. Females with this condition typically “grow into tomboys, with more rough-and-tumble play, a greater interest in trucks than dolls, better spatial abilities, and, when they get older, more sexual fantasies and attraction involving other girls” (Pinker, The Blank Slate, 238). The number of studies on girls affected with CAH is enormous and the results are somewhat mixed. Some have found very little behavioral differences between girls with CAH and unaffected girls (see Fausto-Sterling, Sexing the Body, 74-75), and other studies document many behavior differences. In spite of the mixed results, virtually all studies agree that as children, girls with CAH prefer rough and tumble play and male-typical toys much more than unaffected girls (for a review and discussion, see Jordan-Young, Brainstorm, 69-74, cf. 255-268).

[vi] See also the DSM-5, which says that a child might have gender dysphoria is they show “a strong preference for the toys, games, or activities stereotypically used or engaged in by the other gender” (p. 452, cited in McHugh and Mayer, “Sexuality and Gender,” 96).

[viii] B.I. Fagot and R. Hagan, “Aggression in Toddlers: Responses to the Assertive Acts of Boys and Girls, Sex Roles 12 (1985): 341-351.

[ix] J. H. Block, “Conceptions of Sex Roles: Some Cross-Cultural and Longitudinal Perspectives,” American Psychologist 28 (1973): 512-526; M. Mead, Sex and Temperament in Three Primitive Societies (New York: Morrow, 1935); cf. Lips, Sex and Gender, 157.

[xi] Pinker, Blank Slate,349.

[xii] The case was documented in the bestselling book by John Colapinto, As Nature Made Him: The Boy Who Was Raised as a Girl (Harper Collins, 2000) and is talked about in virtually every book on sex and gender.

[xiii] S. J. Bradley, G. D. Oliver, et al. “Experiment of nurture: Ablatio penis at 2 months, sex reassignment at 7 months and a psychosexual follow-up in young adulthood,” Pediatrics 102 (1998) ??.

[xiv] W.G. Reiner, “Cloacal exstrophy: Paper presented at the Lawson Wilkins pediatric Endocrine Society, Boston (2000).

[xv] See Fausto-Sterling, Sexing the Body, 146-232; or more recently, Cordeila Fine, Testosterone Rex.

[xvi] Pamela Dalton, Nadine Doolittle, and Paul Breslin, “Gender-Specific Induction of Enhanced Sensitivity to Odors,” Nature Neuroscience 5 (2005): 199-200; Nassima Boulkroune, et al. “Repetitive Olfactory Exposure to the Biologically Significant Steroid Androstadienone Causes a Hedonic Shift and Gender Dimorphic Changes in Olfactory-Evoked Potentials,” Neuropsychopharmacology 32 (2007): 1822-1829.

[xix] Gender Hurts, 1-2.


Hey Preston -

Thanks again for writing! The relationship between gender and sex is not something I’ve read a lot about, and you’re really helping me think through it. When it comes to gender roles, it sounds like you’re partial to at least some interactionist models (which sound plausible to me too), but I’m still wrestling with the nature/nurture debate when it comes to the relationship between gender roles and determining if someone is a man or a woman.

You mentioned that gender roles shouldn’t determine who is really a man and who is really a woman, but shouldn’t gender roles at least play some part in that determination given some gender roles are based on nature/biology? It would seem as though gender roles that are more biologically determined could play a more prominent role in deciding who is really a man and who is really a woman because they’re more direct manifestations of biological sex; whereas, gender roles that are more sociologically determined could play less of a role (or no role at all?) in deciding who is really and man and who is really a woman.

And, if so, how do we determine what aspects of gender roles are nature driven vs. nurture driven? Im sure it’s not clean-cut, but are there some guiding principles?

Maybe I’m way off base here though! Would love to hear you thoughts!

Thanks so much,


prestonsprinkle's picture

Hey Travis! Thanks for dropping in again. You ask: "shouldn’t gender roles at least play some part in that determination given some gender roles are based on nature/biology?" I guess it depends on your perspective, but I'd still say "I dont think so." My point about nature/nurture feeding into gender roles is not that most roles are purely biologically shaped or determined while some outliers are nurtured into that role--a role that doesn't fit the stereotype. My point is that both nature/nurture play a role in forming both the stereotype and the outliers and that we simply can't unravel the nature/nurture relationship too cleanly. So, for example, aggressive males fit the stereotype and therefore gender role for males, but the fact that they are aggressive isn't simplyi a byproduct of nature, but is shaped both by nature and nurture. Does that make sense? Plus, to me it would make more sense to begin with the one clear stable feature among non-intersex persons: sexual dimorphism. All non-intersex persons are either male or female. Their behaviors and interests and abilities overlap, of course, but in as much as we're going to talk about non-intersex persons as "men" and "women," it would seem better to based these categories on "males" and "females." Hope that helps! 

(By the way, I'm using "men" and "women" as categories that blend sex and gender, while "male" and "female" are strictly about sex.)  

Preston - Thanks so much! I appreciate how you're pushing my thinking, and I'm definitely starting to track more with what you're saying. I have some other clarifying questions, but I'm going to wait for your post on gender identity, because that may help clear up some of the thoughts swimming around in my head! Thanks again.

prestonsprinkle's picture

Sounds good, Travis!

