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Sunday, December 14, 2014

Gender Incongruence and the LDS Church: Frontier of Understanding (Parts 1-4)

by Russ Peterson:

Note: This is the full installment of this week's multi-part post. Parts 1, 2, 3 & 4 hereherehere and here.

In The Family: A Proclamation to the World, the First Presidency and Quorum of the Twelve have taught that "gender is an essential characteristic of individual premortal, mortal, and eternal identity and purpose." Although we are accustomed to thinking of this doctrine as unique to the LDS tradition, it is in fact among the first truths recorded in scripture:
So God created man in his own image, in the image of God created he him; male and female created he them (Genesis 1:27).
The image of God, which includes male and female, is the image and pattern after which God created Adam and Eve, whereupon which He commanded them to multiply and replenish the earth (Genesis 1:28). Latter-day Saints believe the family is "ordained of God." In other words, we hold the family—consisting of man, woman, and children—to be divinely organized by God for the accomplishment of His work, which is to "bring to pass the immortality and eternal life of man" (Moses 1:39).

The fact that man and woman act together in the creation of life is in accordance with divine design. Latter-day Saints believe that sexual relations within the bonds of matrimony constitute a sacrament of marriage, binding two souls together according to the covenant they have made. This pattern, instituted of God for the happiness of His children, neither originated in nor concludes with the mortal sphere. According to the plan of happiness, the family is the fundamental social unit both in time and eternity.

For the vast majority of His children, the nuclear family—consisting of man, woman and children—is congruent with individual development in terms of biology, identity, and attraction. For example, most individuals that appear to be male have functional male sexual anatomy, experience an internal sense of being male, as well as feelings of attraction toward women. Conversely, most individuals that appear to be female have functional female sexual anatomy, experience an internal sense of being female, as well as feelings of attraction toward men. For the purposes of this article, I will refer to this agreement of biology, identity, and attraction as gender congruence.

Gender congruence is so common to the human experience that it is difficult for many to imagine a state of incongruence between biology, gender, and attraction. Furthermore, gender congruence—the most common outcome of human development—is so innate to personal experience that few individuals outside the social sciences even become aware that biology, gender, and attraction are separate constructs that can and do develop independently of each other.

When we consider the central role of procreation in the Plan of Happiness along with the declaration that "gender is an essential characteristic of individual premortal, mortal, and eternal identity and purpose," it should not surprise us to realize that these teachings undergird a set of cultural beliefs within the Church about those whose experiences are different from the gender congruent majority. These beliefs might be summarized as follows:
  1. Since gender "is an essential characteristic of individual premortal, mortal and eternal identity," matters of gender and sex are always clearly defined in the mortal state.
  2. A loving Father in Heaven wouldn’t create circumstances that give rise to gender uncertainty, gender incongruence, or same-sex attraction.
  3. Uncertainty (or confusion) about sex or gender is a Sign of the Times and/or evidence of the deterioration of society.
  4. Gender incongruence proceeds from an individual’s decision to deviate from the Plan of Happiness.
My purpose is to give members of the Church the understanding necessary to "bear one another's burdens" in terms of gender incongruence, just as we are under covenant to do so with regard to every other problem incidental to the mortal sphere. Although I will not be writing in technical terms, some basic biological concepts bear explanation and discussion; my goal is to do so in a manner accessible to the general membership of the Church.

Biology: "Is It a Boy or a Girl?"

This is the first question parents are asked when they announce they are expecting a baby, and the answer frames a lifetime of expectations. Although a baby's sex is usually obvious from appearance, there are a number of conditions—called disorders of sex development—that can interfere with male or female development according to standard biological templates. Although a detailed review of biological disorders is beyond the scope of this article, I will outline some points that are key to understanding the biological development of sex.

Most are aware that human growth and development is determined by an individual's genetic code, consisting of 46 chromosomes. Most chromosomes come in two similar pairs; however, one pair of chromosomes is different. The sex chromosomes (X and Y) are so called because they determine an individual's sex. Generally, the presence of a Y chromosome causes the development of male sexual anatomy. Absent a Y chromosome, development proceeds according to a female pattern.

As simple as it would seem, chromosomes do not completely determine an individual's sex. During fetal development, genes within chromosomes cause sex hormones to be produced, and it is the sex hormones that cause certain embryonic tissue to develop into male or female sex organs. In general, a Y chromosome causes testosterone (the male sex hormone) to be produced, and it is testosterone that causes the fetus to develop as a male. In the absence of a Y chromosome and the resulting testosterone, development proceeds according to a female pattern.

Each of these major factors that steer the biological development of sex—chromosomes and hormones—is subject to the same kinds of errors incidental to the mortal state. Each time the genetic code is copied errors can be introduced. The endocrine (hormone) system is also subject to problems, a few of which we will consider in due course. Once again, it is not our purpose to undertake a comprehensive review of the literature; however, there are some basic concepts that are important to understand and that provide context for our broader discussion.

