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What follows is Part 1 of a series from The Christian Post,  I thought I may be worth reproducing it here as there is so much in the news of late about Transgenderism.  As Christians we need to have the information so as to be able to respond.

Editor's Note: This is Part 1 in a Christian Post series on how Christians should respond to transgenderism.

The percentage of American adults who identify as transgender has doubled over the past decade to about 1.4 million people. And that number is expected to increase, especially as more children are now beginning to identify as someone of the opposite gender.

The Christian Post is launching this series on transgenderism as children as young as 3 are being increasingly told that it's normal to change their gender identity and as parents and institutions are being forced to accommodate and embrace transgender children.

The first part of the series will offer an overview of the science and the few studies that were done to better understand why people identify as transgender.

To begin with, let's define some terms.

Sex is assigned at birth. It "refers to one's biological status as either male or female, and is associated primarily with physical attributes such as chromosomes, hormone prevalence, and external and internal anatomy."

Gender "refers to the socially constructed roles, behaviors, activities, and attributes that a given society considers appropriate for boys and men or girls and women. These influence the ways that people act, interact, and feel about themselves. While aspects of biological sex are similar across different cultures, aspects of gender may differ."

Transgender is "an umbrella term for persons whose gender identity, gender expression or behaviour does not conform to that typically associated with the sex to which they were assigned at birth."

Gender identity "refers to a person's internal sense of being male, female or something else."

Gender dysphoria (also known as gender identity disorder): "formal diagnosis given by mental health professionals to people who experience distress because of a significant incongruence between the gender with which they personally identify and the gender with which they were born."

The Science

Currently, little is known about what causes some people to reject their biological sex and identify with the opposite gender.

Previous research findings — much of it on the brain — have led some to conclude that being transgender is not a choice. But not all researchers are on board with that conclusion.

So is there a biological basis for being transgender?

Here's a look at some of the studies often cited by those who argue that transgender persons are born that way.

In 1995, a study by the Graduate School Neurosciences Amsterdam and the Netherlands Institute for Brain Research showed "a female brain structure in genetically male transsexuals."

Researchers had looked at a part of the brain called the bed nucleus of the stria terminalis (BSTc) — a brain area that is essential for sexual behavior and is larger in men than in women. They found that male-to-female transsexuals had a female-sized BSTc.

The researchers also noted that "the size of the BSTc was not influenced by sex hormones in adulthood and was independent of sexual orientation."

In a follow-up study in 2000, the same research institutions looked at the neurons — specialized cells that transmit information — in the BSTc. More specifically, they examined the number of somatostatin-expressing neurons. They found that men had almost twice as many somatostatin neurons as women.

Male-to-female transsexuals had a similar number of neurons in the BSTc to that of women. The number of neurons in a female-to-male transsexual was similar to that of men.

Researchers concluded that there could be a "neurobiological basis of gender identity disorder."

In 2009, the UCLA School of Medicine's Department of Neurology analyzed MRI data of 24 male-to-female (MTF) transsexuals not yet treated with cross-sex hormones. Researchers found that "regional gray matter variation in MTF transsexuals is more similar to the pattern found in men than in women. However, MTF transsexuals show a significantly larger volume of regional gray matter in the right putamen compared to men."

This finding, UCLA researchers said, "supports the assumption that brain anatomy plays a role in gender identity."

An additional study that has led some to make similar conclusions that being transgender is caused by genetics is a 2013 one on twins by the Pacific Center for Sex and Society in Hawaii.

Researchers use the twin study design to determine whether a trait is due to genes. Identical twins share nearly 100 percent of their genes and are raised in the same family environments whereas fraternal twins share around half their genes. Thus, "if a trait is more common among identical twins than fraternal twins, it suggests genetic factors are partly responsible."

The Pacific Center researchers analyzed over 100 sets of twins where at least one had transitioned from one gender to the other. They found a 28.38 percent concordance among identical twins compared to a 0.34 percent concordance among fraternal twins — meaning the identical twins are more likely to both be transgender than fraternal twins are.

The results from all of these studies have been presented by many as evidence that there is a genetic basis for transgender identity.

Nevertheless, research on transgenderism is still in its infancy and there have been no "irrefutable conclusions," Reuters recently reported.

