The Supreme Court convenes Wednesday to hear oral arguments in United States v. Skrmetti, the first meaningful transgender-issue case to reach the highest court in our land. In question is the constitutionality of a Tennessee law (and a similar one in Kentucky) banning medical procedures that would enable children “to identify with, or live as, a purported identity inconsistent with the minor’s sex” or to treat “purported discomfort or distress from a discordance between the minor’s sex and asserted identity.”
Or in plainer terms: Can states make it illegal to use puberty blockers, hormones, and surgery to medically transition children?
The briefs submitted to the court for and against the Tennessee law gave a preview of this week’s arguments. One side warns that such a ban “imposes immediate and devastating harm” and “wholly ignores the thriving lived experiences of [trans] individuals.” The other writes with equal urgency of “healthcare providers pressuring [parents] to place their children on the ‘conveyor belt’ of medical transition” and details a troubling list of risks from medical transition, including “infertility, sexual dysfunction, diminished bone density, myocardial infarction, cardiovascular disease, and cancer.”
These briefs are a highbrow version of the culture-war conversations many Christians can expect this Christmas—and realistically, for years to come, however the court rules on this case in 2025. But what if we prepared ourselves for those conversations (and more public dialogues about trans topics) instead of just stumbling into them? What if, as 1 Peter 3:15 directs us to do for our hope in Christ, we were ready “to give an answer” with “gentleness and respect”? What if we could share Christ’s love and wisdom about trans issues in ways that are actually a bridge to the gospel, rather than a barrier?
Like many Christians, I believe the Bible affirms biological sex and the gender binary (1 Cor. 11:2–16). God intended each of us to grow into either a male-bodied man or a female-bodied woman, according to his good design at creation (Gen. 1–3).
Unfortunately, because we live in a fallen world, all of us experience some level of brokenness in our biological sex or gender. For some, this brokenness manifests as a painful incongruence between the biological sex of their body and their inner sense of being a man or a woman (an experience sometimes referred to as gender incongruence or being trans). Then, overly rigid, culturally constructed gender expectations can multiply the distress of trans people—a term I’ll use, for the sake of simplicity, to describe anyone who experiences gender incongruence, regardless of their medical decisions or theological conclusions.
Amid this distress, God commands believers to resist the sinful temptation to remake themselves in their own desired image using medical transition. Yet God does not abandon trans people in their pain. He invites them to honor his gift of their biological sex and to lean on their siblings in Christ as they manage the pain of incongruence.
Though gender incongruence is a kind of brokenness that God did not intend, it is not a sin, nor is it an experience anyone chooses. And though research suggests that about 80 percent of gender incongruence resolves itself before adulthood without medical transition, there is no formula for reducing that incongruence.
As he is with all of us, God is merciful to trans people. And that includes those who have succumbed to the temptation of medical transition earlier in life; the Bible makes clear that sinfully altering (or being forced to alter) one’s biological sex does not prevent people from becoming part of God’s family (Isa. 56:1–5; Acts 8:26-39).
I don’t think my views here are so unusual among American Christians. Unfortunately, many non-Christians have heard something very different from Christians speaking about trans issues. They’ve heard prominent Christians say that being trans is either fake or a mental illness, something to be debunked, condemned, and stigmatized. They see online chatter about bathroom bills, stereotypical gender roles, and “groomers” and conclude that Christians view trans people as predators plotting to endanger women and manipulate or mutilate children.
It would be a grave mistake to cede this conversation to extreme voices in either direction. Too many Christians participated in the gay marriage debate of the 2000s in ways that did not draw people to Jesus. But this debate could be different.
The cultural context is certainly different: Whereas public opinion in America moved decisively in favor of gay marriage, the trend line has turned on trans issues; a biblical ethic on gender is not outside the mainstream. Most Americans also share Christians’ concerns about medical transition for children: One poll found 59 percent of registered voters in the US support banning medical transition for minors, as the laws in the Supreme Court case do. A Washington Post–KFF survey had similar results.
That’s why we need to prepare for these conversations, even if we wish we could avoid the topic altogether. Many of us have family, friends, neighbors, and coworkers for whom this isn’t a matter of distant politics and public policy. It’s personal, and we owe those loved ones a conversation that approaches the subject seriously, in love, and with sound scriptural grounding.
So what should we prepare to say? We shouldn’t soften or qualify the biblical ethic I shared above. But neither should we neglect to “mourn with those who mourn” (Rom. 12:15).
When My Sermon Riled Our City
That looks like believing those who report feeling painful gender incongruence and alienation from their own bodies. We should reject baseless allegations that all trans people are predators and dismissive assertions that they’re mentally ill. And while we affirm that God did not intend for anyone to experience gender incongruence, we should also affirm that it isn’t their fault. God isn’t surprised, and God loves trans people deeply. He made them in his image, died for their salvation, and wants them to follow his wisdom so they can experience fullness of life in him.
God also has a role here for the church. Christians with gender incongruence should not have to hide their experience from siblings in the faith. Our churches must be places where trans people find community in the body of Christ. They should find support to resist the temptation of using hormones or surgery—support that includes pushing back on harmful and reductive gender stereotypes that come from our culture, not the Bible.
We can extend compassion and community to trans people and hold fast to a biblical gender ethic. Imagine the effect a Christian witness like this could have—especially for persuadable non-Christians who are looking for a sensible, honest answer to the gender debate.
How we share God’s wisdom matters. Andrew Marin’s Us Versus Us describes the results of “the largest-ever scientific survey of LGBT religious history, beliefs, and practices.” That survey found that the primary reason LBGTQ people leave the faith is not theology about sex and gender. It’s “negative personal experiences” with Christians and local churches, including exclusion for the mere experience of gender incongruence or same-sex attraction, estrangement by Christian family members, teachings that lacked compassion or nuance, and false hope for gender or sexual orientation change.
Tellingly, Us Versus Us reports, 76 percent of LBGTQ people who had left the faith said they were open to returning, and 92 percent of those said their return wouldn’t depend on a church changing its theology about sex and gender.
These numbers reiterate that Christians can and must push back against both transphobia and the idol of self-invention. We must answer our neighbors’ genuine cultural and ethical questions in ways that are biblically robust, intellectually satisfying, and aligned with scientific evidence. For example, we can simultaneously advocate for the dignity of trans people and highlight consistent research (summarized in the Cass Review and elsewhere) that medical transition has not been demonstrated to reliably reduce depression or suicidality. And we must humbly learn from the Christians already faithfully navigating gender incongruence right in our pews—Christians convinced of biblical gender ethics and glorifying God in the midst of their brokenness.
This is an opportunity for Christians to learn from the errors of the past and share the gospel “to win as many as possible” (1 Cor. 9:19). Christians don’t have to abandon biblical truth to communicate Christ’s wisdom to trans people and those who love them. We can prepare to speak in both grace and truth.
Pieter Valk is a speaker and author, the director of Equip, a cofounder of the Nashville Family of Brothers, an aspiring deacon in the ACNA, and a licensed professional counselor. Find more on his theology here, and find him on socials @pieterLvalk.
