What Does the Bible Say about Having a Sex Change?

From Issue: R&R – November 2016


A Brief Introduction to Transgenderism

In April 2015, Bruce Jenner, the gold medal men’s decathlon winner at the 1976 Montreal Olympic games, participated in a nationally televised interview with ABC News’ Diane Sawyer in which he explained that he had struggled with his gender identity since childhood. In his words, “My brain is much more female than it is male. It’s hard for people to understand that, but that’s what my soul is…. That female side is part of me. That’s who I am.”1 A few months later, in July 2015, Jenner appeared on the cover of Vanity Fair magazine dressed as a woman and announcing that he had changed his name to Caitlyn.2 In the same month, he received ESPN’s prestigious Arthur Ashe Award for Courage, largely because of his very public “transition” from Bruce to Caitlyn.3 In December 2015, he was featured once again, this time in an extensive article in TIME Magazine.4

People like Jenner suffer from “gender identity disorder,” or “gender dysphoria,” and are referred to as “transgender.” Transgender people are biologically members of one gender but identify in their minds with the other. While Jenner is probably the most famous transgender person in the world, he certainly is not alone. For instance, Chastity Bono,the only child of Cher and Sonny Bono, explained in an interview with Oprah Winfrey that she felt that her body was betraying her and discussed her transition from female to male in the 2011 film, Becoming Chaz.5 According to a June 2016 report from the Williams Institute, a think tank at the UCLA School of Law dedicated to research on sexual orientation law and public policy, approximately 0.6% of adults in the United States, or 1.4 million individuals, identify as transgender.6

A Brief Introduction to Sex Change Operations

A percentage of transgender individuals, including some youths, undergo sex change operations, or “gender reassignment surgeries,” each year.7 Generally, before undergoing surgery to alter the genitalia and other body parts, people must be diagnosed with gender identity disorder, procure a letter of recommendation from a therapist, begin hormone therapy, and live publicly as a member of the opposite sex for up to one year.8 Women desiring to live as men often have mastectomies and hysterectomies. Men transitioning to live as women can have procedures to alter the appearance of their eyes, noses, chins, and Adam’s apples, and to remove their male sexual parts. The full panoply of surgical procedures can cost well over $100,000.9

Efforts to provide legal and social support to transgender individuals have been underway for quite some time, but those efforts have recently erupted into the public consciousness in sometimes shocking fashion.10 For instance, the phenomenon of people claiming that their true gender is inconsistent with their physical anatomy has progressed so that there has been much public and political debate about which public bathrooms males and females should be able to use.11 In April 2016, Target Corporation, the retail giant, issued a statement welcoming “transgender team members and guests to use the restroom or fitting room facility that corresponds with their gender identity.”12 In May 2016, the federal government threatened to withhold federal funding from public schools declining to allow transgender students to use bathrooms that correspond with their gender identity rather than the gender listed on their birth certificates.13 These issues have been matriculating through the courts of law for several years now, and many have been alarmed and saddened by the aggressive advances of those presently seeking to legitimize transgenderism.14


While the Bible has much to say about human sexuality, it comes as no surprise that it does not specifically address the idea of having a sex change operation or gender reassignment surgery. The technology obviously did not exist in Bible times, and there is no reason to suspect that Bible writers would ever have contemplated a “sex change.” However, the Bible’s provision of “all things that pertain to life and godliness” (2 Peter 1:3, ESV) includes principles that bear directly on matters relating to transgenderism.

What the Scriptures Teach about Determining Gender

As an initial matter, “[t]he hypothesis that gender identity is an innate, fixed property of human beings that is independent of biological sex—that a person might be ‘a man trapped in a woman’s body’ or ‘a woman trapped in a man’s body’—is not supported by scientific evidence.”15 However, in light of recent efforts to define gender as a psychological construct, that is, the consequence of what one thinks or feels, one must consider the way gender is depicted in Scripture; it is consistently presented as a consequence of nature. God created Adam as a male, and He created Eve as a female (Genesis 5:1-2; Matthew 19:4). They were physically complementary beings capable of producing offspring together (Genesis 1:28), and their offspring were distinctly male or female as they were (Genesis 5:3-4). On the one hand, males had an anatomical design that included the ability to produce “seed” while  impregnating females (Genesis 38:9). On the other, females had an anatomical design consistent with bearing and nursing children (see, for example, Genesis 4:1-2,17,25; 3:16, 20; 21:7; 1 Samuel 1:23). So, then, since the beginning, each human being has been “fearfully and wonderfully made” in the image of God as either a male or a female (Psalm 139:14-16; Genesis 1:26-27; Isaiah 44:2,24).16

Notice that the determination of one’s gender did not depend on his or her individual thoughts or preferences. The classification was readily made at birth based on physical anatomy.  A Hebrew “man child” was to be circumcised on the eighth day following his birth (Genesis 17:12-14; Leviticus 12:3). Moreover, under the Law of Moses, a woman who birthed a male child was ceremonially unclean for seven days (Leviticus 12:1-2), but a woman who birthed a female child was ceremonially unclean for two weeks (Leviticus 12:5). The Bible clearly depicts ancient people, at God’s direction, making determinations regarding gender at the time children were born based on their anatomy, and proper classification depended exclusively on one’s physical characteristics at birth. The appropriate social roles and psychological constructs, then, flowed from a person’s anatomical design.

