The Spring 2015 edition of the Journal for Biblical Manhood and Womanhood has just been released. And one of the recurring themes in that journal is transgenderism. Addressing some of the medical implications of transgender surgery, Craig Kline, M.D. and David Schrock have co-written a piece entitled, “What is Gender Reassignment Surgery? A Medical Assessment and Biblical Appraisal.” What follows is the biblical and ethical conclusion to that article.
It may be surprising to discover how much the Bible speaks about surgery on the genitalia. Among the many instances, the most prolific concerns the topic of circumcision. Beginning with the Abrahamic covenant (see Gen 17:10–14, 23–27) and legislated in the covenant with Israel (Lev 12:3), circumcision is found throughout the Bible. Though the theological meaning of circumcision is beyond the scope of this article, it is worth noticing that this covenant was a form of surgery on male genitalia, displaying a distinguishing mark that served as a sign of the covenant made between God and man. Later, in a section of Leviticus where qualifications for priesthood were described (Lev 21:20) and again when Moses prepared Israel to enter the Promised Land (Deut 23:1), the Law excluded from the assembly of the LORD anyone who had “crushed testicles” or “whose male organ is cut off.”
Circumcision continues to play an important role in the New Testament. While the physical act of removing the foreskin is associated with the old covenant and thus discontinued in the church, its typological fulfillment—the circumcised heart (Deut 10:16; 30:6; cf. Ezek 36:26–27)—is common to all new covenant believers (Col 2:11). Moving from old covenant to new, the New Testament records many heated discussions about the discontinuity of physical circumcision (e.g., Acts 15; Romans 2 and 4; Galatians 2). Without engaging all these passages, what, if anything, might Scripture’s discussion of circumcision contribute to the modern discussion about gender reassignment surgery? Let me suggest two things.
First, gender reassignment surgery may, metaphorically speaking, be the “circumcision” of transgenderism’s “gospel.” Just as the true gospel includes a circumcision—of the fleshunder the old covenant, which pointed forward to the true circumcision of the heart under the new covenant—so the false gospel of transgenderism invites its participants to mutilate their genitalia in order to find a kind of “salvation.” Likewise, just as the true gospel has a mediator who inaugurates a covenant with blood (1 Tim 2:5; Heb 9:18), so too transgenderism’s gospel has created a guild of mediators—advocates, entertainers, politicians, and now surgeons—who following the cultural zeitgeist can put to death the old man and raise “her” anew. Moreover, in denying God his rightful place as sovereign over creation, they establish themselves as autonomous lords. By consequence, transgenderism mimicks the true gospel by solving a “fallen condition” that is not revealed by God’s Word, but that comes from an autonomous, personal feeling (i.e., men and women trapped in the wrong body). At the same time, transgenderism prescribes a method of “salvation” by way of bloodshed—a “new creation” through surgical “circumcision.”
Of course, sexual rebellion and the distortion of gender roles is nothing new. Lamech boasts of twisting God’s creation when he sings of claiming two wives (Gen 4:23–24), and the Law of Moses lists cross-dressing as a way humans reject the goodness of God’s creation (Deut 22:5). But now, with advances in medical technology, what used to be feigned through clothes and mannerisms is now surgically possible. There is nothing new under the sun, but what is new is the plethora of medically-acceptable ways to deface God’s creation.
Therefore, with many moral, theological, epochal, and physical differences between old covenant Israel and the modern transsexual, the one similarity worth noting is that both “religions” present salvation through the manipulation of the flesh. By doing something to the genitalia, it is perceived that blessings will follow—in Israel these blessings were the holy promises given to Abraham and his offspring; to the trans community blessing is found in sexual gratification—however that is defined by them. To be clear, there is a radical difference between circumcision under the old covenant and genital mutilation of modern transgenderism—the former was instituted by God (Genesis 17); the latter is the invention of men (cf. Rom 1:32). Likewise, Abraham’s circumcision was an act of faith; gender reassignment surgery is an act of rebellion against God, his created order, and his sovereignty over gender.
Nevertheless, when we understand that circumcision of the flesh was always a sign pointing to the need for an interior purification (Deut 10:16; Jer 4:4; cf. Acts 7:51) and never meant to be salvific in itself, there are also striking similarities. For instance, consider the parallel logic at work in these two systems of salvation. Writing of circumcision’s ultimate futility, Paul encourages the Judaizers to go the whole way and “emasculate themselves” (Gal 5:12). Whereas the Judaizers believed that circumcision brought them closer to God, Paul knew that as an inveterate sinner physical circumcision accomplished nothing. Therefore, he commissioned the Judaizers to go further and emasculate themselves, which under the Law invoked the judgment of God—i.e., separation from his holy presence.
By analogy, Christians believe that despite the sincerest intentions of transsexuals, the surgery they desire to perform on the body needs to be performed on their heart. While these children of Adam long to match their bodies with their inner perception, what they need is not a new body, but a new heart. In this way, the Jews of old and the modern trans community are not without similarities, because both face the same problem: They have exchanged the glory of God for the glory of created things, and therefore God has given them over to a “depraved mind to what ought not to be done” (Rom 1:23, 28).