Among the most common problems of sex development are the those that feature an extra or missing chromosome. Males have one X and one Y chromosome (XY); females have two X chromosomes (XX). However, extra chromosomes can be present in the egg or the sperm, whereupon an individual can develop with three sex chromosomes (XXX, XYY, or XXY). Of these, an XXY presentation—also called Klinefelter's syndrome—causes the most problems for sexual development. Those affected "are often tall and produce relatively small amounts of testosterone. As a result of this hormone imbalance, affected males have incompletely developed secondary male sex characteristics."1

Sperm or egg cells can also lack a sex chromosome, leading to the development of Turner's syndrome. Individuals with Turner's syndrome have a single X chromosome but no Y or second X chromosome. Those affected "experience abnormal growth patterns, are short in stature, generally lack prominent female secondary sexual characteristics and are sterile."1 Beyond the presence or absence of entire chromosomes, there are a host of conditions that involve errors and mutations of individual genes. These conditions—while relatively rare—are too numerous to list. Time will permit only a brief glimpse at a few of them.

We considered earlier that the development of sex is a function of the interplay between an individual’s genetic code and the hormones produced during development. One genetic error causes a condition known as congenital adrenal hyperplasia. When untreated, genetically female (XX) individuals "develop an outwardly male appearance. This disorder, also called adrenogenital syndrome (AGS), results from a genetically caused deficiency of cortisol, a steroid hormone produced by the adrenal cortex."1

There are still other disorders that arise from an inability of bodily cells to recognize androgens (the male sex hormones). In androgen insensitivity syndrome, individuals that are genetically male (XY) develop breasts and female sex organs due to a genetic mutation wherein cells lack the receptors to recognize and respond to male sex hormones. As per our previous discussion, in these cases, sex development proceeds according to a female pattern, and most of these individuals only discover the problem when they marry and find they are unable to conceive.

Finally, there are a number of "intersex" conditions wherein children are born with sex organs that are neither clearly male or female. Most often these presentations are found to be caused by the same kinds of genetic and/or hormonal problems we have already discussed. Often medical or surgical interventions are sought in an effort to help such individuals lead normal lives as male or female.

Considering that we have listed only a few of the more than 30 known disorders of sex development, it should come as no surprise that the overall incidence (1.7%) is fairly high.2 To put this in perspective, on average these conditions will affect 4-7 individuals in a typical LDS ward. Although we may not share their challenges, these individuals deserve our love, understanding, and support.

Gender and Individual Identity

Consider for a moment the experience of an individual with androgen insensitivity syndrome—one of the disorders of sex development described in the previous section. These individuals that are genetically male (with X and Y chromosomes) nevertheless develop as females, along with outwardly female sexual anatomy. Most do not become aware of their condition until they are medically examined to find the cause of infertility when they are trying to conceive children.

Imagine what it might be like to grow up normally as a female, only to learn during adulthood that you are genetically male, and that your female gender presentation is due to a genetic error. In the context of the current discussion, imagine further what we might say should such an individual express feelings of gender confusion (e.g., that the externally manifested gender did not match the individual's internal experience).3

This illustration helps us separate the concept of biological sex from that of gender identity. Whereas biological sex refers primarily to sexual anatomy and physical characteristics, gender identity refers to an individual's internal experience of gender. Most often gender identity is consistent with biological sex, but sometimes it is not. For reasons not clearly understood, there are cases where the inner sense of gender identity does not match the outward manifestation of biological sex. Interestingly, most often this incongruence cannot be explained by a recognized disorder of sex development spoken of in the previous section.

What we do know is that gender formation and identity are highly influenced by culture. That is, parents typically convey to children expectations about gender in accordance with a child's biological sex; thus children learn to identify with a particular gender based on these experiences and expectations. Furthermore, gender identification happens early in a child's development—well before the age of 8, and this gender identity is most often stable over time. Typically, when an individual announces as an adult that outwardly perceived gender is opposite that of inner experience, that individual is most often acknowledging later in life a gender identity that formed earlier during childhood.

For the gender congruent majority, the separation of biological sex and gender identity is difficult both to imagine and to understand. Few outside the social sciences are able to clearly separate gender identity from biological sex. This is because: 1) gender is so innate to personal experience that most lack a frame of reference for understanding how gender can differ from biological sex; 2) gender incongruence is seldom disclosed; and 3) exposure to these topics is limited outside college courses that specifically address them.

We also know that identification with a particular gender is a developmental process; gender identity is not something an individual consciously chooses. This is true both for gender-congruent and gender-incongruent individuals. For a frame of reference, ask yourself if you can remember choosing to see yourself as male or female. Alternatively, you might ask why an individual would bring upon him or herself shame and ridicule by choosing to identify with a gender that is opposite his or her biological sex. Sometimes gender-incongruent individuals seek surgical intervention for their condition. In doing so, they are generally not trying to change gender; rather, they are seeking to make their external appearance and biology congruent with their internal sense of gender identity.

