Suicide rates among the transgender community are more than 25 times the rate of the general population. Statistics from a 2010 survey of more than 7,000 transgender individuals conducted by the National Center for Transgender Equality and the National Gay and Lesbian Task Force reveal that “A staggering 41% of respondents reported attempting suicide compared to 1.6% of the general population …” (emphasis removed).[1] Also revealed in the study is that “Over a quarter of the respondents misused drugs or alcohol specifically to cope with the discrimination they faced due to their gender identity or expression;” and:

Respondents reported over four times the national average of HIV infection, 2.64% in our sample compared to .6% in the general population, with rates for transgender women at 3.76%, and with those who are unemployed (4.67%) or who have engaged in sex work (15.32%) even higher; (emphasis removed).[2]

Suicide rates among the transgender community are more than 25 times the rate of the general population.

The popular consensus is that these statistics are driven by increased mental stress resulting from the social and economic burdens of being visually non-conforming. As such, it is generally believed that the best solution for transgender individuals who have chosen to whole-heartedly embrace their gender identity is to undergo hormonal therapy and, often, sex-reassignment surgery. However popular this consensus may be, it is not firmly established in reliable scientific data. The Guardian reports:

There is no conclusive evidence that sex change operations improve the lives of transsexuals, with many people remaining severely distressed and even suicidal after the operation, according to a medical review conducted exclusively for Guardian Weekend tomorrow.

The review of more than 100 international medical studies of post-operative transsexuals by the University of Birmingham’s aggressive research intelligence facility (Arif) found no robust scientific evidence that gender reassignment surgery is clinically effective.[3]

 

Follow-up studies indicate that while sex-reassignment patients are overwhelmingly satisfied with the cosmetic effects of the surgery, the surgery results in little change to their mental health and living conditions. In a Wall Street Journal article titled “Transgender Surgery Isn’t the Solution,” Dr. Paul McHugh, a psychiatrist at Johns Hopkins Hospital recalls:

We at Johns Hopkins University—which in the 1960s was the first American medical center to venture into “sex-reassignment surgery”—launched a study in the 1970s comparing the outcomes of transgendered people who had the surgery with the outcomes of those who did not. Most of the surgically treated patients described themselves as “satisfied” by the results, but their subsequent psycho-social adjustments were no better than those who didn’t have the surgery. And so at Hopkins we stopped doing sex-reassignment surgery, since producing a “satisfied” but still troubled patient seemed an inadequate reason for surgically amputating normal organs.[4]

In a First Things article titled “Surgical Sex,” Dr. McHugh expounds:

They had much the same problems with relationships, work, and emotions as before. The hope that they would emerge now from their emotional difficulties to flourish psychologically had not been fulfilled.

We saw the results as demonstrating that just as these men enjoyed cross-dressing as women before the operation so they enjoyed cross-living after it. But they were no better in their psychological integration or any easier to live with. With these facts in hand I concluded that Hopkins was fundamentally cooperating with a mental illness. We psychiatrists, I thought, would do better to concentrate on trying to fix their minds and not their genitalia.[5]

Dr. McHugh’s findings are further corroborated by a Swedish long-term study of 324 sex-reassignment patients which concludes:

Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.[6]

Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population.

The Guardian reports:

Arif [Aggressive Research Intelligence Facility], which advises the NHS in the West Midlands about the evidence base of healthcare treatments, found that most of the medical research on gender reassignment was poorly designed, which skewed the results to suggest that sex change operations are beneficial. … For example, in a five-year study of 727 post-operative transsexuals published last year, 495 people dropped out for unknown reasons. Dr Hyde said the high drop out rate could reflect high levels of dissatisfaction or even suicide among post-operative transsexuals.[7]

Given the available data, the director of the University of Birmingham’s Aggressive Research Intelligence Facility Dr. Chris Hyde, has concluded:

There is a huge uncertainty over whether changing someone’s sex is a good or a bad thing. While no doubt great care is taken to ensure that appropriate patients undergo gender reassignment, there’s still a large number of people who have the surgery but remain traumatised [sic] – often to the point of committing suicide. … The bottom line is that although it’s clear that some people do well with gender reassignment surgery, the available research does little to reassure about how many patients do badly and, if so, how badly.[8]

 

Perhaps greater heed should have been paid to Dr. Ihlenfeld’s caution in 1979 that 80% of patients who want to change their sex shouldn’t do it.[9] Warning that the transgender patient is “the only patient who diagnoses himself and prescribes his own treatment”, Dr. Ihlenfeld comments, “There is too much unhappiness among people who have had the surgery. Too many of them end as suicides.”[10] Furthermore, research from the U.S. and Holland reveals that as many as 20% of patients may regret changing their sex.[11]

The transgender patient is the only patient who diagnoses himself and prescribes his own treatment.