Thanks so much for this; it’s incredibly helpful for me to read. Please write your next blog post soon!!!

prestonsprinkle's picture

Haha! Thanks for letting me know, Susan! The next blog post will start talking about Gender Identity; specifically, the scientific validity of the claim that our brains are sexually dimorphic--male and female--and that some males might have a female brain and vice versa. Should be fun. It's alraedy written, but I usually pass the draft by several other people, then get feedback and make the necessary edits, then I sit on it for a bit, make some more edits, then more edits, and then I hit "upload" and "publish." It's long process! But I'm hoping the next post will be out by this time next week. 

Hey Preston, just wanted to chime in to say I totally relate to the Christian men's retreat dilemma. The church focusing too narrowly on stereotypical masculinity. There is a local church whose annual men's retreat --at one point -- included taking a sledgehammer to a car they hauled in from a junk yard. It's an event I would never feel safe attending as a Christian male who is not stereotypically masculine. This truncated view of masculinity is disheartening when I know I am a role model for Christian men in the way I have surrendered my sexuality to Jesus as a same-sex attracted man (side B) and found freedom from porn addiction (thanks be to God). My patience is wearing thin for immature and narrow displays of masculinity being applauded. I hope and pray that the boldness and vulnerability of a nurturing, sensitive, present masculinity comes to the fore and is honoured and given a place. Thanks for your work, your writings are thoughtful and very helpful. Blessings

prestonsprinkle's picture

Thanks for these thoughts, Scott! They are echoed by so many people I know--both gay/SSA and straight. For what it's worth, there's a lot more straight guys who feel the same, and yet are too shamed to actually admit it. One of my buddies is a former Navy Seal, celebrated sniper, killed for a living. He told me that from the time he was a kid, he hated to see things die--especially animals and people. He just buried all of that because he thought he had to. So sad. 

Glad you're enjoying the posts! 

Ugh. I'm totally with Scott here. I despise gendered events. Why do men get wings and women get pastries? Why do women's things seem to think we don't have brains and can't reason?

What you said here, Preston, about gender roles really resonated with me. Evangelical churches have this narrow definition of men and "ladies" - gag me with a spoon! - and it really harms all of us. By clinging to those tight definitions of roles, churches are actively marginalizing their members.

prestonsprinkle's picture

Thanks Dayna! Your "Ugh" seems to be a growing trend in these comments! Glad I'm not alone :) 

Hello Preston, your information on Men's and Women's retreats made me chuckle. My wife will never go to a woman's retreat because she so dislikes the "girliness" of them. She wonders why they always need to make crafts and paint rocks? On the other hand, our men's retreats include fishing, skeet shooting and other sports, which I like. What is to be done? It is difficult to please everyone. Do churches even need to have distinctive men's and women's retreats? Are we really different beyond our biology that we need to have separate retreats? I will wait and see what the upcoming posts have to say. Finally, "gender roles" and "gender identity" I assume are fairly newer terms. How can we apply scripture?

I love your well thought out, researched, and humorous blog posts. I think two other folks where moving towards my question and comment in their posts. One post referred to the Nature/nuture discussion and the significance of the role of the nature in gender roles, and the other poster discussed men's retreats and his experience with "narrow" masculinity. If there is a nature part to gender roles (which I agree with you), might not that be helpful to distinguish and attempt to define. It could help better describe masculinity and femininity in a way that moves beyond the "general" and beyond societal standards. I would suggest referring to masculinity and femininity as the God/nature given outward expressions of our sex, a subpart of the wider gender role. I think this would help as you explore some of your future questions, as well as honor our Creator and help those who are on the periphery of the "general" in gender roles.

prestonsprinkle's picture

Thanks for this, David! I'm going to mull over your suggestion: " I would suggest referring to masculinity and femininity as the God/nature given outward expressions of our sex, a subpart of the wider gender role." Can you tease this out a bit more? I THINK I know what you're getting at, but it's not 100% clear to me. 

In the meantime, part of the thing that muddles "masculinity" and "femininity" is the fact that cultural expectations bleed into our understanding through "nurture's" contribution. That is, it's almost impossible for us to think about what "masc/fem" even mean apart from our socio-cultural location, but the latter can be deeply flawed. It's a tangled web of God's possible intention through some aspects of nature's contribution (though even that, through the fall, can be flawed) along with nurture's contribution. 

Anyway, I'll leave it at that. I'd love to hear you expand on your point a bit more.  

Thanks Preston. While I think as men and women we have a lot more in common than we do different, those small differences matter (many who are married know these small differences can be a big point of enjoyment as well as conflict). Differences in men and women exist across all times and cultures, although those differences may present differently from one culture to the next and from one time to the next. Just the fact that gender roles exist at all points to a desire in humans to interact in the world as unique to one’s sex. I think this helps back up the view as you state that there is a portion of gender roles that is nature driven/God given. I also agree with you that the fall of mankind affected all nature including the nature portion of our gender. We are all broken in our gender and sex. This means we all struggle with our gender to some degree. We all at times betray our gender role and part of our design/purpose as gendered beings. If this is true, don’t we need to know what we are struggling with and struggling toward? This might also enable us to better know what we should let go about gender roles within our cultures too. To say that nature/God given gender roles are too affected by the fall and too corrupted by culture to identify any semblance of the original design, I believe would be conceding to a Post-Modern viewpoint that truth cannot be determined beyond one’s culture and miss an opportunity to bring some helpful clarity to a painful, confusing and contentious subject. The consequences in not doing so is to move toward genderlessness (where it seems we’re heading) or remain in possibly oppressive cultural gender stereotypes (where it seems we’ve been). I think this may be an essential piece of moving toward an understanding of gender and would be skipped over to our own detriment. I think we ought to humbly attempt to identify what we can about that original design for our gender roles, as vague, general, or abstract as it may be and distinguish it from the fallen, and possibly culturally corrupted portions of gender roles. Then calling that nature/God given portion masculinity, true femininity, God given masculinity or something else to help distinguish it and set it apart as valuable and distinct. I would also propose that this part could be attempted to be identified by examining and comparing what we can observe from gender roles pre-fall/pre-culture, gender roles post-fall/pre-culture, gender roles post-fall/uncorrupted by culture, and gender roles post-fall/corrupted by culture across all cultures. God’s Word gives us clues to these with Adam and Eve, Jesus, and gender based scriptural instructions. This can be combined with the sociological information we have readily available on different cultures. Rites of passage really highlight cultural views of gender roles and may present a good baseline to compare and contrast with. I don’t think this is above your paygrade and I would encourage you to not retreat away from this part. You can do it Preston!