Sexual Attraction and Development

Thus far we have considered biological sex and gender identity in terms of mortal growth and development. We have discussed some of the genetic and other problems incidental to a fallen world. I would like to introduce the discussion of sexual attraction by recalling an experience I had with a client years ago in private practice.

Jane* sat across from me and related the history of her past relationships. She had been married three times, and each of the men she had married had turned out to be terribly abusive. She was contemplating marriage for the fourth time, and she had started to see signs that this fourth man was also abusive. Rather than risk repeating the same mistake, she sought professional help. Why, she wondered, was she repeatedly attracted to men who turned out to be abusive?

As we sat in session, Jane recalled elements of her childhood. Her own father had been an abusive alcoholic and Jane remembered vowing that she would escape the circumstances that had framed her youth. With each successive relationship, Jane became more deeply depressed as she tried unsuccessfully to escape her past.

As Jane and I traced her relationship history, Jane became aware of patterns she had not previously recognized. The men she had married all shared specific personality traits with her father. Since these traits were familiar to her, Jane felt comfortable in the presence of these men. In time these feelings of comfort helped Jane to feel safe and secure, and it was from this sense of safety and security that feelings of sexual attraction developed. Although Jane recognized consciously that she did not want to participate in abusive relationships, the mechanisms whereby her attractions developed were initially outside her awareness and thus, outside her control.

From a clinical perspective, it has likewise been long understood that the emergence of sexual attraction(s) is a non-deliberative process. In other words, sexual attractions unfold over time outside the sphere of conscious direction or control. For a frame of reference, a reader might try to recall a time when he or she chose to be/become attracted to a certain sex or gender. For most individuals, attractions are not chosen; rather, they unfold over time and are framed by a host of factors, including genetics, biology, hormones, early learning, social expectations, and role modeling, to name a few. Additionally, the development of sexual attractions can also be influenced by one's sexual history, including the experience of sexual abuse or early experimentation.

Many theories have been proposed to explain the development of same-sex attraction. These have included theories focused on family dynamics, genetic factors, hormonal influences during development, etc. Among the various theories, none has been shown to account for more than a nominal amount of variance in the development of same-sex attraction. This suggests that several factors are involved, and that the interplay between the factors is highly complex. As we would expect, the development of sexual attractions is an intensely personal process.

The scientific literature that has emerged has helped us understand some of the biological component(s) of same-sex attraction. Again, this is not meant to be an all-inclusive list:

First, there appear to be some structural differences in the brains of those who identify as gay. In the brain there is a group of structures known as the "sexually dimorphic nuclei." In lay terms, this description denotes structure(s) that are different in men than they are in women. Studies have shown that for gay men, these structures are closer in size to the sexually dimorphic nuclei of women than to those of other men.

This coincides with what we know about how hormones influence the body throughout development. During development, hormones determine whether certain tissues develop according to male or female developmental templates. Testosterone drives male sexual development, not only at puberty but beginning in the womb. We are only recently beginning to understand how a mother's own sex hormones influence this process during embryonic development, but research suggests that this influence can vary greatly from one individual to the next. As with all factors relating to the mortal state, these systems are subject to error, disorder, and disease, which in turn can have profound implications for normal or atypical sexual development.

Finally, we know that certain neural pathways—once established—are not meant to change during an individual's lifetime. Consider, for example, the process by which birds form maternal bonds via the mechanism known as imprinting. Shortly after hatching, ducklings focus on the first moving thing larger than themselves and establish their part of the parent/offspring bond with whatever it is they see. This would typically be the mother duck, but the mechanism of the imprint is such that ducklings can become imprinted on other species, including humans. When this happens, we wouldn't say that the duck's bond is natural, but we can appreciate that it seems natural to the duck.

Our purpose is not to equate humans with ducks. Rather, it is meant to demonstrate the power of early learning and how it can interact with biology. Certain neural pathways, once established, are not meant to change during an individual’s lifetime. Correctly established, there is no need for them to change. However, once established, they can prove highly resistant to change over time. Such appears to be the case with same-sex attraction. By the time an individual becomes aware of his/her sexual attractions, most facets of development have already played out and have been incorporated as part of an individual's identity and personality.

Cultural Beliefs Revisited

Earlier we summarized a set of cultural beliefs within the Church about those whose experiences are different from the gender congruent majority. In light of what we have just considered, let us revisit each of them in turn:

1) Since gender "is an essential characteristic of individual premortal, mortal and eternal identity," matters of gender and sex are always clearly defined in the mortal state.

LDS doctrine asserts that gender is immutable and eternal. This gospel principle suggests an ideal that frequently is not met in mortality. We have considered a few of the many disorders of sex development, along with some of the genetic and hormonal conditions that may seriously complicate matters of sex and gender identity and development. While biological sex, gender, and attraction usually develop according to a pattern that naturally perpetuates life, each is separate. Whether in matters of biological sex, gender identity, or attraction, gender incongruence usually unfolds outside of an individual’s awareness and/or control.

2) A loving Father in Heaven wouldn't create circumstances that give rise to gender uncertainty, gender incongruence, or same-sex attraction.

