Theology in the Raw - S2 Ep1094: A Raw Conversation with the Master Yoda of the Faith and LGBTQ Conversation: Dr. Mark Yarhouse

Episode Date: July 17, 2023

Dr. Mark A. Yarhouse, Psy.D., is a clinical psychologist who specializes in conflicts tied to religious identity and sexual and gender identity. He assists people who are navigating the complex relationship between their sexual or gender identity and Christian faith. He is the Dr. Arthur P. and Mrs. Jean May Rech Chair in Psychology at Wheaton College, where he runs the Sexual and Gender Identity (SGI) Institute. He is an award-winning teacher and researcher and is the past recipient of the Gary Collins Award for Excellence in Christian Counseling. He has published over 80 peer-reviewed journal articles and book chapters and is author or co-author of several books, including Understanding Sexual Identity: A Resource for Youth Ministers and Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture. His most recent books are Sexual Identity & Faith and Costly Obedience: Listening to and Learning from Celibate Gay Christians. In this conversation, Mark and I talk about many things related to his journey in the sexuality/gender conversation over the last 25 years including sexual orietnation change efforts, the cause of same-sex attraction, the complexity of gender dysphoria and gender identity, the role that social influence plays in the rise in teens identifying as trans, and many other questions. 

Hello, friends. Welcome back to another episode of Theology in the Raw. It is my great honor to have the one and only Dr. Mark Yarhouse on Theology in the Raw today. Dr. Yarhouse is a professor of psychology at Wheaton College. He's also the director of Sexual and Gender Identity Institute at Wheaton College. He's the author of over 80 peer-reviewed journal articles and book chapters and the author or co-author of many books, including Understanding Sexual Identity, Understanding Gender Dysphoria, Sexual Identity and Faith, Costly Obedience, and many, many others. If anybody has done any kind of research in the question of faith, sexuality, gender identity, especially looking into some of the psychological questions that often come up. I've got a mentor either formally or informally to so many of us that have

wandered into this conversation. So it's a great honor to have my friend, Dr. Mark Yarhouse, the master Yoda of the sexuality and gender conversation as it pertains to the evangelical Christian faith. Mark, I can't believe this is the first time you've been on the podcast. So anyway, this has been a long time coming, but thanks for coming on. Yeah, I'm glad to do it. I'm surprised. I haven't connected either, but glad, glad to do so today. Well, there's been a few people where I'm like, you know, wake up one day. I'm like, oh my word. I've never had that person on the podcast, even though I'm like close to them and friends with them and, and run in similar circles. So I think you're, you're one of those, the one that I'm like, I can't believe I haven't had you on. So it hasn't been intentional for sure.

I don't know if that's the first time you've been called the master Yoda of the sexuality, gender conversation. Definitely the first time. Yeah, definitely the first time. I mean, you've been in this space for a long time. Can you take us back to the beginning? When did you get interested in this conversation? It's been almost a couple decades, right? Yeah.

in this conversation? It's been almost a couple of decades, right? Yeah. So it's been 25 years that I've been teaching psychology as a professor. And actually prior to that is when it occurred. So I was a graduate student and I was studying at Wheaton College and I had the department chair, Stan Jones, who's been a mentor to me for years. He invited me to be his research assistant. And it was such an honor to be asked. I just said yes without knowing what we were going to even study. And so I come to the first meeting and he asked if I'd read anything that he'd written. It wasn't the worst interview you could imagine. It was just terrible. But he had like three lines of research and one of them was on sexual orientation. And he wanted, in particular, to look at how mainline churches were developing these sexuality task forces, and they were reviewing scientific research and saying, here are the ethical conclusions we draw based on what we find in the research. So he wanted to look at the science. What does the science actually say?

And then what's the logical relationship between the science and the ethical conclusions for the church's moral debate? And I had a philosophy background as well as psychology, and he thought I could sort of help him kind of think through that with him. So we worked on that probably for four or five years. He became the provost, so the senior academic officer at Wheaton. And the level of look around, there are no Christians in psychology writing about these topics. And the Christians outside of psychology didn't seem to be familiar with all the research I'd been studying the last four or five years. So to me, it almost felt like a matter of stewardship. Like here I'd been given this mentoring relationship, this opportunity, what would I do with that? And I had other areas of interest, other reasons I went to graduate. I mean, this was not a topic that was of interest to me. I just was doing my work. And, you know, that served me well at the American Psychological Association, other places like that.

The other thing I would say about that is that his I think his his calling and he and I've talked about this has been a little bit more apologetics, like defending orthodoxy, kind of that understanding. And I think mine, I had to find my own path. So let me tell you one more story about that. And then it was the first APA conference I went to when I was starting as an assistant professor. And I was listening to two gay psychologists talk about gay Christians who were leaving the gay community to go to Christian ministries that they said were harmful to them. And I thought, wow, what an interesting research question. Are those ministries harmful to these gay Christians? And then he said, thinking the audience was mostly gay psychologists, he said, we are failing our people, by which he meant we're failing to meet needs for spirituality and the sacred. And so they leave

the mainstream gay community to go find that in these ministries that are hurtful to them. And I just was really struck by that phrase, our people. And I realized later at lunch, I just had never heard a pastor, never heard somebody say from the pulpit, we're failing our people, by which the pastor would mean we're failing to meet needs for identity and community and significance. And people find that not in the church. They find that in the mainstream LGBTQ community. So I think a lot of my research ended up being a little bit more pastoral and like, how do you how do you walk with people through what's the developmental journey like? How do you come alongside people?