Some experience regret before enduring surgery, such as Brad/Ria Cooper who made headlines as Britain’s youngest sex change patient. After suffering “huge mental anguish” as a trans woman and massive hormone-induced mood swings, Ria Cooper decided to de-transition, choosing to return to her male identity as Brad Cooper.[12] Others, such as Walt Heyer, suffer sex change regret after experiencing reconstructive surgery. Walt Heyer was 42 years old, married, and a father of 2 when he chose to undergo sex-reassignment surgery and become Laura Jensen. Eight years later, he realized that his desire to change sexes was based upon deep-rooted childhood trauma rather than a genetic disorder. With no safe reversal procedures at the time, Walt Heyer chose to once again live as a man, despite having some permanent feminine physical features.[13] Today, Walt Heyer manages the website Sex Change Regret and is the author of several books, including Paper Genders.

 

In a Federalist article titled “Transgender Characters May Win Emmys, but Transgender People Hurt Themselves,” Walt Heyer testifies that the process of disconnecting from one’s former identity while building a new identity is a “marvelous distraction for a while, but it isn’t a permanent solution when the underlying issues remain unaddressed.”[14] Eventually, reality catches up, and the individual is often left with broken relationships, a mutilated body, and the same mental stress as they suffered before changing their sex. Walt Heyer writes, “Gender change is at its heart a self-destructive act. Transgenders not only annihilate their birth identity, they destroy everyone and everything in their wake: family, wife, children, brothers or sisters, and career.”[15] Unfortunately, there often remains no hope at this point. No longer can the individual convince themselves that being true to their “real” self or that changing their wardrobe, voice, or body will allow their problems to go away. Having sacrificed and done “everything,” the sorrow and self-hatred ultimately remains.

Gender change is at its heart a self-destructive act.

Someone who has reached this place is often at their breaking point, desperate for a solution. Unfortunately, far too many transgender individuals find that solution in suicide. However, their story need not end in tragedy if we as Christians would extend to them the hope of the gospel. Rather than affirm their lifestyle choices in an effort to prevent them from feeling sorrow, anger, and regret, we as Christians should continually hold out the gospel in love. Until someone is disillusioned about their choices, they are unable to make a change. This requires that we share the truth, even when it hurts. Walt Heyer is an example of someone who reached rock bottom and found Jesus. He shares:

Perhaps life’s wisdom is only found by looking back over one’s shoulder at the clear view of the carnage that results from the madness of self-destruction. Regret, once acknowledged, opened my eyes to see what I had thought was reality. “I should be a woman” was only an illusion. The moment the word “regret” tumbled from my lips, I was open to truth and wisdom. I started to consider the possibility of leaving my surgically-altered life as a transgender woman and resume living as the male gender given me at birth.[16]

Walt finds strength to live according to his biological gender through his personal relationship with God, declaring, “My victory has come by allowing the Lord in my heart, [and] becoming God-focused instead of self-centered …”[17]

 

In the Bible, the Apostle Paul was no stranger to regret. Having been personally enslaved by sins that haunted him throughout his life, the Apostle Paul was intimately familiar with the guilt and despair that can come from one’s past. Yet he was also intimately familiar with the forgiveness and hope that can come from Jesus Christ, and he devoted his life to sharing this truth with others. It is precisely because the Apostle Paul had himself sinned beyond measure that he spoke so boldly about the sins of others—not to condemn them, but to point the way to forgiveness. In 1 Timothy 3:12–17, the Apostle Paul writes:

I thank him who has given me strength, Christ Jesus our Lord, because he judged me faithful, appointing me to his service, though formerly I was a blasphemer, persecutor, and insolent opponent. But I received mercy because I had acted ignorantly in unbelief, and the grace of our Lord overflowed for me with the faith and love that are in Christ Jesus. The saying is trustworthy and deserving of full acceptance, that Christ Jesus came into the world to save sinners, of whom I am the foremost. But I received mercy for this reason, that in me, as the foremost, Jesus Christ might display his perfect patience as an example to those who were to believe in him for eternal life. To the King of the ages, immortal, invisible, the only God, be honor and glory forever and ever. Amen.