This is one of the most infatuating and divisive beliefs regarding matters of sex and gender in LDS culture—and certainly one of the most persistent. The belief originates from a misapplication of logic: If the eternal pattern of life and procreation includes perfect agreement between sex, gender, and attraction, how could the children of God—being His creations—experience anything different? Or, in other words, "Why would a loving Father do that to His children?"

The answer is that he wouldn't. And doesn't—any more than He creates war, famine, disease, or natural disasters. Each of these is common to a fallen, mortal state. But the fact that God doesn't create gender incongruence is not to say that many of His children don't experience the same, because they do. Matters of sex, gender, and individual development are not immune from the effects of the Fall.

As a church, we collectively invite nonbelievers to take the proverbial "leap of faith"—to choose to believe in something they have not yet experienced. Many refuse to do so, saying they cannot believe in something without experiencing physical proof. When we say, in effect, that gender incongruence does not exist because we personally haven't experienced it (or because we don't want to believe it exists or because it makes us uncomfortable), are we not essentially making the same mistake? At the very least, we are allowing personal ignorance and biases to interfere with the support and compassion we might otherwise render to our brothers and sisters who struggle with some of the more difficult challenges of mortality.

3) Uncertainty (or confusion) about sex or gender is a Sign of the Times and/or evidence of the deterioration of society.

This has been a common interpretation of the increasing visibility given to matters of gender incongruence, particularly as those outside the gender-congruent majority have been more vocal in asserting their points of view. However, other factors are at play here, and in the interest of our discussion I will observe a few of them.

First, from the scientific community has come the understanding that gender incongruence is neither consciously chosen nor likely to change over time. This understanding has been at odds with the cultural/religious belief (still to be revisited) that gender incongruence proceeds from an individual's decision to deviate from the Plan of Happiness. However, this understanding has prompted a seismic shift in thought about those who struggle with gender incongruence. The effects of that revolution are still being realized.

Second, in our day modern technology increasingly facilitates communication between those with common interests who had previously been unable to connect. This happens not only with regard to gender congruence/incongruence, but also with many other issues, concerns, and interests. Communication networks have provided a voice to many groups who have not previously been accorded an audience in the public square.

Third, when we finally do hear these voices, is it surprising that the gender congruent majority would be uncomfortable with their messages—particularly when they focus on what has been termed "radical self-acceptance"? Or to use the words of one observer: "That's fine if [gay and lesbian individuals] want to live their lives however they want, but do they have to demand that the rest of us accept it and call it normal?"

This question strikes at the heart of the acceptance that gender incongruent individuals seek for themselves. For a frame of reference, recall that several decades ago, left-handed individuals were encouraged (and often forced) to adopt right-handedness because it was viewed as "correct" in the minds of many educators. We might suppose that left-handed individuals disliked this coercion and welcomed the day when they could choose to exercise their preferences without it.

From that frame of reference, we might understand the greater aversion that gender-incongruent individuals have to the messages that they are defective and that they therefore must live their lives according to someone else's determination of what is right for them. For many of these individuals, the process of "coming out" involves an acceptance of self that is likewise a final and deliberate rejection of self-hatred and self-loathing. We might not agree with the message, but from this example hopefully we can understand its context, and how it doesn't stem from a person's desire to be "wicked."

4) Gender incongruence proceeds from an individual's decision to deviate from the Plan of Happiness.

As understanding replaces ignorance, this belief persists primarily among those who cling to tradition over truth, and who prefer to render judgment instead of compassion. Can we pass judgment on that which we haven't experienced? Or can we continue to deny the reality of gender incongruence because we haven't personally experienced it? Does personal discomfort prevent us from rendering Christlike compassion?

Not always but often, discomfort with a particular issue can be an indication of inner conflict. Being at peace with our own individual sexuality can help us think clearly and render support without judgment to those whose struggles might be very different from our own.

Individual Accommodation

In The Family: A Proclamation to the World, we read that "Disability, death, or other circumstances may necessitate individual adaptation." We have considered some of the many different circumstances that call for "individual adaptation." Because of its relevance to our discussion, I will share an example of this adaptation as it applied to one LDS family. Names and personally identifying details have been changed.

From all appearances, Jeff and Sarah* were an ideal couple with an adopted son when the missionaries found them and started to teach them. They were receptive to the message of the restoration and eventually accepted the invitation to be baptized. During the baptismal interview, however, Jeff and Sarah disclosed something very unusual: Jeff had been born female and had undergone surgery for gender reassignment. Jeff and Sarah were both genetically female.

The Brethren were consulted. Jeff's gender reassignment had been contemplated and completed before the couple learned that this practice was contrary to the teachings of the Church. Yet here was a couple that was living as a family and had a child. They desired baptism.

After some deliberation, it was decided that the couple could be baptized but that Jeff—having been born female—could not hold the priesthood, nor could the couple be sealed in the temple. Their family situation, the couple was told, would be worked out in the hereafter. The son grew up wondering at times why his father couldn't hold the priesthood but otherwise the family participated in their ward community.