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Hey David, 

Thanks for your thoughts! Toward the end, you said: "God’s Word gives us clues to these with Adam and Eve, Jesus, and gender based scriptural instructions. This can be combined with the sociological information we have readily available on different cultures. Rites of passage really highlight cultural views of gender roles and may present a good baseline to compare and contrast with."

If I'm hearing your correctly, you're suggesting that we can use both God's word (special revelation) and cross-cultural patterns of male/female behavior or roles (gender revelation) to figrue how how men and women should act. Or something like that? Or, what does it mean to identify with and live out our sex/gender?

This is one of THE most important and practical questions that I'm ultimately after. In fact, part of the reason why I'm taking so much time to figure out "who we are" is so that we'll be in a better place to answer the question "how should we live." Because "how we should live" will be oriented toward identity.

Regarding gender specific commands in Scripture. I find it fascinating how few there are! Seriously. Can you think of any commands giving to women and not men, or vice versa? Think of Titus 2, the famous "girls only" passage. But 8 of the 10 commands given to women are repeated elswhere to men (and I think the "busy at home" command is misunderstood, but...). Maybe "submit to your husbands" is female-only (though we are all called to submit to one another (Eph 5:21) and Christ's submission to the Father (Phil 2) is a paradigm for us all to follow. There are some culturally specific commands about clothing and dress (1 Tim 2; 1 Cor 11; 1 Pet 3) that might be female specific, but the principle (modesty, humility) driving these commands would apply to men. 

Honestly, what are the commands for women that don't apply to men or to men that don't apply to women? Even if there are a few, there seems to be much fewer than peopl often think.  

Thanks David, Your comments are excellent, and I do think there is much to be learned from discerning what could be called true Scriptural masculinity and femininity. In this, we should keep in mind a key point in Scripture which is often missed, that men and women are equal in God's eyes, even with different roles in some areas.

As Preston points out in his reply there is relatively little scripture devoted exclusively to pointing out differences in roles of females vs males. There are however, multiple indications (some direct and some indirect) in scripture that point to different roles for the sexes. In Genesis 2 we see that Adam was created to work in the garden and take care of it (obviously that's not his only purpose, but "work" and "care" were closely associated with his creation). Again in chapter 3 we see the curse on the ground and the reference to "sweat of your brow", indicating for the second time that man has a role of "work".

Also in the same book, God created Eve as a "helper" for Adam. Again, this is obviously not the total extent of her role, but it was the initial revelation of a role associated with her. I would add too that Eve, in helping Adam, was also involved in work and care, so the distinctions presented in this scripture are not purely black and white. The Lord tells Eve that her husband will rule over her. I think that culturally we ignore the context of the entire Bible, this "rule over you" is often exaggerated. But it appears that a role of the male is at least to be a leader while the role of the female is equal, but different in this area. Again I don't think we should take this to an extreme, I believe that God intended for each sex to serve the other, to defer to each other, to care for each other, etc. At the same time, it appears that men have a leadership role.

There are also hints of a nurturing role for women, although here is not the most prominent of those hints.

In Proverbs 31:10-11 & 27, among other things women are urged to be keepers of the home. Likewise in Titus 2:5 they are to guide the house. There are other indications that this role is assigned to women. I think its obvious (but some may disagree) that the woman certainly has the authority to assign work to the husband, and certainly the husband should endeavor to help in the house, but it appears that God has split the roles along some areas, and this is one example.

All this has to be balanced with other commands such as "bear one another burdens"...

There are other differences in roles, males are urged to be in control of their emotions and passions, provide for their family, serve as a protector, etc.

It appears if we look at Scripture in total, that men and women and the Father, Son, and Spirit can function as equals in rank and role. Those bearing different roles are not subordinate or superior to one another, even when one has a helping role. Jesus and Eve model servant leadership. In fact, for men and women, all authority is delegated authority from God We need authority to complete our work, but it should never be used over other people, to keep them subordinate. Bottom line, there are definitely roles that as you suggest, we should aspire to fill based on our sex.

I am a biologist by training and early career but I now work helping people recover from various forms of sexual brokenness. Like Preston, I have some random, unorganized thoughts that relate to this topic I wanted to share.

One thing I don’t hear anyone outside of the biological sciences in relationship to transgenderism is how biological sex develops during embryogenesis in the first place. You won’t see this exactly spelled out in an embryology text book, but it is a fact that animals (and humans) begin development as females. That is, all of us start out with a female template.

To boil it down to the very basics, all of us have an X gene and we all begin development along those lines. Even our sexual organs start development toward female morphology. Then, if a Y gene is present, it triggers the activation of a number of genes found on other chromosomes that change female sex organs into male sex organs. Other parts of the body are similarly affected to become male.