Until someone is disillusioned about their choices, they are unable to make a change.

The Bible is filled with examples of God not only forgiving people, but of God transforming lives. The Apostle Paul is quite possibly the best example of this. God took Paul—a blasphemer and one of the most ardent persecutors of the Christian Church—and transformed him into one of history’s greatest Christian missionaries who could instruct the church at Corinth in 1 Corinthians 11:1, “Be imitators of me, as I am of Christ.” Moreover, God used the Apostle Paul to pen 13 books of the Bible. Similarly, God took Jacob—a liar and a cheat who deceived his father into giving him his brother’s birthright—and transformed him into a man of faith who fathered the twelve tribes of Israel. Throughout Scripture, God refers to Himself as the God of Abraham, Isaac, and Jacob. Another example is David who not only committed adultery, but engineered the death of the woman’s husband in order to hide his sin, and yet God promised David that his lineage would reign eternally in the Millennial Kingdom, and that Jesus the Messiah would come from his line. We could continue and look at Moses—a murder whom God used to free His people from slavery and to lead them to the Promised Land; Gideon—a coward whom God used to defeat an oppressive army as numerous as the sand on the sea shore; Peter, a man who denied Jesus, and yet Jesus gave him the keys to the Kingdom; or any number of other examples in Scripture.

 

God is in the business of transforming lives. The Church is filled with ex-sinners. There are ex-liars, ex-cheats, ex-addicts, ex-adulterers, ex-gays, ex-transsexuals, ex-you-fill-in-the-blank. Given that man is naturally bent toward doing evil, it is probably true that none of these would have overcome their temptation in their own strength. It is only through the transformative power of the Holy Spirit that anyone is capable of overcoming their greatest temptations. It is only when a person relinquishes his sinful identity and turns to Jesus Christ in humble repentance that the power of sin is truly broken in an individual’s life. No longer must they be identified by their sin. Instead, they are identified as a child of God. This is the good news of Jesus Christ! Galatians 4:4–7 says:

But when the fullness of time had come, God sent forth his Son, born of woman, born under the law, to redeem those who were under the law, so that we might receive adoption as sons. And because you are sons, God has sent the Spirit of his Son into our hearts, crying, “Abba!  Father!” So you are no longer a slave, but a son, and if a son, then an heir through God.

The Bible is filled with examples of God not only forgiving people, but of God transforming lives.

Regardless of our sin, regardless of how much damage we have caused to ourselves or to those around us, God offers every one of us forgiveness. Romans 10:9–10 teaches, “[I]f you confess with your mouth that Jesus is Lord and believe in your heart that God raised him from the dead, you will be saved. For with the heart one believes and is justified, and with the mouth one confesses and is saved.” However, Romans chapter 10 does not conclude with verse 10. It goes on to say:

For the Scripture says, “Everyone who believes in him will not be put to shame.” … For “everyone who calls on the name of the Lord will be saved.” How then will they call on him in whom they have not believed? And how are they to believe in him of whom they have never heard? And how are they to hear without someone preaching? And how are they to preach unless they are sent? As it is written, “How beautiful are the feet of those who preach the good news!”

As Christians, we have been commissioned to take this message of hope and salvation to those who need it. And who is in greater need than the individual who struggles with self-hatred and desperation?

 

Recent news, media, and legislative events have made it evident that there is an entire community of people who know that something isn’t right and are desperately seeking a solution. Unfortunately, they are focused upon transforming their bodies when they should be focused on transforming their spirits. However, the natural guide in this process is conspicuously absent. “Transgender” may have been the word of the year in 2015, but it does not seem to have entered the Church’s vocabulary.[18] The silence of the Church on the matter of gender dysphoria is deafening. How can transgender individuals receive the transformative power of Jesus Christ if the Christian refuses to share with them the truth of God’s Word?

There is an entire community of people who know that something isn’t right and are desperately seeking a solution.