Currently, the "largest-ever study of its kind" is underway with scientists from five research institutions — including Vanderbilt University Medical Center, George Washington University and Boston Children's Hospital — exploring whether there is a genetic factor behind the existence of transgender persons.

In the meantime, findings from the aforementioned studies have been rejected by some as inconclusive or even accepted as evidence that there is no genetic cause.

Michelle Cretella, a board certified pediatrician with an interest in adolescent mental and sexual health who is also the president of the American College of Pediatricians, a conservative organization, told The Christian Post that the twin study from 2013 shows that transgender identity is not something one is born with.

"If transgenderism were 'hard wired by factors before birth,' then every identical twin would have the same gender identity, but they do not. Transgenderism is in the mind, not in the body," Cretella said. "This is why there is no medical test that can diagnose a person as transgender; we must simply take the individual's word for it because only the individual knows what he or she is thinking and feeling."

As for the research on brain structure, scholars at Johns Hopkins University in Maryland released a report in 2016, arguing that there is not enough definitive scientific evidence available to suggest that gay, lesbian and transgender individuals are born that way.

Lawrence S. Mayer and Paul R. McHugh argued that the studies had small sample sizes and need further scientific consideration.

"The question is not simply whether there are differences between the brains of transgender individuals and people identifying with the gender corresponding to their biological sex, but whether gender identity is a fixed, innate, and biological trait, even when it does not correspond to biological sex, or whether environmental or psychological causes contribute to the development of a sense of gender identity in such cases," they contended. "Neurological differences in transgender adults might be the consequence of biological factors such as genes or prenatal hormone exposure, or of psychological and environmental factors such as childhood abuse, or they could result from some combination of the two.

"There are no serial, longitudinal, or prospective studies looking at the brains of cross-gender identifying children who develop to later identify as transgender adults. Lack of this research severely limits our ability to understand causal relationships between brain morphology, or functional activity, and the later development of gender identity different from biological sex."

Hormone Therapy

A 2014 study by the American Foundation for Suicide Prevention and the Williams Institute — UCLA School of Law's think tank — showed that more than 4 in 10 trans men and trans women tried to commit suicide. The prevalence of suicide attempts was highest among those who are younger (18 to 24).

Puberty suppression therapy through hormone intervention is increasingly being recommended for children with gender dysphoria and at younger ages. Advocates argue that puberty blockers may improve the mental health of transgender adolescents on the grounds that puberty can be "unbearable" for transgender teens.

A 2011 study that analyzed 70 adolescents who received puberty suppression between 2000 and 2008 found that behavioral and emotional problems and depressive symptoms decreased after the puberty blocking treatment. The study concluded that "puberty suppression may be considered a valuable contribution in the clinical management of gender dysphoria in adolescents."

Although advocates claim that puberty blockers are safe and reversible, others argue that it can do more harm than good.

Cretella told CP that puberty blockers have been associated with possible bone damage in young women, as well as obesity, and testicular cancer in men and cognitive deficits.

"More importantly, when a child is placed on blockers between the ages of 9 and 12, followed seamlessly (or concurrently) with cross-sex hormones (testosterone and estrogen), the child is rendered permanently sterile," she warned.

In a June 2017 report, Mayer, McHugh and Paul Hruz, associate professor of Pediatrics, Endocrinology and Diabetes at Washington University in St. Louis, warned that physicians and parents are endangering children when they expose them to puberty-blocking hormone therapy considering that it has not been adequately researched yet.

"[U]ntil controlled clinical trials of puberty suppression are carried out, this intervention should be considered experimental," the report states.

Hruz contended: "In essence, what is being done with these children is uncontrolled experimentation on them and they are not even being told that they are being experimented on. It is not presented in that way."

The scholars also noted that gender dysphoria in children does not often persist into adulthood.

In biological males, persistence of gender dysphoria has ranged from 2.2 to 30 percent, and in biological females, persistence has ranged from 12 to 50 percent, according to the American Psychiatric Association.

Mayer, who recently retired as professor of statistics and biostatistics at Arizona State University and scholar-in-residence at Johns Hopkins University, warned in an interview with CP that putting children through hormone therapy could almost eliminate the possibility that gender dysphoria will stop persisting into adulthood.