When Jeff and Sarah's son turned 18, they disclosed to him the particulars of their family situation, including why Jeff couldn't hold the priesthood and why the family couldn't be sealed together. As we might imagine, this was very difficult for the son to accept, and he sought professional assistance.

This is but one example of individual adaptation. While the particular circumstances might have been unique, Jeff and Sarah's situation demonstrates the kind of adaptation that can be made when the situation so requires. Clearly the Brethren have recognized 1) that certain family situations are beyond doctrinal reconciliation here in mortality, and 2) as a result, the best/default answer has to be an acknowledgment that these issues will be worked out in the hereafter.

Moving Forward

Though they are important to consider, it is unrealistic to think that exceptions will ever dictate policy standards, especially within the Church. The Church is given to be a light to the world, and the focus on eternal family relationships is not ancillary to its message. Rather, the family unit is the strength of the Church. Such is our doctrine. How, then, do we reconcile the hope of the eternal family with the challenges of gender incongruence that so frequently beset our friends and loved ones here in mortality?

To answer that question I would like to invoke the metaphor of gathering that is central to our history and heritage. We gather with our families; we gather to our wards and stakes to receive instruction and fellowship. And early in the history of the Church the Saints were called to gather and build Zion in the American West.

Though all were called to gather, it was known at the outset that for various reasons some would be unable to reach Zion. Some started the journey infirm with old age or physical health problems. Others became ill from the various diseases that plagued the early Saints because of the impoverished conditions through which they waded on their journey West.

But the call nevertheless was to gather and, as for most pilgrims, the call of the journey was more important than the geographical destination. The call to gather gave the Saints a homeland, an ideal toward which to strive. And there, as the pioneer hymn poignantly declared, the Saints would be blessed.

The modern call to Latter-day Saints is to gather into the safety of the family unit, which is organized in the temple when man and woman are sealed together as husband and wife. Thus organized, the family is the foundation of a Zion society and the strength of the Church.

Those who struggle with gender incongruence are often unable—through no fault of their own—to establish families according to the pattern outlined by prophets and leaders of the Church. In many cases they desire to continue with the Church but they experience significant personal isolation if they do.

There is much we can borrow from our heritage as we contemplate this challenge. Even though many were infirm as they started the journey West, no one was forgotten. It was incumbent upon every Latter-day Saint to care even for those who might not make it, to gather and nurture them according to the covenant they had made to "bear one another's burdens." The old pioneer hymn directly addressed those who would not see Zion but would die in the attempt: "And should we die before our journey's through, Happy day! All is well!" This refrain no doubt gave many a pioneer courage to continue the journey in the midst of suffering and affliction.

What is the modern day corollary? We can learn to say to our brothers and sisters who wrestle with gender incongruence—both in word and in deed—"Even if you aren't able to create a Zion family in this life, and even if you cannot now enjoy the blessings of the temple, we love you and we want you to journey with us. We will not judge or forsake you because of the challenges you face. We will not leave you alone to wander in the wilderness!"

What are the barriers to adopting this attitude and approach? Principally there are two: 1) the residual belief that gender incongruence is the struggler's fault, and 2) the idea that gender incongruence is contagious. Since we have already addressed the first belief we will briefly consider the second.

Because of rhetoric that was popular in the 1960's and 1970's, there is still a vestige of belief that gender incongruence is contagious—that is, that exposure to gender incongruence will somehow cause children or others to wrestle with it in some form themselves. This is borne not of understanding but of fear and uncertainty. Moreover, it has been rejected by the scientific community and also by the Church; however, in our daily practice we avoid those with gender incongruence and fail to actively welcome them in the Church. Often the reasons echo the exclusionary attitudes Jesus encountered and lectured against in His ministry.

We need not worry that exposure to gender incongruence in its various forms will cause these same challenges for our children. We can live and teach our children the doctrine of the eternal family while welcoming and loving those who struggle, and while teaching our children to withhold judgment for those whose situations differ from our own. These two ideas are not incompatible for Latter-day Saints.

The example and teachings of Jesus are instructive here. When the woman taken in adultery was brought to the Savior, He refused to condemn her. If the Savior—who alone had the right and the capacity to render perfect judgment—nevertheless refused to condemn this woman, ought not we follow His example as members of His Church?

Jesus likewise taught the Nephites after His resurrection. Speaking of those who were not among the Church, the Savior instructed:
And behold, ye shall meet together oft; and ye shall not forbid any man from coming unto you when ye shall meet together, but suffer them that they may come unto you and forbid them not.

But ye shall pray for them, and shall not cast them out; and if it so be that they come unto you oft ye shall pray for them unto the Father, in my name.


And ye see that I have commanded that none of you should go away, but rather have commanded that ye should come unto me…” (3 Nephi 18:22-23, 25).
Although the Savior is clear that all are welcome in our worship services, it is also clear that one can be "cast out" without being physically removed from a congregation. It is far more common for individuals to feel "cast out" of our congregations by the aspersions and judgments of others. Can we say collectively that we are true disciples of Christ as long as this is the case?