We know now that the gene dmrt1 found on the 9th chromosome plays a part in this. In fact, the reason some XY embryos do not develop into male but develop female morphology is linked to a failure of the dmrt1 gene. If there is only one copy of dmrt1 on one of our two 9th chromosomes, the female organs will only partially morph toward female. If dmrt1 does not work at all the XY individual will continue to develop and become completely female. The biological term for this is 46XY Complete Gonadal Dysgenesis. This is an overly-simplistic explanation but hopefully will do for the moment.

Again, we all start out as if we were to become females. At a certain point, if there is a Y gene, it overrides that development plan and sets a new course. Unless something goes wrong with the Y gene or the genes it is supposed to activate.

What does that have to do with transgenderism? My thoughts are not fully developed, but this is what I am thinking so far:

Because our base template is female, I find it confusing that there has been such a huge spike in women who are identifying as males. From a biological point of view, that doesn’t make sense. Without a Y chromosome to trigger the activation of male genes I do not see a biological reason for this new phenomenon.

On the other hand, it is easy for me to see how an XY individual “feeling female” could have a biological influence, since “female” is essentially the foundation we are all built on. I can imagine, though we have no evidence to date, that some male gene was not fully turned on contributing to an XY individual feeling female. No one has yet found a gene related to what we call feeling masculine or feminine but it is not impossible to imagine.

I do not see the other way around having the same kind of biological explanation. I don’t see how an XX individual could have any male-related genes activated. That is what the Y gene does, and there is no Y gene. Females identifying as males, to me, looks a lot more like an environmental influence. The fact that much of the recent surge in transgenderism among XX individuals is late onset seems to add credence to my thoughts. Late onset indicates something that happened long after birth, not at birth.

Of course, it could also be that the causes of gender dysphoria in XY individuals is completely different than in XX. Or, more likely, there are a huge number of potential causes for gender dysphoria that have little to do with each other.

I’d love to hear your reaction to this as I continue to formulate my thoughts.

prestonsprinkle's picture

This is so good, John! I'm very aware of your first few paragraphs about female/XX being the default and "male" being switched on by the presence of a Y chromosome. I'm not a biologist, but I've tried to do a lot of reading in this area, so what you're saying here matches perfectly with what I'm reading. 

I'm also aware of the massive increase in females (especially teenagers) embracing a cross-sex or cross-gender identity. I've written about the growing phenomenon of rapid onset gender dysphoria here:

This is somewhat related to your point. For instance, the Tavistock Gender clinic in England has seen a 5,000% increase of people and most of them have been female, which has given rise to all the controversy surrounding the clinic.

 Anyway, I'd love to continue to dialogue with you about your statement: "I do not see the other way around having the same kind of biological explanation. I don’t see how an XX individual could have any male-related genes activated. That is what the Y gene does, and there is no Y gene. Females identifying as males, to me, looks a lot more like an environmental influence. The fact that much of the recent surge in transgenderism among XX individuals is late onset seems to add credence to my thoughts. Late onset indicates something that happened long after birth, not at birth."

I'm going to try to play devil's advocate here. Could there be other biological causes of, say, early onset gender dysphoria beyond the genetic pathway you've articulated? What about the role of prenatal hormone exposure; for instance, where genetic females recieve higher doses of androgens, which results in more male-typical behaviors? (The intersex condition of Congenital Adrenal Hyperplasia would be a more extreme form of this.) What about people with early onset gender dysphoria, which has been incredibly intense and lifelong from the age of 4 years old, who also have not experienced any sort of trauma or abuse or anything "bad" from nurture, yet still have intense gender dysphoria?

Just some questions I'm sorting through. I'd love to hear your thoughts!  

Yes, there could, of course, be other biological causes of early onset gender dysphoria beyond the pathways I described. I would suspect that there is likely a biological aspect to all early onset gender dysphoria, but that does not mean biology is 100% responsible. Different personalities respond very differently to environmental factors and what is deemed traumatic or not traumatic to most may be experienced quite differently by someone else. Gender dysphoria itself is a response to internal trauma that some people experience but most do not.

Please understand, I am no expert in transgenderism. I'm just trying to understand it better myself. What stood out to me in what I wrote was the fact that what separates a male and female is not as much as a lot of people think. We all have the same genes available that could make a male or female. The presence or absence of a Y chromosome is what normally turns on or off different sets of these genes that are within all of us. Even though I am a biologist I never stopped and considered that before now. I don't think most people really understand that.

Now, I don't know if knowing that fact would calm most people down or make them freak out. I am not always the best at predicting how people are going to react to information (a problem most of us scientifically minded people have). Science doesn't care what you think or what your morals are. It just tells us what is. What we do with that information becomes what is important. I suppose that is what you are working on and why I'm following along.

It does concern me that there are rapidly rising numbers of people experiencing transgenderism. I've read your books (as well as books of others) and know all the possible explanations. No matter the cause, it is a concern. From a species health point of view, no form of dysphoria is good news for the human race. But we also need to learn how to be better family to those who experience gender dysphoria. There is a tension there that most people I know don't want to deal with. People seem to think one is accurate but not the other. Again, science tells us what is, not what we wish was true. I prefer dealing with reality, no matter how uncomfortable it may be.

prestonsprinkle's picture

Thanks again, John! Seriously, I'd love to sit down and talk to you about all of this. I love your heart and your humble quest for what is true and real and good for others. 

I agree that biology probably plays some role, perhaps in some a very srong roll, and yet pure "nature" is rarely the sole 100% cause of dysphoria. Nature and nurture are so intertwined that they're impossible to untangle. And from what I've read and the stories I've listened to, there are multiple traumatic events that could cause, or shape, or nurture dysphoria in some people. I just read an article by a transgender scholar who talked about the link between body dissociation and trauma and how all of this might be connected to gender dysphoria in some people.