"The benefits are that you will have this person to be more comfortable in their identity," he said. "But what choice do you give a kid who has been without hormones for three years? And now, a lot of these kids may just go along. You are foreclosing on the chance for them to return to a gender identity consistent with their biological sex."

Sex Reassignment Surgery

According to the Encyclopedia of Surgery, the number of gender reassignment procedures conducted in the United States each year is estimated at between 100 and 500.

Transitioning to the opposite sex requires several surgeries.

For males transitioning to females, Cretella explained that one would need facial reconstruction, reduction of the Adam's apple, breast implants, surgical castration, and surgery to remove the penis and construct a "neovagina." The neovagina is "really just a pouch," she noted. Also, the urinary tract must be re-routed.

As for females looking to become men, Cretella explained that the the patient may obtain a double mastectomy (removal of breasts), hysterectomy (removal of all or part of the uterus), and an oophorectomy (removal of ovaries).

"But many only go through with the double mastectomy," Cretella noted.

She told CP that even though genital surgery is not recommended before the age of 18, some surgeons are performing procedures on patients of younger ages.

Although advocates say that hormone therapy and sex reassignment may improve the mental health of transsexuals, an extensive long-term study conducted in Sweden by scholars at the Karolinska Institute and Gothenburg University concluded that "persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population."

The study analyzed 324 sex-reassigned persons (191 male-to-females, 133 female-to-males) for over 30 years after their gender transitions from a period of 1973 to 2003.

"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," the study reads.

Cretella told CP that the Sweden study is "the best study we have."

"Initially, most subjects reported feeling relief and experienced improved social functioning. Beginning at 10 years out, however, rates of depression and anxiety began to rise significantly," Cretella said. "By 30 years following surgery the completed suicide rate was nearly 20 times that of the general population. Transgender activists are quick to point out that it is possible that transgender identified individuals denied surgery might experience even higher suicide rates (we do not have that data), but all experts agree that hormones and surgery are clearly not the cure many proclaim them to be."

Mayer and McHugh's 2016 report considered the Sweden study to be "one of the more robust and well-designed studies to examine outcomes for persons who underwent sex-reassignment surgery." However, "the study did not compare outcome variables before and after sex-reassignment surgery; only outcomes after surgery were evaluated."

In analyzing various reports and studies on whether reassignment surgeries have a positive effect on a transgender person's mental health, Mayer and McHugh concluded that a "skeptical view" should be taken "toward the claim that sex-reassignment procedures provide the hoped-for benefits or resolve the underlying issues that contribute to elevated mental health risks among the transgender population."

"While we work to stop maltreatment and misunderstanding, we should also work to study and understand whatever factors may contribute to the high rates of suicide and other psychological and behavioral health problems among the transgender population, and to think more clearly about the treatment options that are available," the report stated.

(c) The Christian Post August 10th, 2017

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  • Today we continue with part 2 of of this article - Looking At What the Bible Says

    Editor's Note: This is Part 2 in a Christian Post series on how Christians should respond to transgenderism. Part 2 will look at the theology.

    When it comes to making a biblical case for transgender identity, some have cited scriptures about "natural-born eunuchs" and Apostle Paul's words that there is "neither male nor female" in Christ Jesus. This argument and arguments against it were already laid out in a previous Christian Post article.

    Offering more insights on what the Bible has to say about the issue of gender identity, Dr. Richard Land, who is president of Southern Evangelical Seminary in North Carolina, and Pentecostal pastor Bishop Harry Jackson spoke with CP and began with how God created humans.

    "The Bible tells us in Psalm 139 that God knits and embroiders us together in our mother's womb. And all of our parts were in God's book before any of them came to be. Clearly, God is involved in every conception that takes place," said Land, noting that it is a biological fact that one's sex is determined at that precise moment.

    Jackson, who leads Hope Christian Church in Beltsville, Maryland, explained that one's biological sex is not only a divine imprint but part of God's "assignment" to the human being.

    "I believe that God gives us the original assignment of gender, even nationality — what we would call race — where we were born, and the family into which we were born. All of that is pre-selected by God. He wants us to steward that uniqueness as a beginning point, as a gift from God," Jackson said.