As we work to abandon the notion that gender incongruence is the struggler's fault or that it proceeds from a decision to deviate from the Plan of Happiness, we realize there are a number of other doctrines that apply to this challenge, just as they do to every other:
Bear One Another's Burdens. This foundational covenant forms the very basis of a Christian community. At the time of baptism, we pledge to "bear one another's burdens, that they may be light… to mourn with those that mourn… and to comfort those that stand in need of comfort" (Mosiah 18:8-9). But if we can somehow dismiss as wicked those who struggle with gender incongruence, saying they have brought upon themselves their afflictions, we feel justified in withholding the support that would otherwise be our Christian obligation.

I Give Unto Men Weakness That They May be Humble. The scriptures clearly teach that certain challenges are given to us by the Savior "that [we] may be humble," and to prompt us to seek His healing influence throughout our lives. Why, then, must we sometimes suppose in the Church that some challenges (such as same-sex attraction) could neither be given by the Savior nor (possibly) present from birth? As we earlier discussed, we understand that God is not the creator of weakness and imperfection; these come to us through the instrumentality of the mortal state. We are given no scriptural assurance that a particular challenge will not be ours in mortality; rather, we are promised that if we come unto Him, the grace of Christ is "sufficient… [to] make weak things become strong unto [us]" (Ether 12:27). There is no challenge that is not subject to the healing influence of the Savior.

The Spirit of Contention is Not of Me. Among Church members, few topics seem more likely to ignite contention than gender incongruence. This contention is most often between 1) those who struggle with gender incongruence and tire of being ostracized and judged as "wicked" for a struggle they did not choose, and 2) those who cannot or will not view gender incongruence as anything but sin. We can disengage from battle and acknowledge that some struggles may indeed be with us from birth. Since we clearly teach and understand that no trait or tendency can deprive one of individual agency, there is no reason for contending with someone who feels that any particular challenge may have been present from birth.

Study It Out. The first page of the Church publication "God Loveth His Children" declares that "Many questions… including some related to same-gender attractions, must await a future answer, even in the next life." This may indeed be true; however, this stance is often invoked in an attempt to absolve us of responsibility to diligently seek the answers we need. "Behold," the Lord says in the 9th section of the Doctrine and Covenants, "you have not understood; you have supposed that I would give it unto you, when you took no thought save it was to ask me. But, behold, I say unto you, that you must study it out in your mind; then you must ask me if it be right" (D&C 9:7-8). Although this counsel was given regarding the process of translation, it has been generalized many times by the Brethren as counsel to the lazy: In essence, we cannot expect the Lord to give us answers when we have not diligently studied the issues. We are further counseled to "work out [our] own salvation with fear and trembling before [the Lord]" (Mormon 9:27). Do we honestly think that matters of gender incongruence fall outside the realm of that counsel, or that the Lord will withhold answers to those who diligently seek them? Indeed He may withhold the answers, but until we have done our part in studying these issues, could it be disingenuous to declare that "many questions…must await a future answer, even in the next life"? Or could it be that we feel that we already have the answer, in the form of counsel that is often given to those who struggle: "Just be obedient."

It Is Not Meet that I Should Command In All Things. The Lord continues His counsel in the 58th section of the Doctrine and Covenants: "for he that is compelled in all things, the same is a slothful and not a wise servant; wherefore he receiveth no reward." In some geographical areas, Church leaders have established support for those who struggle with gender incongruence. In other areas, this support has neither been established nor is it likely to be forthcoming.
     As I have visited with local Church leaders in some of these areas, the reasons given for this lack of support could be summarized by the words of one leader. Speaking to me personally, he said, "You know why the Church can't offer this support." He then proceeded to tell me of two men who met at such a support group and became a couple. I have heard this story more than once.
     It is true that support groups can be used for purposes other than those for which the support is offered. But in the Church we don’t withhold support for 12-step addiction programs for fear that participants might meet and abuse substances together. Indeed, we could extrapolate this leader's position to the point of absurdity and conclude that there is no point in meeting together as members of the Church because we are all imperfect and might sin together.
     Instead, the Lord has commanded us to meet together because He knows that—in general—we will find that which we honestly seek. Until genuine support can be offered in the quorums and auxiliaries of the Church, there is a place for support groups. Such meetings should focus not on "curing" those with gender incongruence but on offering support and encouragement to meet the challenges of the day.