To reiterate, this comparison between Old Testament ritual and modern surgery is not materially the same, but when we consider how Jews misused circumcision (as means of salvation) and the way transsexuals pursue surgery as functionally salvific, their comparison becomes more apparent. Whereas circumcision was ordained by God and pointed to a circumcision of the heart that God himself would perform at the right time, the “circumcision” of transsexuals is the invention of (technologically advanced) mankind. Inspired by the father of lies, gender reassignment surgery promises abundant life through the manipulation of the flesh.
On this comparison, it reminds us that when we engage family and friends grappling with gender reassignment surgery, we cannot fight flesh with flesh—“Just learn to live with and love your God-given gender.” No, like Paul and Jesus in the New Testament, we must present a better circumcision—one that strips off the old man and gives disciples new life in Christ (Col 2:11–13; 3:1–3) so that learning to live out one’s God-given gender is not harsh and heavy, but a yoke that is light and easy (see Matt 11:28–30). Indeed, by understanding gender reassignment surgery as a kind of rite of circumcision, it helps us understand why someone would desire to cut on their genitalia—it is part of our story and religious hope too. By remembering circumcision’s place in salvation, it gives us an entry point to speak of a greater gospel, a greater circumcision, and ultimately a greater bodily transformation—the redemption of the body promised to all who are alive in Christ (Rom 8:23).
Second, moving from a big picture analysis of circumcision to a particular text, we return to one verse in Galatians. In Galatians 5:12 Paul expresses with rhetorical force how he wishes Judaizers who were stressing the need for circumcision would “mutilate” or “emasculate” themselves. In the context of Galatians this hyperbole emphasizes the worthlessness of physical circumcision, now that Christ has come. Against the backdrop of the Law, such an action would be both humiliating and disqualifying for temple service (see Lev 21:20; Deut 23:1). Applied to the present discussion, such genital mutilation would invite the curse of God, under the old covenant. Just as sacrifices under the old covenant could not be offered with “testicles bruised or crushed or torn or cut” (Lev 22:24), because they did not meet God’s perfect standard, so willful mutilation of the genitals tears at God’s created design. To those who pursue “salvation” by genital surgery, the Law of God offers a warning and threat—“if you break the law, your circumcision becomes uncircumcision” (Rom 2:27). This goes for the Judaizers in Galatia and modern advocates of gender reassignment surgery.
To both of these parties (as well as to those who sinfully take pride in their uncircumcision), the gospel of Jesus Christ makes a new way to find life. It offers forgiveness now and a glorified body in the new heavens and the new earth. Yet, as Russell Moore has observed, gender reassignment surgery, in the here and now, may “mangle” the body and “create an illusion of a biological reality that isn’t there,” but it cannot reassign gender. Therefore, as men and women come to Christ on the other side of their gender reassignment, the solution is not just external reassembly. Reconstructing a person’s bodily appearance may not be possible or (medically) wise, but what can be done and must be done is to point new creations in Christ to the approaching reality of their bodily redemption, and to live in light of that reality. As Paul says in Colossians 3, “If you have been raised with Christ, seek the things that are above, where Christ is. . . . Put to death what is earthly in you, . . . Put on then [like a new garment], as God’s chosen ones, holy and beloved, compassionate hearts, kindness, humility, meekness, and patience” (v. 1, 5, 12).
Until the resurrection of the body, Christians groan like the eunuchs of old. But like eunuchs in Israel who mourned their displacement from the covenant promises, the gospel of Jesus Christ promises family, children, and blessing in the kingdom of God (see Isaiah 54). On this point, Moore has again made the comparison between those who undergo gender reassignment surgeries with those are eunuchs. As with circumcision, eunuchs are mentioned throughout the Bible. In some instances they were males who were castrated, or had other genital surgery, to serve in special roles within their respective kingdoms. Others may have been born as eunuchs. Jesus speaks to both of these conditions when he says, “For there are eunuchs who have been so from birth, and there are eunuchs who have been made eunuchs by men, and there are eunuchs who have made themselves eunuchs for the sake of the kingdom of heaven” (Matt 19:12). Still in everyone of these cases, the main point is that God is big enough to bring blessing to all who repent and believe in the gospel of the kingdom—even those who were deceived into pursuing gender reassignment surgery.
That being said, we must close with this unassailable truth. In the Bible, with all that it speaks about circumcision and the existence of eunuchs, it never supports practices changing a child’s sex at birth towards the opposite sex. It does present circumcision of the heart (Deut 30:6) as the only way of lasting joy and salvation. In its affirmation of this spiritual surgery, the Bible stands against any kind of gender reassignment surgery, as a way of gratifying the flesh. Therefore, in all cases, we conclude that the Bible never supports the desire to change the appearance of the body to mimic the opposite gender. As with those who pursue sexual immorality—heterosexuals or homosexuals—the hope of the gospel is that any person through faith and repentance can be changed through the washing, sanctification, and justification of Jesus Christ, and not through the adoption, assimilation, or acceptance of sinful roles or practices (1 Cor 6:9–11).
