John Piper has cautioned Christian healthcare workers against any involvement in gender reassignment surgeries.
On his Desiring God website, the popular theologian went as far as to say that they should have no part in the pre- and post-op care of patients who have undergone such surgeries.
He argued that doing so would contribute to the "ongoing normalization of evil" both in the hospital and in the wider world.
His answer was in response to a Christian nurse who wrote to him asking his view about her work at a hospital that performs these surgeries.
"I play no role in the decisions made to undergo these surgeries," she wrote.
"I believe the decision itself is sinful. The question I cannot resolve is this: Is it sinful for me to serve as a nurse involved in the care of these patients in the pre-op and recovery settings?"
Piper acknowledged that hospitals provide all kinds of surgeries and therapies, with varying medication and care policies but instead of only providing healing and healthcare, some are doing "untold damage" by following "man-centered values" and participating in things like abortion, assisted suicide and the "illusion" of gender transition.
To participate in gender reassignment surgeries, he warned, was in contradiction to "God's revealed will".
"For example, the hospital staff, instead of caring for old people, now may euthanize them, kill them," he said.
"Instead of caring for mothers and babies in crisis pregnancies, they may kill the children.
"Instead of helping men flourish as men and women flourish as women, they pursue the illusion of surgically and hormonally turning men into women and women into men, which can never happen."
Christian healthcare workers in these settings "are no longer simply a bona fide participation in a common grace of healing done in the name of Jesus".
Instead, they are settings "where the external manifestations of God's order are openly defied, and where untold damage is being done to sometimes desperate people".
"Which means that your participation becomes, against your will, a support for contradicting God's revealed will, for damaging people, and for bringing part of the ongoing normalization of evil in this hospital and in the world," he said.
Piper concluded by urging the nurse to seek the Lord earnestly for alternative ways of using her "life-giving abilities".