Jesus proclaimed, 'the truth will set you free' (John 8:32). Gloria Steinem waspishly added (utilising somewhat earthy language) that first it will make you exceedingly annoyed. The truth might or might not make us angry, but it needs to be sought fearlessly and without bias.

Inter-sex conditions (for definitions of the terms used in this article, see the note at the end) cover much more than anatomical variations observable at birth. A number of genetic, physiological and anatomical factors are involved. These range from the presence of an extra chromosome (as in Turner Syndrome) through androgen insensitivity (in which cells do not respond to testosterone and related hormones, causing female-appearing genitals in infants with male chromosomes) to conditions such as vaginal agenesis (in which genetically female babies are born without a vagina). Some of these are regularly associated with gender dysphoria while others are not.

The number of inter-sex individuals is difficult to determine accurately, with estimates varying between one and two percent of the population. Even at the lower end of this estimate some seventy million people worldwide are inter-sex, significantly more than the entire population of the UK.

While inter-sex conditions are biological in origin, the roots of transgender experience are much more difficult to determine. Research demonstrates that reality is much more complex than much popular writing suggests.

A meta-analysis of almost seventy years of research published by VU University Medical Centre, Amsterdam in 2013, makes fascinating reading. With regard to gender identity it reaches the conclusion that, 'not one causal factor can be determined and it is most likely that gender identity development is the result of a complex interplay between biological, environmental and psychological factors'. This indicates that transgender experience defies simple explanation and requires nuanced interpretation and reflective response.

A Christian Response

Most Christians will want to know what the bible has to say about transgender issues. Without delving into the complex world of biblical hermeneutics, it is important to point out that Christians differ vastly in the ways in which they understand the nature, role, interpretation and application of Scripture. There is, therefore, no easy answer to this question. Nonetheless, a few observations might prove helpful.

The biblical authors had almost no scientific knowledge available to them relevant to transgender issues. Consequently, it should not surprise us to find that they do not explicitly discuss inter-sex conditions, gender identity or transgender issues.

Biblical texts that are sometimes viewed as being relevant ought, therefore, to be approached with caution. Paul's comment that there is neither male not female in Christ (Galatians 3:28) comes in the context of celebrating unity in Christ; it is not a statement on sex or gender. Jesus' echo of the 'male and female' creation statement (Genesis 1:27), as well as his comments on eunuchs, were uttered in the context of a discussion on marriage and divorce as practiced within Second Temple Judaism and ought not to be pressed into an exploration of transgender issues (Matthew 19: 2-12). The decree, 'A man's item shall not be on a woman, and a man shall not wear a woman's garment' (Deuteronomy 22:5) has been interpreted variously by Jewish scholars over the past two thousand years but with a consensus that it does not address transgender issues.

The 'key' biblical reference is seen by many to be Genesis 1:27, 'So God created man in his own image, in the image of God he created him; male and female he created them.' The relevance to this for an understanding of transgender issues, however, depends largely on whether this passage is to be understood prescriptively (stating God's intention in creation) or descriptively (stating the author's observation of creation). Arguments can be made either way, but the balance lies with the text being descriptive (in contrast to the prescriptive text of verse 26). Much of the Genesis 1 text is descriptive (for example, the delineation of livestock, crawling creatures and wild animals); at the very least enough uncertainty exists over adopting a prescriptive interpretation to make it an unsure foundation for a Christian discussion of transgender issues.

We are on much firmer ground when we focus on pastoral and relational concerns where the Scriptures do speak with great clarity. Both the Sermon on the Mount (Matthew 5-7) and the absorbing image of the sheep and the goats (Matthew 25) provide rich resources for guidance.

Transgender people are people

Regardless of our sex or gender we are all made in the image of God and we are all loved equally by God, without distinction. As followers of Jesus we are called to stand with the marginalised, identifying wholeheartedly with them. Jesus' discourse in Matthew 25 calls us to realise that when we do either good or ill to the marginalised we do it to him.

No one chooses their sex and (whatever the cause) no one chooses to experience gender dysphoria, yet transgender individuals are often pushed to the margins of the Church and society. As Christians, we need to listen much more carefully to transgender people's stories. Their lives are already complex and often difficult; we must not add to the trauma that many of them face.

To extend to people the courtesy of being free to describe themselves as they are rather than as others might wish them to be is a simple application of the Golden Rule. To respond with love, acceptance and support is part of loving our neighbours as ourselves. Sadly, the Church has too often lagged behind society in accepting our common diverse, humanity. The Church has often been a late-comer in opposing such evils as racism, slavery and homophobia only to convince itself that it has always been a champion of equality.

Those of us who have never struggled with gender issues and who have had no reason to question our gender assignment must decide how we view transgender people. More importantly, we must decide how we are going to relate to them. Are they sinful, sick or simply distinctive? Will we try to convert them, to heal them or is it possible that we might just celebrate them?

Note on definitions used: Understanding Transgender Issues

One of the frustrations in grappling with transgender issues is the inconsistent way in which language is used both at popular and academic levels. Another is trying to find material that seeks to understand the issues involved rather than trying to bolster pre-existing opinions based on ethical, philosophical or theological conviction. In this article, I have tried my best not to add to the frustration. .

Terminology

Based on usage by the American Psychological Association:

Sex refers to the biological traits associated with a distinction between males and or females

Gender refers to the social, psychological and cultural traits associated with a distinction between males and females.

Gender assignment refers to the classification of an infant at birth as either male or female

Gender dysphoria refers to dissociation from the physical or social aspect of one's assigned gender.

Gender identity refers to one's self-identification as male, female or other.

Inter-sex refers to a variety of conditions in which one's sex does not conform to that typically associated with being either male or female.

Transgender refers to people whose gender identity does not conform to their gender assignment.

Revd Dr Brendan McCarthy is the Church of England's national adviser on medical ethics and health and social care.