God Will Hold Us Responsible. In an oft-quoted instruction, Elder John Taylor said, "If you do not magnify your callings, God will hold you responsible for those whom you might have saved had you done your duty."
     In preceding decades, thousands in the Church with same-sex attraction or other forms of gender incongruence followed counsel from Church leaders to marry. Often these individuals were advised that marriage would resolve their challenges. Years later these members have sought support from local Church leaders often to find such support unavailable because of personal prejudice or discomfort.
     Personal prejudice and discomfort are never valid reasons for failure to act. Even if those with gender incongruence are unrighteously judged as undeserving of help, the children of such marriages cannot be. They suffer when their families disintegrate, and their burdens are not infrequently compounded by the suicidal inclinations of their parents, who despair when their burdens are neither lightened nor understood.
     Recall Captain Moroni’s lament that "thousands have fallen… while it might have otherwise been if ye had rendered… sufficient strength and succor for them" (Alma 60:5). Could his words apply anew to those who struggle with gender incongruence? President Boyd K. Packer has taught that the priesthood holds "consummate power" to heal every affliction. But if those who hold its keys fail to act according to the repeated requests of those who struggle, of what use are they?

With the recent revolution in thinking about gender incongruence, the world will be increasingly unable to discern our Christianity if it continues to witness the perceived rejection of those who struggle. Thus the Church stands at a cultural crossroads: If it changes its policies toward same-sex marriage or other gender-incongruent situations, the Church risks diluting its focus on the eternal family as it is currently defined. However, if the Church is not perceived as welcoming of gender-incongruent individuals, it will increasingly fail to be seen as a light to the world.

Observing the ever-changing attitudes and values of society—and hopeful for the Second Coming of the Savior—some members of the Church have adopted a defeatist attitude toward the world and the issues set forth herein. Some expect that the Lord will come and save the Saints from having to wrestle with gender incongruence and related challenges.

Church members study the signs of the times and prepare for the return of the Messiah, but ultimately the Lord will come when He chooses. Until then, He has set forth his expectation that, as Saints, we are to study the issues and work out our own salvation. With a perfect knowledge of human development and sexuality, the Lord is neither limited in His capacity to understand nor inclined to judge according to the contracted notions of men. Rather, He loves all of His children and seeks to save each of them. We are not fit for His kingdom until our attitudes fully reflect His. There is much room for growth among Latter-day Saints in the care, love, and welcoming of those with gender incongruence.

When we consider the doctrine that "It is not good that … man should be alone" along with the understanding that gender incongruence (including same-sex attraction) is not purposely chosen, it is clear that for most in the world, the issue of same-sex marriage is viewed not through the lens of righteousness versus wickedness, but rather from the perspective that mutual commitment is worth honoring. Imagine for a moment that the men of the Church were given a commandment to remain single throughout mortality. Would we offer support to them, or would we leave them to carry this burden alone? In either case, what kind of success might we expect? Certainly there is more room for compassion and understanding regarding this issue than is common in our discourse.

Regarding the cultural crossroads at which the Church now stands, we may remember that the Church faced a similar juncture regarding polygamy. When the Church faced a threat to its mission and its very existence over plural marriage, the prophet changed the policy—but not the doctrine—of marriage. The Manifesto clearly outlines the thought process behind the change. Members of the Church were asked to consider whether the entire work of the Church should cease because of the persecution that surrounded the issue of plural marriage. The answer was that the Church would observe the law of the land in order to realize its mission. Are echoes of the past applicable today?

Finally, we return to The Family: A Proclamation to the World, which teaches that "Disability, death, or other circumstances may necessitate individual adaptation." Earlier we considered one circumstance that called for individual adaptation. Are there others? Is there space for us to acknowledge that certain individual and family situations are beyond doctrinal reconciliation here in mortality? Can we grow such that as Church members we support our brothers and sisters with gender incongruence, offering encouragement and love while withholding judgment? Can we do less and still call ourselves Latter-day Saints?

Approaching Zion

As we journey toward Zion, we cannot suppose that God is pleased when our actions or attitudes leave any of His children to wander in the wilderness. As individuals find their place among the Saints they are imbued with a sense of identity and taught of their infinite worth as children of God; they are commanded to be a light to the world and are reminded continually of their heritage.

When gender-incongruent individuals are not welcomed in the Church, it should not surprise us to see them turn elsewhere for identity and support. Those who have adopted trait-based identities are quick to welcome those who long for acceptance, and each time they do we lose another Latter-day Saint.