One question about chromosomes: have you thought through the possible implications that epigenetics might play? Could post natal events switch on or off the Y chromosome? (I'm not even sure if this is a thing; just thinking out loud.) 


External changes to DNA such as epigenetics do not typically affect all DNA molecules in a fetus. These changes typically affect a specific tissue, which varies. It is a misunderstanding to envision all 30+ trillion or so cells in a person to be affected the same way by an external source. For example, some kinds of cancer can be caused by epigenetic influences, but not every cell will develop cancer.

The Y chromosome stands out, however in our DNA. Studies indicate that the Y chromosome is particularly robust in resisting changes to it. One primary kind of epigenetic effect is called DNA methylation. The Y chromosome appears to be more resistant to external mutation or change than other chromosomes. One study of DNA in a family line showed very little change due to DNA methylation over several thousand years in the Y chromosomes of males. That is a very significant finding.

That does not mean epigenetics could not explain some aspects of transgenderism. If it can, however, it is likely not related to the Y chromosome itself but other genes. It would also likely affect only genes in certain tissues, and we don't know what that might be right now. So, for now all this is strictly hypothetical.

Not sure if that clears anything up or not...

Hey John, I am not a biologist. I'm a counselor who specializes in trauma and sexual issues and an IVF Dad. So most of my embryonic research has come out of having my own embryos. From my research and understanding I would challenge the statement that "we all start out as if we were to become females". I have read that we start out having tissue for both male and female sexual organs and that our DNA blue print activates what tissue forms and which goes away. It may be more accurate to say that we all have a common human tissue template rather than assigning sex to anything beyond our genetic coding. Knowing you are an empiricist, here's some of the data I'm citing:

Hi Preston,
Thanks for putting this into words and backing it up with scholarship that I don't have. I've thought this way for a long time. It was a bit scary for me to really engage with this topic and think that if I'd grown up in a different environment I would be so confused. I mean, I'm not the least bit gay but I'm far more socially "masculine" than "feminine." And I do feel incredibly uncomfortable and generally avoid ladies' gatherings at church. I will never forget the ladies' prayer retreat while I was working as a full-time missionary. I wished the whole time I could have gone on the men's retreat. I was hungry, okay? We had pancakes for breakfast and they're like "muffins for snack" and I'm like "seriously? I can't any more carbs! I will eat a half pound bacon cheeseburger, right now." I didn't say that. I was trying to be nice. But I ate way more than my fair share of the lunch meat. And ALL the strawberries. There were no burgers. There was soup. I wanted to go hiking and play Frisbee (the men had played) and no one else seemed to want to go outside at all.
I've never questioned my identity. I'm a woman. I am married with three kids. But this is a difficult and important topic and, like you say, the church marginalizes people. I am excited to see this begin to change.

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This is so funny! And...sad. Seems like your thoughts are shared by many others, some of whom are commenting on the post! I think it's so good for pastors and leaders to read your concerns. 

But it sounds like the ladies take issue with it more than the guys, from scanning other comments. :)

I think perhaps the church has taken a fighting stance against the cultural idea that there's no difference between men and women and gone way off the other side, as they often do. Similarly to the Protestant response to feminism where suddenly churches started making "the role of women in church" policies and limiting women strangely and inconsistently. It was perfectly fine for me to preach the gospel unto the heathen in remote Canada (it actually was remote) but once I came back I couldn't teach a mixed-sex Sunday school class older than middle schoolers.

I think we as a church should be more careful about not going overboard when we engage with unbiblical cultural trends. We can easily end up just as unbiblical in a different extreme.

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Super wise words, Mary! Pendulum swings are never helpful, and people are prone to over react in the opposite direction in ways that end up mirroring the very tone/posture of the thing we hate. Cf. Politics.

In short, I'm trying to celebtate sex difference while not canonizing cultural steretypes that aren't rooted in Scripture (or God's intention for male and female behavior). That parenthentical part is tough. What exactly does it mean to live faithufully as a man or women? Are there specific acts or attitudes that go against God's intention for male-specific and female-specific behavior? I know complimentarians could list a whole bunch, though I'm not sure how many are actually biblical, and egalitarians might not list any, and I'm not sure that's God's intention either (1 Cor 11, etc.). Anyway, really trying to sort all of this out. 

Hey Preston, I love the work you’re doing and I’m so grateful for the resources you have made available for church leaders.

At the beginning of this post, you approach this conversation from a perspective that seems to deny the thought of gender existing on a spectrum. For example, you set the definition of gender identity as the internal, self-identity with one, both, or neither of the two genders. I don’t know if you cover the idea of a “gender spectrum” in another post, and if so this comment may well be moot. It seems that if someone was reading from the “camp” of gender as a spectrum, they would be helped by an explanation as to why it is that you are making this approach. I would also find such an explanation helpful for the times I have conversations with people who view gender as being on a spectrum.

Thoughts? Thanks again for your sensitivity to this topic and your willingness to share what you’ve found!

prestonsprinkle's picture

Hey Joe, 

Thanks for this! I think the "gender as a spectrum" is the majority popular opinion, and it really resonates with everything I've said in this post. It all comes down to: what exactly do you mean by "gender." If it's gender roles--masculinity and femininity--then yes of course, these cultural stereotypes exist on a spectrum, not in two hard and fast boxes. Does that make sesne? 