Thus, a biblical understanding of sexuality cannot support gender reassignment surgery. This truth must be compassionately affirmed to those who are struggling with gender dysphoria, and who are contemplating such surgical procedures. Where the Bible affirms that we should receive our birth gender as a gift from God and that it should direct the nature of our sexual desires, it never affirms a person’s desire should dictate their gender. In every case, anatomy dictates and directs gender—not the reverse. Scripture commands that our physical bodies are meant to glorify God (1 Cor 6:19), and followers must humbly and willingly submit to God’s providence in giving us the body he wants us to have, in order to glorify him in the gender that comports to our anatomy.
May God honor our efforts to think biblically and critically about the issue of gender reassignment surgery. May he give us gospel-fueled grace to love the trans community in the name of Christ. And may he glorify himself by saving many in Christ who are now pursuing salvation in the flesh.
For an overview and bibliography of the history and significance of circumcision in the Bible and ancient Near Eastern cultures, see John Meade, “Circumcision of the Heart in Leviticus and Deuteronomy: Divine Means for Resolving Curse and Bringing Blessing,” SBJT 18.3 (2014): 59–85.
Against the overly permissive interpretation of Peter C. Craigie (The Book of Deuteronomy [NICOT; Grand Rapids: Zondervan, 1976], 296–97), Eugene Merrill (Deuteronomy [NAC; Nashville: Broadman & Holman, 1994], 307) rightly observes the importance of physical purity in the presence of God: “The emasculation, described here as a ‘wounding by crushing’ (pĕsûa dakkâ) or a ‘cutting off of the male organ’ (kĕrût šapkâ), may, presumably, be genetic, accidental, or intentional; but that is irrelevant because the end result is the same—the male thus deformed could have no access to the assembly of the Lord.”
Credit to Andrew Walker for this observation, as well as pointing out that just as the Law of Moses called for obedience to external laws, so too transgenderism, as a cultural phenomenon, calls those afflicted by its conditions to obey its “laws,” which are enforced through political and legal pressure applied by approved “mediators.” What is the lasting effect? Gender reassignment becomes a type of works salvation that in the end neither saves nor works.
Though unlikely that transsexuals think of their plight in terms of salvation, it is striking to read the words of Susan Stryker (“(De)Subjugated Knowledges: An Introduction to Transgender Studies,” in The Transgender Studies Reader [ed. Susan Stryker and Stephen Whittle; New York: Routledge, 2006], 3), who says that the social “systems of power” associated with transgenderism “operate on actual bodies [i.e., persons], capable of producing pain and pleasure, health and sickness, punishment and reward, life and death” (cited in Kessler, “Transgender/Third Gender/Transsexualism,” 2:425). Without realizing it, she is employing the language of redemption.
As we understand the pagan roots of ancient Near Eastern cross-dressing, it becomes clear the differences between then and now are not a matter of kind but degree. Illustrating that point, Daniel I. Block observes, “this injunction seeks to preserve the order built into creation, specifically the fundamental distinction between male and female. For a person to wear anything associated with the opposite gender confuses one’s sexual identity and blurs established boundaries” (Deuteronomy [NIVAC; Grand Rapids: Zondervan, 2012], 512).
On sex as a way of salvation, see Daniel R. Heimbach, True Sexual Morality: Recovering Biblical Standards for a Culture in Crisis (Wheaton, IL: Crossway, 2014), 55–56.
For an illuminating theological and cultural commentary, see Timothy George, Galatians (NAC; Nashville: Broadman & Holman, 1994), 371–73.
Drawing the parallel closer between the Judaizers’ heresy and the genital mutilation of the pagan priests near Galatia, George writes, “One of the major centers for the worship of Cybele [a mother goddess, whose priests were known to castrate themselves] was at Pessinus, a leading city in North Galatia. It is quite possible that some of Paul’s readers may themselves have been devotees of the Cybeline cult in their pre-Christian days. In any event, they could not have missed the insinuation of Paul’s allusion: the Judaizers who made so much of circumcision were really no better guides to the spiritual life than the pagan priest who castrated themselves in service to an idolatrous religion” (ibid., 372). If Paul could compare the wrong use of the Law with pagan practices, which he clearly did in Galatians 4:8–9, it is equally permissible (hermeneutically-speaking) to make the comparison between the wrongful use of circumcision with the pagan mutilation of the flesh today. On gender reassignment surgery as a pagan practice, see the way Heimbach defines paganism in True Sexual Morality, 52–54.
Russell D. Moore, “Joan or John? Christian Ethics: This Year’s Dilemma,” May 2009, accessed February 17, 2015, http://cdn1.russellmoore.com/2009/06/joan-or-john.pdf.
Emphasis mine. Read all of Colossians 3:1–17 to see the way that death and resurrection with Christ changes the believer.
Moore, “Joan or John?”