    "In the context of that, the Lord has a fairly strict set of boundaries that He wants us to carry out, principles by which we live."

    At a recent SES event on "God, Sex, & Gender," Land posed the question, "What is a human being?"

    He pointed to the first chapter in the first book of the Bible — Genesis — where it states that God made man in His image and likeness, and "male and female He created them."

    There is a difference between human beings and the rest of creation as humans are the only creature that have the divine image, Land stressed.

    "A human being is a special creation of God, thus human life is sacred," he said.

    Additionally, the Apostle Paul, Land noted to CP, calls the human body "the temple of the Holy Spirit" in 1 Corinthians 6 and the word he uses for temple in the Greek refers to the Holy of Holies, the innermost part of the temple. This was the very place where the Holy Spirit — the shekinah glory — dwelled.

    With all that said, when someone maintains that he or she was born in the wrong body, this is not just a matter of confusion; it represents the "ultimate rebellion" against God's design for them, Land contended.

    Jackson also called transgenderism a rebellion against the original assignment God gave each person.

    In essence, Land believes that transgenderism is "self-idolatry."

    "It is the ultimate attempt to become one's own god. I want to be different than the way God made me so I'm going to employ modern medical science to change my gender, chemically and surgically," he maintained.

    "The religion of America today is narcissism. … We want to define our own version of truth of who we are regardless of anything else."

    He went on to explain that at the root of the transgender movement is a resurgent Gnostic belief that the body and mind are not united and the hedonistic creed of the sexual revolution: "If it feels good, do it."

    "The sacred trinity of modern man is I, myself, and me. And it is only with modern science that people have the ability to claim they can change their gender and seek to do so," Land, a father of three, said.

    Renowned Anglican theologian N.T. Wright also recently called the confusion about gender identity a "form of the ancient philosophy of Gnosticism."

    "The Gnostic, one who 'knows,' has discovered the secret of 'who I really am,' behind the deceptive outward appearance," Wright said.

    "This involves denying the goodness, or even the ultimate reality, of the natural world. Nature, however, tends to strike back, with the likely victims in this case being vulnerable and impressionable youngsters who, as confused adults, will pay the price for their elders' fashionable fantasies."

    Christians should have particular reverence for their God-given biology and the human body because the Lord took on a human frame, noted Land, who is also executive editor of The Christian Post and former president of the Southern Baptist Convention's Ethics & Religious Liberty Commission.

    "We are not what God intended us to be," he said, speaking of how much our bodies matter. "He intended us to be the vice-regents of creation and we have become slaves to our own sin and desires through the Fall. But Jesus came … in order that He might make us everything that He is."

    And when people receive Christ and what was accomplished on the cross by faith, they are in the process of being all that God created them to be.

    Pastorally speaking, both Land and Jackson emphasized the need to love transgender persons.

    "Christians have an obligation and a responsibility to love people who identify as transgender and to seek to act redemptively toward them," Land emphasized, adding that those who struggle with gender dysphoria should never be made fun of or mocked.

    At the same time, pastors should not affirm transgenderism as normative.

    "You do them no service by acquiescing to their malady and calling it normal," Land said. "Calling it normal does not make it normal, affirming it as healthy does not make it healthy.

    "God has set the norms and when you live in a society where there are no norms, everything is normal, and that is a recipe for madness."

    For Jackson, he outlined three things he would tell someone who has gender confusion:

    "1) God loves them, 2) they are not an accident, and 3) they should be willing and expect the grace of God to help them comply with God's commandments for their behavior on any level," he explained.

    "We have to understand that the people who come to us for help in the context of Christian ministry, they have to be willing to accept the Bible as the highest authority for human behavior, and whatever counseling and encouragement and help will be based prescriptively on what the Bible teaches."

    Jackson said that if he pastors someone who thinks that ministers are prejudiced against them, he said he cannot help it, because he's not going to change the doctrine of his church to accommodate an exceedingly small minority of people.

    People must come to understand that when they accept Jesus, it is a call to a lifestyle and journey with God, Jackson added, emphasizing that it's imperative for churches to find a way to teach about these things in a loving but directive manner in order to set people on a course to have a normal family life as they pursue God and the Scriptures.

    The Christian Post - August 11th, 2017

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