In terms of gender identity, it's often defined as "one's internal sense of self." If you define gender this way, then of course it's a spectrum. How many "internal senses of self" exist in the world? I don't know, about 7 billion? (Which is why some people say there are an infinite number of genders...)

It all comes down to how you define gender in relation to biological sex, which is why I'm spending so much time upfront looking into these categories.

In short, the "gender spectrum" view is precisely why I'm starting this blog series where I do. What. IS. Gender?? 

Preston, Thanks so much for your studies and pastoring influence. I am Chairman of the Elder Board at our Church in Illinois, and recently we wrote a Biblical policy on human sexuality. When I shared it with our staff, one of them gave me your book and web site. I enrolled in your on line course and read one of your books (You are an excellent writer!). I then used one of your on line video's with the Elder Board (Can we truly love LGBT...people and still hold on to Biblical Truth). It went really well. Thank you!! My question is this: Why now. Why in the millenia of Human Sexuality has this phenomenon of Trans...appeared now. Is it our science that has offered a pathway? Is it our culture that has changed? Thoughts? By the way, the blog is excellent. Keep going!

prestonsprinkle's picture

Man, I don't know, David. That's a tough question for me to answer. Here are a few possibilities that might make for a perfect storm: 

- genuine gender dysphoria has always existed, and yet people who experienced this have had to hide their experience for fear of being "found out." The church's shame culture has done a great job villifying the struggles of the minority.

- Postmodernism allows for truth to be relative and subjective, and experiences to determine what is true

- Add to this the excessive western emphasis on individuality.

- Add to this the untouchable sanctity of identity; that one's identity cannot be questioned at all, whatsoever, no matter the evidence for or against such identity. If you question a person's idenity, you're probably a racist. And Trump supporter. etc. etc. 

-  Add to this the church's adoption of stereotypical gender roles and baptised them as biblical--even though most of them aren't. 

Just some "thoughts out loud" :) 

I don't want to overcomplicate matters here, but it occurred to me from your comment on epigenetics several comments ago that the nature/nurture debate is even less clear cut than many people think. Genetics doesn't have the final say on the expression of biological sex or brain structure. There are so many environmental factors at play, both in utero and postnatal that can influence how a person develops.

Some things like sexually differentiated brain structure may be genetically predisposed, but the environment during development may significantly influence the final results. Human brains continue to develop until the mid twenties when the prefrontal cortex finally integrates with the rest of the brain. Insurance companies have long since identified the statistical results of this brain development and offer a reduction in auto insurance premiums when a driver turns 25. It's mere statistics that drivers over the age of 25 tend to have fewer accidents and we can trace this change back to this critical brain development.

My point is that environmental factors like air and water quality, injury, malnutrition, trauma, and substance use (prescription or illicit) may have an impact on the expression of what is indelibly written in our genes. The presence or absence of a Y chromosome isn't the only factor influencing the development of statistically "normal" male anatomy and physiology. The mother's diet, environment, etc. can influence how the genetic blueprint is expressed for a developing fetus. Similarly lead or other substances in the environment of a child, whether in the water supply or in paint chips in older homes, can have significant impact on brain development. I've read some about studies comparing brain structure between men and women and there is so much more research to be done regarding what factors can influence these structural developments.

I also want to mention that I too am one of those men who doesn't feel like I can easily be shoehorned into society's stereotype for masculinity. I enjoy a number of stereotypical male activities like hunting, hiking, camping, and American football. I have an equal love for music, musical theater, and art. I would love to see congregations become more sensitive to the broad variation in gender expression.

Lastly, I am a parent of an adult child who identifies as transgender. The recent phenomenon of rapid late onset gender dysphoria is all too real for me and my family. I greatly appreciate your sensitive, intelligent, and witty approach to what is an oft confusing, difficult, and highly polarized topic.

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Thanks so much for your wise and pesonal thoughts! So funny you mention all the stuff about neuroplasticity and nature/nurture interactions. I'm going to get into all of that in the next post where I discuss the so-called "brain-sex theory." I pretty much agree with everything you say here. I mean, it's easy to agree with; it's not really up for debate any longer :) 

Hey, I'd love to hear your story, in particular about what it's like to parent a person with ROGD. If you'd be willing share in private, you can email here: [email protected]

Thanks Jeff! Glad you're following the posts.  

Hello Preston,

I first want to thank you for your hard work and for opening up a platform that allows for discussion. I have written on some of these topics before and comments can get quite harsh.

I appreciate your focus on essentialism. I agree that while there is quite a bit of variance in the categories of men and women, these deviations don't eliminate the categories of men and women. I also appreciate your sense of caution and openness to the things we do not know. It is unfortunate that what was previous studied as "transsexuality" has been politicized and included in the larger gender ideology that is playing out in society. I use the term transexual, because I saw an individual ask the question here, “why are there so many trans individuals today?” I believe the prevalence hasn’t increased, but rather the labels use has increased. Trans as a label and as a diagnosis has been liberally handed out to include dissociative disorders, identity disorders, body dysmorphic issues, and gender expansive individuals such as drag queens and non binary folks. I believe you are right to notice that gender has been complicated and therefore the terms should be clearly defined in order to have a productive discussion.

I read your blogs and follow the publishings from your institute with keen interest as a Christian who decided to medically transition a few years ago.
I have always held a more traditional view than my LGBT friends, which has left me in kind of a theological island. Pastors I have sat down with to talk about my life expect to meet someone who doesn’t care about traditional gender roles or a historically christian sexual ethics. After just a half hour of conversation, they realize that couldn’t be farther from the truth!

