Serving Our Children Means Saying No to Youth Gender Medicine

The Biden administration’s newly announced opposition to gender transition surgeries for minors is welcome. But Christians would be mistaken to let this news make us less vigilant on this issue.

The announcement only came after The New York Times reported late last month on efforts by the administration to “remove age limits for adolescent surgeries from guidelines for care of transgender minors.” And the White House clarified that the administration still supports “gender-affirming care for minors, which represents a continuum of care,” and respects “the role of parents, families, and doctors in these decisions.”

Youth gender medicine of all kinds also remains a live issue in state government and the judicial system. On June 24, the Supreme Court agreed to review a case challenging a Tennessee law that prohibits “gender-affirming care for transgender youths.” United States v. Skrmetti addresses whether the state ban violates the equal protection clause of the 14th Amendment.

Tennessee’s law currently differentiates the rights of a minor for treatment of a “congenital defect, precocious puberty, disease, or physical injury” from treatments rendered for “gender dysphoria, gender identity disorder, gender incongruence, or any mental condition, disorder, disability, or abnormality.” Even so, medical groups like the American Academy of Pediatrics (AAP) and the American Medical Association (AMA) oppose such laws based on the claims that such medical procedures have reduced suicide attempts and decreased rates of depression and anxiety among minors who identify as transgender.

The neglected question is whether that’s true. What has been overlooked in these debates is that the well-being and long-term health of minors is taking a back seat to appeasing activists and politicians.

Such procedures, whether they be puberty-blocking medications or various surgeries, are misguided attempts by medical professionals who sincerely believe that they are helping children. However, sincerity does not sanctify an action. As Charles Spurgeon once said, “If you sincerely drink poison, it will kill you: if you sincerely cut your throat, you will die. If you sincerely believe a lie, you will suffer the consequences. You must not only be sincere, but you must be right.”

In the case of “gender-affirming care,” those who suffer the consequences of the lie are children. To even speak of “gender-affirming care” without qualification betrays a Christian’s fundamental convictions about the dignity of human life. Medicine heals the body; gender reassignment surgery disfigures it.

In fact, while American activist and medical groups claim that “gender-affirming care” works, other medical groups in Europe are questioning these claims, raising serious concerns about the ongoing health impact of these procedures, which is giving pause to medical professionals and lawmakers alike around the world. Recently, UK researcher Hilary Cass released her review of relevant studies and flagged the unstudied long-term impact of such medical procedures on minors, especially regarding “cognitive and psychosexual development.”

That should come as no surprise to Christians. These procedures are steeped in the demonstrably false idea that our gender has no relationship to our biology. If we desire to offer compassionate care to those who are in distress, we are best to counsel our children on the goodness of their created bodies as those made in God’s image. God’s design for his creation is very good (Gen. 1:31). The compassionate and loving course of action in these cases is not found in embracing a lie but in speaking the truth in love (Eph. 4:15).

With children experiencing gender dysphoria, we must be patient, listen to them, pray for them, teach them, and, when necessary, connect them with a professional Christian counselor. But social or medical transition is not the answer.

Doctors and surgeons currently perform these irreversible procedures with near impunity due to poorly researched studies that suggest there is some immediate benefit conferred to the child suffering from these mental disorders. Long-term studies, however, show that people “with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population.”

What is also rarely mentioned are the rates of desistance among children who grow up without puberty-blocking medication and surgical alteration to their bodies, or the distress that many continue to feel after these procedures. Our government has a moral obligation to address these purported treatments and to expose the real harm that takes place in the name of “care.”

The bodies and brains of our children ought never to be regarded as pawns for political gain. They hold inherent dignity as image-bearers. Caring for them well in the midst of their mental distress forbids us from thinking or acting in any way that denies the rights of their Creator and Lord.

The Biden administration’s opposition to surgery is a start, but it’s only a start. Christians should support comprehensive bans on these treatments out of regard for God’s good design for humanity and his express purpose for governments in society (Rom. 13:1–17). Such laws guide our governing authorities and serve a good purpose that benefits all of humanity. We should desire and support such laws, for they prevent irreparable harm to the most vulnerable people among us and affirm that God has created and ordered us for his glory and our good.

This is not just a political and medical matter; it’s a theological matter as well. If, as Christians, we believe that God has created humanity in his image, then any debate regarding the health and well-being of children is inherently theological. The themes of God as creator, humanity as part of his creation, and the obligations of humans as stewards over the rest of creation bear great significance for how we ought to care for children in society.

In Matthew 18, Jesus tells his followers that unless they become like children, they will not enter the kingdom of heaven, and that whoever welcomes a fellow believer (child) welcomes Christ as well. He continues: “If anyone causes one of these little ones—those who believe in me—to stumble, it would be better for them to have a large millstone hung around their neck and to be drowned in the depths of the sea” (v. 6).

Jesus’ point here is that just as children were to be protected from harm in the world, so also his disciples should be protected and not be caused to stumble by others. This comparison only works if Jesus’ audience understood that he expected both children in the world and the “children” of his kingdom to be protected from harm. If anyone ought to understand the importance of protecting children in the world, it should be those who have taken on the identity of a child of God and know the consequences of causing little ones to stumble.

Protecting children is the right and loving thing to do. It should be a priority for our government and for us as the people of God.

Casey Hough is director of partnerships and curriculum at World Hope Ministries International and assistant professor of biblical interpretation at Luther Rice College and Seminary. He is author of Known for Love: Loving Your LGBTQ Friends and Family Without Compromising Biblical Truth (Moody, 2024).