Is It a Sin to Have Sex-Change Surgery?

With all the uproar today over transgender issues, especially in the church, there’s an important question that is not often asked, namely, “Is it a sin to have sex-change surgery?”

I can hear two immediate responses to the question.

The first represents “traditional” Christian thinking and says: “Of course it’s a sin! You’re mutilating or removing perfectly healthy body parts and trying to play God by changing who He made you to be. You don’t do this to the temple of the Holy Spirit.”

The second represents “progressive” Christian thinking and says: “How dare you call this a sin! And who made you the judge? This is actually life-saving surgery that has helped many of God’s precious children find wholeness. And it’s called gender-reassignment surgery, not sex-change surgery.”

Which view is right? And does the Word even address the question of sex-change surgery or, more broadly, the question of transgender identity?

Before probing these questions, it’s important to remember that we are talking about people and not just issues, and some of these people have suffered severe mental and emotional torment for years before deciding to have sex-change surgery, to the point that, in their minds, it was either sex-change surgery or suicide.

Those of us who never struggled with this cannot pretend to understand their agony, and to the extent we simply brand them “freaks” or “perverts” or “degenerates” is the extent to which we do not share the heart of God.

It’s also important to remember that some of these individuals profess a strong faith in Jesus and an absolute faith in the Scriptures, pointing out that they are not engaging in any forbidden sexual relationships. They are simply finding peace from mental torment and affirming what they believe to be their true identity.

So, what does the Word of God have to say about all this?

Let’s begin with stating the obvious: The Bible does not say anything specific about sex-change surgery (or about body-altering surgery in general).

What the Bible does say is that: 1) God created human beings male and female; 2) male-female distinctions are of foundational importance; 3) male-female distinctions should be celebrated. (When Paul taught that there is no male or female in Christ, he did not mean that there are no distinctions between the sexes. To the contrary, he often gave different instructions to men and women. What he meant was that there is full equality in Christ for men and women, slaves and free, Jews and Gentiles; see Galatians 3:28.)

And so, while we recognize that some people are born with biological or chromosomal abnormalities, generally identified as intersex, we don’t overthrow God’s intended order for their sake. Rather, with compassion, we view them as suffering from a handicap and we work with them to find the best way to achieve wholeness, which could include surgery to address a particular aspect of that handicap.

But that does not mean for a second that we embrace the contemporary war on gender, a war that denigrates gender distinctions as oppressive and constricting. Rather, we recognize that the war on gender is a war against God’s intended order for humanity.

Consequently, there is no scriptural support for people who want to live like “Sally [who] considers himself a gender outlaw, playing outside the traditional definitions of man and woman.”

Unfortunately, in its desire to affirm those on the fringes, LGBT activism often embraces an “anything goes” mentality in terms of sexual orientation and gender identity, affirming people like Tobi Hill-Meyer, self-described as “just about your average multiracial, pansexual, transracially inseminated queerspawn, genderqueer, transdyke, colonized mestiza, pornographer, activist, writer.”

Of course, Hill-Meyer is hardly claiming to be a born-again Christian, but under no circumstances do the Scriptures affirm this kind of gender-mocking mentality, nor is there a place for relationships described in the Village Voice as, “We are transgendered men (female-to-male, or FTM). My boyfriend is the mother of my child.”

As for the question of cross-dressing, Deuteronomy 22:5 is often cited: “A woman is not to wear male clothing, and a man is not to put on a woman’s garment, for everyone who does these things is detestable to the LORD your God” (Deut. 22:5, HCSB).

The fact that this practice is described as “detestable to the LORD your God” almost certainly means that it is on a different level than dietary laws or other ritual prohibitions, which were not sinful in themselves but were given to keep Israel separate from the nations. (For the Hebrew phrase “detestable to the LORD your God” in Deuteronomy, see 7:25; 12:31; 17:1; 18:12; 23:19; 25:16; 27:15.)*

But what exactly does the verse mean?

According to the IVP Bible Background Commentary, “Just as clothing served as a status marker in the ancient world, it also distinguished gender. … Most instances in which cross-dressing or transvestism are mentioned in ancient Near Eastern texts are cultic or legal in nature. … It may be this association with other religions that made transvestism an ‘abomination’ in Deuteronomy, but the issue may also be the blurring of gender distinctions.”

Of course, readers who identify as transgender would say they are not cross-dressing but are dressing in accord with their true gender identity. It is doubtful they would have fared well with that mentality in ancient Israel.

What about the question of sex-change surgery?

Let’s approach this from a different angle.

What about those who suffer with BIID, Body Identity Integrity Disorder, sometimes referring to themselves as transabled? They are tormented by the presence of healthy limbs (or other body parts), finding peace only when that healthy body part is removed or disabled.

Is it a sin for them to have a healthy limb amputated or healthy eyes blinded, even if this is the only way for them to find peace?

When I asked two transgender activists on the Tyra Banks Show whether it was right for someone with BIID to amputate a healthy limb, they told me it was not. Yet one of these activists was a prominent male-to-female doctor famous for sex-change surgeries!

As Selwyn Duke noted, “Sure, it strikes us as the most horrid malpractice when a doctor amputates healthy body parts, such as a pair of legs. But, then, should we call it something else just because those healthy body parts are between the legs?”

On one of the more bizarre episodes on the Jerry Springer Show, a man who identifies as Sandra and who cut off his legs with a circular saw, was ridiculed by Springer and the crowd, not because he cross-dresses but because he cut off his legs. In contrast, his wife and daughter expressed little concern that he amputated his limbs. Instead, they were furious with him for destroying their lives by identifying as a woman.

As for “Sandra,” he was very happy with both of his decisions, now confined to a wheelchair and proudly wearing a dress.

How revealing that the audience had no problem with a biological male finding peace by living as a woman but ridiculed him for finding peace by amputating his limbs.

Returning, then, to the question of sex-change surgery, should we view it as we view chemotherapy, which is destructive in itself but can often effectively fight cancer? In that case, we would say it is not ideal but may be a life saver.

Obviously, God alone is the Judge, and only He knows exactly what is happening inside someone’s brain—be it a physical malfunction or an emotional malfunction—but I cannot possibly believe that God’s best solution for a biological and chromosomal female who identifies as a male is for her to have her breasts removed, her genitalia radically (and imperfectly) altered, and her body pumped with male hormones for the rest of her life.

At best, it would appear that such radical surgery is terribly misguided but perhaps done out of great duress.

At worst, it would be open sin against God.

But since the clear majority of those who identify as transgender have struggled with these issues for years, some since early childhood, and since many are doing something radical as a last alternative, desperately looking for peace and wholeness, we should not condemn them.

Instead, we should meet them where they are, recognizing that many still live in a fragile emotional state and suffer ongoing rejection from family and friends, we should help them affirm God’s intended male-female order, we should encourage them to repent of wrong actions where possible, and we should, with great longsuffering, stand by them as they seek wholeness within and without.

And if we are on the front lines of speaking out against transgender activism in our society—as I believe we should be—we should also be on the front lines of reaching out to transgender individuals with compassion, spending time on our knees praying for their wholeness too.

*I have not addressed the question of those who are born eunuchs (to use Jesus’ description in Matthew 19:12), since it refers to people who were without sexual capacity. While some who are intersex might fall in this category, it does not apply to the vast majority of those who identify as transgender.)