I wanted to press into a particular portion of your second blog—the section at the end where you focus on generalities vs. absolutes. Those ideas have been brought up to me by well meaning pastors as an intended source of comfort. It always fell flat to me, because most transexual individuals have a sense of incongruity beyond the stereotypes. In my experience, the stereotypes might have contributed to part of my dysphoria, but only in so far as I wanted to fit in and be a part of the other girls. The largest and most distressing part of my dysphoria was the daily never ending sense of incongruence with my body that escalated at puberty. Some have referred to it as Dr. Yarhouse mentions in his book Understanding Gender Dysphoria and I’m paraphrasing “like dissonance in music or the gray noise in the background of a radio.” For me personally, it felt like an electric current through my body that caused my joints to ache, my stomach turn, my hands shake, and nausea in the most severe moments of dysphoria. Laying in bed at night, it almost felt that the electric circuits in my body didn’t quite match up, like cramming two wrong puzzle pieces together. I was sick for many years and tried many different approaches before deciding on HRT—which after about a year helped alleviate many of my physical symptoms. It was the physical systems apart from the gender stereotypes that I wanted healing from. I find the David Rimer story fascinating as well, because I see the same outcomes with persistent trans individuals. No matter how much they strive to conform to their sex and hold dysphoria at bay, there’s always a moment at some point of their lives where they have to face it head on. I believe the Rimer story is a great example that gender identity strongly shaped by nature and therefore can be hard to shift. If as Christians we come to the conclusion that individuals should not transition in any degree, then I wonder how we can help shoulder the burdens of living with a conflicting biological sex and gender identity?

I have always been in love with the Bible, interested in theology, and its why I continue to study these matters. I am grateful that you have trans people around you to talk to. I crave that, because I never met another christian who has struggled with dysphoria. It can be incredibly lonely. I enjoy your writing as food for thought and want to challenge you in that whatever you find and discover while digging through these complicated issues that you continue to explore practically how christian communities can walk with transgender people. From what I experienced at most churches, the message is either revulsion, stay quiet, or complete acceptance—all of which I think have their flaws

Thanks for contributing to the discussion!


Preston, in response to your questions about about chromosomes, radio lab did an interesting series called Gonads, where they studied genes, intersex individuals, and created about four episode exploring the issue. In the episode titled Gonads: X and Y they talked about how it isn’t just the Y chromosome that determines maleness, but a certain SRY gene (this is way over my pay grade too). To summarize here: they explained that cells in a male are constantly trying to change back to female cells, but the SRY gene acts as an inhibitor, thats says “stop, your male”. They explain it much better than I can, but I think it lends itself to Johns point of how little genetically speaking separates men and women.

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I woke up this morning and was so delighted to read your comment! I'm honored and humbled at your kind words and I'm so excited that you had the courage to comment on the post and for your willingness to help me better undersand this topic. I have so much to say and so much to ask...but why don't we chat offline? If you want to, can you email [email protected] and have Chris set up a time to chat? Or, we could just email back and forth as well. Or...not; whatever you prefer :) 

I would love to connect you with some other trans/gender-dysphoric Christians if you want. I'm sure they'd be delighted to be a freind and sounding board for what I'm sure can be such a lonely experience. Just let me know and I'll be happy to connect you.

Thanks so much for your description of what incongruence feels like and how it doesn't seem to be just about stereotypes. In particular, you said: "For me personally, it felt like an electric current through my body that caused my joints to ache, my stomach turn, my hands shake, and nausea in the most severe moments of dysphoria. Laying in bed at night, it almost felt that the electric circuits in my body didn’t quite match up, like cramming two wrong puzzle pieces together." I can't tell you how much this is helpful for me to hear. People like me who don't experience this need to hear things like this every single day so that it gets through our thick skulls how complex and difficult experiences like yours are. I would love to know: is there anything people like me can do to "be with you" in those moments?

I'll get into this aspect of dysphoria in the next few posts where I'm going to focus on gender identity--the more internal/psychological aspect of gender. Can I quote you in my next blog post? It's already a SUPER long post, but I think these kinds of descriptions are so helpful for non-trans people to hear. But again, if you don't want me to quote you, no worries! 

Thanks again for reading the blog posts and for your gracious words about my work. Oh, and yes, I would very much LOVE your feedback, pushback, additional thoughts, suggestions for edit, etc. Seriously. Even if we end up agreeing to disagree on some aspects of this conversation, I genuinely want to learn from you, be challenged by you, and shore up any holes and missing links in my own thinking.

God bless you, Addie!



Thank you for your response. I sent an email over to Chris and would love to chat in the near future! In response to your question about how Christians can be with me during particular hard times of dysphoria is a question I have by no means answered fully and still trying to figure out.

I think a place to start is to support singles in general. I think one of the hardest feelings for trans christians, gay christians, and long-time single christians is a pervasive feeling that they're broken and don't really know where they belong in church communities that seam to "idolize" the family. Family's are great, but great things have to be valued properly--neither under or over valuing good things. For single people, especially as we approach or pass the age where our friends are getting married get the message that we need to find someone or that our lives are in a holding pattern. I think there are great areas where singles can serve the church, but families get busy or don't think about how singles can be incorporated in family life. (Sam Allbery has a lot of good things to say about this topic

Second: I believe learning about and understanding gender dysphoria can be a huge help. The current cultural landscape and discussion on gender can leave many christians scoffing or just disgusted by trans people (I have sat in many of a pew hearing people berate and almost mock trans/gay people) while I sat quietly behind them. Despite the popular cultural view of self autonomy and self identification there as been decades of research as far back as the early 1930's of transexualism as a mental and medical disorder. Learning about how difficult it can be to live with dysphoria is sure to invoke some type of sympathy.