What the Scriptures Teach about Transvestism

Following diagnosis that a person has a gender identity disorder, i.e., that he or she identifies psychologically with the opposite gender, a transgender person desiring to undergo a sex change operation typically has to live publically as a member of the opposite sex. This would include efforts like cross-dressing or transvestism, i.e., dressing in a manner traditionally associated with the opposite sex. While public sentiment regarding such behavior has changed rapidly in recent years, the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II) classified transvestism as a “sexual deviation,”17 and it used to be commonly understood to be a psychological disorder that required intervention.18

The “sexual deviation” designation concurred with God’s Word. For example, 1 Corinthians 11:13-14 teaches that the natural differences in gender in a culture ought to be maintained. Also, in Deuteronomy 22:5, the Bible says: “A woman shall not wear a man’s garment, nor shall a man put on a woman’s cloak, for whoever does these things is an abomination to the Lord your God.” The Hebrew word translated “abomination” refers to something disgusting and repugnant, whether ritually or ethically.19 These verses clearly preclude a woman from changing her appearance to look like a man or a man from altering his appearance to present himself as a woman, and they describe Jehovah’s feelings about men and women wearing clothing properly associated with the opposite gender.

What the Scriptures Teach about Elective Mutilation

As noted above, “transitioning” sometimes involves drugs and/or operations to alter one’s physical appearance so that one looks more like a member of the opposite gender.  In the Old Testament, self-mutilation is associated with idol worship (1 Kings 18:24-29) and mourning among those who did not know Jehovah (Deuteronomy 14:1-2). The Lord specifically prohibited His people from engaging in such cuttings of the flesh (Leviticus 19:28). In the New Testament, a demon-possessed man engaged in self-mutilation before he was healed by Jesus (Mark 5:2-5). Clearly then, the Scriptures depict self-mutilation as an indicator of underlying spiritual and psychological disturbances, and certain studies seem to confirm this observation.20 For instance, a 2011 study of 324 Swedish transsexuals by the Karolinska Institute noted that “[p]ersons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population.”21

While amputations were sometimes prescribed as punishment (Deuteronomy 25:11-12) or inflicted during times of war in Bible times (Ezekiel 23:25), there are no instances of God approving elective amputations in Scripture. Moreover, the New Testament teaches that Christians’ bodies belong to God and must be used to glorify Him (1 Corinthians 6:19-20). There simply is no authority for elective mutilation without His direction or approval.

Concluding Observations

It is not surprising that the Bible does not speak specifically about having a sex change or gender reassignment surgery. Predictably, though, it does address each stage in the progression toward such procedures. First, according to the Scriptures, gender is determined by physiology rather than psychology. Second, attempts to present oneself as a member of the opposite gender are unnatural and condemnable. Third, elective mutilations of the body are indicative of an unhealthy mind that does not recognize and accept God’s ownership of the human body. In short, while the Bible never mentions the phrase “sex change operation,” it denounces every step along the way to such procedures, up to and including the procedures themselves.

A right-thinking person, one free from spiritual and psychological encumbrances, would nourish and cherish his or her body, rather than hate it enough to intentionally disfigure it (Ephesians 5:29). Hence, it is illogical and self-contradictory to recognize gender identity disorder as a mental disorder where the mind does not embrace the reality of one’s physical gender and then proceed to alter the healthy body to conform with the troubled mind.22 Those suffering from gender dysphoria need to change their minds rather than their bodies. Consequently, transsexuals, like everyone else, desperately need Jesus and the Gospel. There is forgiveness and healing in Christ, of course, but, like everyone else, they must submit to His lordship and repent if they want to be saved from the eternal consequences of their sins.


1 “Bruce Jenner: The Interview,” (2015), ABC News, April 24,

2 Buzz Bissinger (2015), “Caitlyn Jenner Talks About Her Mother’s Reaction and Transgender Fans,” Vanity Fair, June 2,

3 “Caitlyn Jenner to Receive Ashe Award” (2015), ESPN , June 2,

4 Katy Steinmetz (2015), “Caitlyn Jenner,” TIME Magazine, 186[25/26]:144-150.

5 Sheila Marikar (2015), “Chaz Bono Talks ‘Becoming Chaz,’ Cher on ‘Oprah,’” ABC News, 1517; Jeremy Kinser (2011), “Because Chaz Bono is a Fortunate Son,” Advocate, 1050:24-31.