Presently, there are precious few books available that specifically address the subject of transgenderism from a Biblical perspective. Moreover, the vast majority of these books claim that the Bible supports transgenderism. Similarly, it is difficult to find sermons on the matter. Where then is someone who is struggling with sexual confusion supposed to turn for answers? The Church is silent, and the only alternatives to the Church are mostly eager to affirm and encourage transgender feelings.

If we alienate the transgender community in our effort to stand upon the truth of God’s Word, then we forfeit our opportunity to share the gospel when they become disillusioned.

So, what are we to do as Christians? The subject of transgenderism is complicated and controversial. There simply is not enough data to speak with authority on the science of the matter. Neither is there enough data to speak with authority on the social implications of transgenderism. Speculation is presented as fact, and social experimentation is presented as a proven solution. As Christians, we would do well to avoid becoming ensnared in such a quagmire of ideological arguments. Instead, we must learn what the Bible says about the key questions undergirding transgenderism. Questions such as: Is the body sacred? Does gender matter? Is gender distinct from biological sex? Does God make mistakes? etc., etc. However, we cannot merely store the answers to these questions in our brains. As Christians, we must communicate these truths with others—especially with those who do not agree—but it is crucial that this be done gently and in love (1 Cor. 16:13–14; Gal. 6:1).

 

If we alienate the transgender community in our effort to stand upon the truth of God’s Word, then we forfeit our opportunity to share the gospel when they become disillusioned. Why would they turn for answers to those they believe harbor animosity toward them? Similarly, if we affirm the transgender lifestyle in an effort to show our love and tolerance, then we can offer them no hope of change when they realize the path they are treading leads only to destruction and hopelessness. Why would they look for hope from someone who says they and the transgender individual are already so similar that we need not discuss the differences? Instead, when we as Christians stand apart from the transgender ideology in an honest yet loving manner, we protect the hope of the gospel.

 

We are not responsible for convicting others of their sin. This is the responsibility of the Holy Spirit. Jesus told His disciples in John 16:8, “[W]hen [the Holy Spirit] comes, he will convict the world concerning sin and righteousness and judgment:” We are merely messengers responsible for telling others the truth of God’s Word. We stand as candles in the dark–sometimes shedding light upon the lies people believe, other times drawing people to the light. However, if we place our light under a bowl, then we can do nobody any good (Matt. 5:14–16). Therefore, we proclaim the truth of God’s Word to those who will listen, and we treat everyone with love and gentleness. In so doing, we encourage the convicting work of the Holy Spirit in the hearts and minds of others.


  1. Grant, et al., “National Transgender Discrimination Survey Report on Health and Health Care.”
  2. Ibid.
  3. Batty, “Sex Changes Are Not Effective, Say Researchers.”
  4. “Paul McHugh: Transgender Surgery Isn’t the Solution – WSJ.”
  5. Paul McHugh, “Surgical Sex,” First Things, November 2004, Source: Brown, Can You Be Gay and Christian?, 22.
  6. Dehjne, et al., “Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden.”
  7. Batty, “Sex Changes Are Not Effective, Say Researchers.”
  8. Ibid.
  9. Garrett Oppenheim, “Ihlenfeld Cautions on Hormones: Stresses Psychological Dangers,” Transition, no. 8 (January/February 1979), Source: Oppenheim, “Ihlenfeld Cautions on Hormones: Stresses Psychological Dangers.”
  10. Ibid.
  11. Batty, “Sex Changes Are Not Effective, Say Researchers.”
  12. Winter, “‘I Was Born a Boy, Became a Girl, and Now I Want to Be a Boy Again’: Britain’s Youngest Sex Swap Patient to Reverse Her Sex Change Treatment.”
  13. Akbar, “The Man Who’s had TWO Sex Changes: Incredible Story of Walt, Who Became Laura, then REVERSED the Operation Because He Believes Surgeons in US and Europe Are Too Quick to Operate.”
  14. Heyer, “Tansgender Character May Win Emmys, but Transgender People Hurt Themselves.”
  15. Ibid.
  16. Ibid.
  17. Sex Change Regret, “Examples.”
  18. Taylor, “Why 2015 Was the Year of Trans Visibility.”

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Transitioning Copyright © 2016 by Timothy Zebell is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.