As a people, we need to understand Church culture and its impact on those with gender incongruence. Beginning with our youth programs, Church culture often favors those who participate in organized sports and who otherwise reinforce our ideas about gender and gender roles. In his essay "Basketball Doctrines," Orson Scott Card writes about this and how our Young Men's programs need to be tailored to meet the needs of all of our youth, rather than just those who enjoy organized sports. Because of its relevance to our larger discussion, I will include two excerpts from his essay. After outlining the problem, Card writes the following under the heading "What Can We Do, Officially?"
"What difference can this essay possibly make? The Brethren aren't going to change … policy because of this essay … Church leaders who love basketball and believe in the old team spirit are simply baffled when they hear people like me talk with such hostility about a game they love so much.
     In fact, their most compassionate answer usually is to try to find ways to force LDS teams to let even the incompetent players have some playing time. When such rules are enforced, of course, they only cause bitterness and resentment of the poor incompetent player, whose blunders cost their team the victory. Incompetent players are only valued when they bring the total number on the floor to five, so the game won't be forfeited. Thus, what is meant as a gesture of 'inclusion' is really just a way of making it even more painful for marginal players.
     And such measures do nothing at all for the boys who simply don't like the game or think of it as a waste of time—which, for them, it is. These young men get a clear message from their local leaders: We don't understand you, and not only that, we don't care enough to try. In some cases, the message is even harsher: We don't like you. And the harshest of all: We wonder if someone who doesn't like sports is really a man."4
Using basketball as an example, Card offers an important insight about Church culture: It mirrors Western culture in assigning value to those who fit well within stereotyped gender roles. But the messages are very different for others whose interests and abilities diverge from those of the masculine "ideal." As he concludes his essay, Card writes:
"Right now the message to young men, from the age of 12 on, is pretty clear. If you're one personality type—the athletic extrovert—you belong! Right on! You're the man! Cool, dude! If you're the opposite personality type—the bookish or artistic introvert—there's another message entirely: Get with the program! Learn to be part of the team! Come out of your shell! This will be so good for you. You're missing out on so much fun and fellowship!"4
Card's point ultimately is not about basketball. Rather it is about how Church culture calculates and conveys an individual's worth according to worldly roles and expectations. Such practices will never reveal the infinite worth of the soul, nor can they lead us to salvation, either individually or as a people. God expects more. He loves His children without measure and "esteemeth all flesh in one" (1 Nephi 17:35). We cannot be saved in His kingdom until we are clothed with charity, which is the perfect and pure love of Christ. And until that charity is manifest by truly loving and welcoming those who are different, the world will increasingly call into question the message and essence of our Christianity.

What is that message? As Latter-day Saints, we teach that The Church of Jesus Christ of Latter-day Saints is the only church authorized to officiate in the ordinances of salvation. As such we refer to the Church as "the only true and living church on the face of the whole earth." We paraphrase this doctrine by saying simply "the Church is true."

We are so accustomed to this phrase that we sometimes forget that "true" also means loyal and faithful. No amount of doctrinal correctness can compensate for failure to be "true" to those who struggle with gender incongruence. This is not an academic matter. In the past, thousands of our gender incongruent brothers and sisters followed well-meaning counsel to marry in order to resolve these challenges. When they have learned that marriage does not resolve gender incongruence, they often face despair that can in turn result in suicide. This is especially true when support is not forthcoming from members and local Church leaders.

Now is the time to honestly reevaluate—both individually and as a Church—our actions and attitudes toward those who struggle with gender incongruence. As we do so, may we bear in mind the following principles:
  1. Although gender "is an essential characteristic of individual premortal, mortal and eternal identity," matters of sex, gender, and attraction are not immune from the effects of the Fall, nor are they always clearly defined in the mortal state.
  2. Gender incongruence generally unfolds outside of individual awareness; it does not proceed from an individual's decision to deviate from the Plan of Happiness.
  3. Gender incongruence is not contagious.
  4. Traditional judgments about gender incongruence—including some perpetuated in Church culture—present an inaccurate picture of a complex challenge faced by thousands of Latter-day Saints.
  5. When those who struggle with gender incongruence feel unwelcome among the Saints, they are apt to turn elsewhere to find a sense of identity and community.
  6. As Latter-day Saints, our Christianity will be incomplete until we truly love and welcome those who are different—including those with gender incongruence.
In the grand design for the exaltation of our Father's children, identity comes before potential. Before we can comprehend our eternal potential, we must first understand that God loves us perfectly as His children, imperfect and incomplete though we may be. Furthermore, although God wants us to become like Him, His desires for our eternal destiny do not prevent Him from loving us exactly as we are at each moment in time.

As members of the Church, we must learn to do the same. As we do so we will find and save many of our brothers and sisters who wrestle with gender incongruence and who have long wandered in the wilderness of judgment, prejudice, and misconception. We must love and welcome them home as children of God, for only then will we have claim on that charity which will prepare us to enter His presence.

* Name(s) has/have been changed.
1World Health Organization, “Gender and Genetics,” (accessed September 15, 2013).
2Anubhav Mittal, “Disorders of Sexual Development,” (accessed September 27, 2013).
3The author is not suggesting that individuals who experience androgen insensitivity syndrome and develop as female wish to change gender when they learn of their condition; nor is he suggesting that gender identity mismatch is caused by or associated with any disorder of sex development (including androgen insensitivity syndrome). Rather, the example serves to illustrate the difference between gender and biological sex, and to help the reader think broadly about these concepts as they apply to others in this article.
4 Orson Scott Card, "Basketball Doctrines," (accessed November 10, 2013).

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Russ Peterson grew up in Idaho Falls, Idaho and is an avid outdoorsman with interests ranging from astronomy to wilderness survival. When not camping or backpacking, Russ is a mental health counselor with interests in gender and suicide prevention. He lives in the Intermountain area and enjoys spending time with his five children. Reach him at rhpeterson <at> gmail dot com.
 photo Line-625_zpse3e49f32.gifImage credit: see Parts 1-4 for credit (used with permission).

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