6 Andrew R. Flores, Jody L. Herman, Gary J. Gates, and Taylor N. T. Brown (2016), “How Many Adults Identify as Transgender in the United-States,” The Williams Institute, p. 3,

7 Erika Napoletano (2016), “Young and Transgender: Supporting Youth to be Their True Selves,” Chicago Health,; “Sex-Change Treatment for Kids on the Rise” (2012), CBS News,

8 Bethany Gibson and Anita J. Catlin (2010), “Care of the Child with the Desire to Change Gender—Part I,” Pediatric Nursing, 36[1]:53-59; Bethany Gibson (2010), “Care of the Child with the Desire to Change Gender—Part II: Female-to-Male Transition,” Pediatric Nursing, 36[2]:112-117; Bernd Meyenburg (1999), “Gender Identity Disorder in Adolescence: Outcomes of Psychotherapy,”Adolescence, 34[134]:305-313.

9 Mary Sobralske (2005), “Primary Care Needs of Patients Who Have Undergone Gender Reassignment,” Journal of the American Academy of Nurse Practitioners, 17[4]:133-138; Alyssa Jackson (2015), “The High Cost of Being Transgender,” CNN, 07/31/health/transgender-costs-irpt/.

10 Kevin D. Williamson (2016), “The Transgender Culture War,” National Review, 68[10]:30-32.

11 Michael Scherer, et al. (2016), “Battle of the Bathroom,” TIME Magazine, 187[20]:30-37.

12 “Continuing to Stand for Inclusivity” (2016), Target Corporation,

13 Evie Blad (2016), “Feds to Schools: Don’t Restrict Transgender Access,” Education Week, 35[31]:1-14.

14 Charlotte Alter (2016), “Hundreds of Thousands Boycott Target Over Trans-Inclusive Bathroom Policy,”, p. 1; Eva Marie-Ayala (2016), “Transgender Policy Altered After Uproar in Fort Worth Schools,” The Dallas Morning News,; Karen Workman (2015), “Missouri Teenagers Protest a Transgender Student’s Use of the Girls’ Bathroom,” The New York Times,

15 Lawrence S. Mayer and Paul R. McHugh (2016), “Sexuality and Gender: Findings from the Biological, Psychological, and Social Sciences,” The New Atlantis, 50:8, Fall,

16 A discussion of hermaphroditism is beyond the purview of this article. Cf. Elizabeth Mitchell  (2009), “Feedback: Hermaphroditism,” Answers in Genesis, December 3,

17 Diagnostic and Statistical Manual of Mental Disorders: DSM-2 (1968) (Washington, D.C.: American Psychiatric Association).

18 Luk Gijs and Anne Brewaeys (2007), “Surgical Treatment of Gender Dysphoria in Adults and Adolescents: Recent Developments, Effectiveness, and Challenges,” Annual Review of Sex Research, 18[1]:182-183; Paul McHugh (2004), “Surgical Sex,” First Things: A Monthly Journal of Religion & Public Life, 147:34-38; Stephen I. Abramowitz (1986), “Psychosocial Outcomes of Sex Reassignment Surgery,” Journal of Consulting and Clinical Psychology, 54[2]:183; John E. Bates, et al. (1975), “Intervention With Families of Gender-Disturbed Boys,” American Journal of Orthopsychiatry, 45[1]:150-157.

19 Francis Brown, S.R. Driver, and Charles A. Briggs, eds. (2008),  A Hebrew and English Lexicon of the Old Testament (Peabody, MA: Hendrickson), pp. 1072-1073.

20 Mayer and McHugh, p. 9; Masahiko Hoshiai, et al. (2010), “Psychiatric Comorbidity Among Patients With Gender Identity Disorder,” Psychiatry & Clinical Neurosciences, 64[5]:514-519; Annelou L.C. de Vries, et al. (2010), “Autism Spectrum Disorders in Gender Dysphoric Children and Adolescents,” Journal of Autism & Developmental Disorders, 40[8]:930-936; Azadeh Mazaheri Meybodi, Ahmad Hajebi, and Atefeh Ghanbari Jolfaei (2014), “The Frequency of Personality Disorders in Patients with Gender Identity Disorder,” Medical Journal of the Islamic Republic of Iran, 28:1-6.

21 Cecilia Dhejne, Paul Lichtenstein, Marcus Boman, et al. (2011), “Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden,” PLoS ONE, 6[2]:1-8.

22 Colin A. Ross (2009), “Ethics of Gender Identity Disorder,” Ethical Human Psychology & Psychiatry, 11[3]:166.


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