After I transitioned, my relationship with my parents became quite strained. The first few years, there was a lot of finger pointing, trying to diagnose why I felt the way I did, trying to over correct and apologize for instance where the thought they "damaged" my masculinity. I sent them to one of your workshops and afterward they seemed a little more interested and appreciated the difficulty of all those long years of suffering silently.

Falling back on simple answers and repeating "just trust in God" can be the most frustrating because my suffering has forced be on my knees praying more often than many I know. These answers remind me of the challenge James asks "what good is it if one of you says [to your brother] 'go in peace, be warmed, and filled,' without giving them the things needed for the body."

These things, in my opinion, are good things to keep in mind when thinking about how to come alongside someone suffering from dysphoria.

prestonsprinkle's picture

Addie, thanks so much for this helpful response. You hit the nail on the head when you said: "I think one of the hardest feelings for trans christians, gay christians, and long-time single christians is a pervasive feeling that they're broken and don't really know where they belong in church communities that seam to "idolize" the family." I can't tell you how many people say the same exact thing. I literally hear this almost every single day. 


"I have sat in many of a pew hearing people berate and almost mock trans/gay people while I sat quietly behind them." Addie--I'm so incredibly sorry for this. I can only imagine how this feels and I'm so sorry for the lasting wounds this must have left on you. If anything, people reading your comment will hopefully play some role in helping the church to NOT have this approach. 

I'm reading the rest of your comment and I'm feeling a mix of joy (that you're seeing your parents come around a bit) and sadness (that you had to experience such "othering" in the church. And your words of wisdom for walking with people wiht dyspohoria is super helpful. I'm looking forward to talking wiht you! 

Hi Preston,

Thanks for this, as always, really helpful, well researched and thought provoking. I haven't read all the comments so apologies is this is overlap.

A few specifics:
With regard Gender roles i agree this is massively influenced by culture. I wonder if gender identity is also affected by culture? Not in all cases at all but certainly as a contributing factor in some. I'll read the next post for you thoughts.

As UK based this was interesting - 'According to the U.K.’s National Health Service, a child might be trans, for instance, if they “dislike or refuse to take part in activities and games that are typically associated with their sex, and want to take part in activities and games typically associated with the opposite sex” or “prefer to play with children of the opposite biological sex" - how can these stereotypes be challenged if, part of the way health services try to identify trans persons is through their engagement with these stereotypes?

Nature/nurture - i'm not a scientist (at all!) but the nature/nuture divide on some areas seems slightly tenuous theologically. Take a baby in the womb. They are being formed biologically speaking, but even here they are being formed socially. Their social environment and upbringing is shaping their biology (i know that's not super technical). I've read enough mum blogs (as a Dad) to have heard that how we treat the baby in utero affects all kinds of things, so just biological, but also attachment and developmental. I wonder if the nature/nuture is too cut and dry where some areas are blurry.

Another big question for me is whether manhood and womanhood, masculinity and femininity are helpful, useful, needed or necessary. I am a male, biological. So what i do, i do as a man. As a man, there are some things that i may generally do or be that women are not. Masculine and feminine are categories, social ones, we use to talk about males and females. How helpful this is is uncertain for me. It seems more people have questions about what they are not, than what they are.

An approach i'm toying with is, rather than trying to go back to design or ideals (i.e. this is what a man or woman is/should be) we are trying to figure these things out within system as it were. Therefore our observations and conclusions are subjective due to being in creation, as creatures, affected by being both creature not creator and by being socially creatures. Even on biology, i agree with the distinctions you made in blog 1. At the same time, what has been biologically significant for determining someone as boy or girl has changed over the years (Genesis 1 wasn't thinking chromosomes and DNA). This may change again in the future. We have to work with what we've got now, but also recognise our limited knowledge.

A different question, rather than how do we define things, might be permissibility. What, as creatures, can we do in respond to the creator? With bodies, sex, science, exploration, creating definitions, running gendered events. What relationships and acts can we pursue or not? This is more of a 'how do i live in the system' rather than a 'what is this system anyway' approach. Not to negate the validity of asking the later but maybe the former has more data we can explore.

prestonsprinkle's picture

David, these are all outstanding thoughts and questions, and I truly resonate with them all. You've touched on a lot of stuff here, so let me give a few thoughts in response, in no particular order: 

- I also tend to think we can't totally seperate gender roles from gender identity. Psychologists tell us that kids start forming their gender identiy as early as 6 mo old and this is done partily in response to the males and females in their live. Whether or not those males and females (usually parents, but also siblings and others) embody the stereotypes or not, and how the child is nurtured into those stereotypes, has at least some effect on how the child will view themselves. It's not ALL nurture. But the nature/nurture distinction, even wiht gender roles and identity, is tough to seperate. 

- Your quote of the UK's National Health Service is telling and typical. This is the point I'm sort of toying with throughout all of my posts. The the role of stereotypes plays a significnat facor in our frameworks, thinking, and even assessments. 

- Your right that we now know about DNA and chromosomes for determining one's sex, but I don't know if I'd say that this has radically changed how we assess whether one is male or female. We still prioritize one's reproductive structures and genetalia; we just now know that the presence of a Y chromosome is what triggers the development of a male child. We now know that female is the default way a child will develop if there is no Y chromosome. So, I'd say we now know mroe details about the biology of male and female, but I wouldn't say that our assessment has "changed," just become more informed.