So it had a little bit of a different flavor. Stan and I's views are very similar, but we just have had a different kind of lines of research. And I think that's been a big part of what early on was part of my career. What if your first projects, maybe it was your first, was that more academic study you did, the longitudinal study done on the effectiveness, I'm probably butchering the title, I'll let you correct it, but the effectiveness of sexual orientation change efforts. Was that your first kind of major project that you did? Or was that early? I know it was early on in your career. Yeah, it was right out of the start.

It was something that Stan was the principal investigator for. that Stan was the principal investigator for. And he worked with me and a couple other people around the country to kind of be hubs where we could interview people. We did a lot of face-to-face interviews of people in those ministries. And then it became mostly online interviews. People would move and it was a seven-year longitudinal study so it ended up being quite a but it taught me a lot about doing research i hadn't really apart from my dissertation i hadn't really done a lot of research um so to be able to work with him on that and see how you set that up and move through your institutional review board and all the things that go into the ethics of it it was really very instructive for me i felt felt like once I had done that, I could probably do any, any other kind of research study. I mean, that's a pretty heated part of the, I mean, this is a heated conversation in general,

but that particular, you know, can people change their sexual orientation is one of the more heated points. What, what did you, what did you find in that, in that study that study well it was a study that nobody nobody liked i mean it was so i think on the one hand on the because this was a very political discussion yeah coming out in the 1990s into the early 2000s and it was it was very heated conversation i think when we published the study there were kind of these two broad views in that heated exchange. And I think some of them were kind of the skeptical pessimist who would say nobody has ever experienced any change whatsoever. And so there was no way that you could have documented anything. And so those folks weren't happy with the study because we did document some meaningful shifts for some people on the continuum. And then on the other

extreme were people who would say that anybody can change if they have enough faith, they put enough effort. And so you can have this kind of 180 degree and we didn't show that either. So it was like, nobody liked the study because it just, and I think today we would frame it differently. You see, you know, you see people having demonstrated fluidity in sexuality, particularly among sexual minority females, and ours was just an outcome study. So we didn't really study the process. We know that they were in small groups, they were praying together, going through curriculum, studying God's word, but we didn't do a process study where you'd look at the variables that would predict an outcome. We just looked at the outcome.

Did people experience change? For all I know, we demonstrated fluidity for people over time. Or I think what was more likely, I think we demonstrated behavioral change and identity label usage and things like that. And some, possibly some underlying patterns of attraction for some people, but probably not as much as people wanted to claim it was and more so than people said was even possible because it had a lot of political stakes in demonstrating anything like that. But then later you have Lisa Diamond, other people saying, no, there is some fluidity documented here. And I think had we framed it more that way, it would have been received differently.

But I think still there's people who would say, and I don't know whether, I mean, I know testimonies of people who would say their orientation has changed. I don't take anything away from that. But that's why you do research. Is it likely to be the next person's experience or how likely that be so i mean there's several several problems i see and this is not methodology and all this stuff that you are an expert in is not my expertise but just looking on from the outside it just several questions come up like what do we mean by change very big difference between somebody changing an identity that can happen within a second you know i could say you know

being a dodger fan is part of my identity or being an American. I'll just like wake up the next day and say, nah, not, not for that team. Or, and then, you know, just the concept of identity can be really flexible and fluid and complex. So changing identity to me feels very different from someone's actual sexual orientation changing in a radical way. Or even like, what about change from like, I used to lust a lot and now I don't. Well, that's different from I'm attracted to the same sex and now I'm not. Or sexual behavior. Changing sexual behavior is a vastly different experience than, again, your unwanted or unchosen attractions changing. Am I right to ask these questions? I mean, just the concept of change is so complex. yeah so we we've included so many different measures because we didn't think we'd be

criticized if you didn't use kinsey if you didn't use the klein if you didn't use shively indicate like we had all these metrics this was a long interview and uh the packets that we used everything but i think what was clearer to me at time seven at the end of the study than it was at time three when we wrote the book, when we wrote an actual scientific article that was peer reviewed and published, when we did that one, I think it was clearer to me what had happened. Because the change that we recorded happened between time one and time two, and then was just maintained from time two to time six. And it was like, so to me, and people kept saying, keep doing the study, keep interviewing, because people, the changes will come, the changes will come. Well, the changes were at the very beginning. And so I started to think, what happens at the very beginning of participating in a Christian ministry? Well, at the very beginning, if you were sexually active, you try not to be sexually active. At the very beginning, you're often told not to identify yourself with the

mainstream identity labels that are used in the community. So you end up seeing those changes more well-documented. And I'm not saying, again, that there couldn't have been any underlying patterns of attraction, but the data didn't line up with that explanation as well as the idea of behavior and identity being the most obvious and the clearest examples of change early on that would then be maintained versus an underlying attraction, though that may have been what happened for some people. And does self-report, I know that's part of just what we have to rely on, right? In studies. But I mean, that can be really sketchy, you know, like relying on self-report, especially, well, at least yours was longitudinal because some people are like,

no, I know a person and he said he changed. And I'm like, okay, well, I don't ask him in 15 years. I don't know. Or I mean, if you perform some more objective measures, would it line up with his self-report? Yeah, I mean, we've thought about that for a little bit. Like, you know, would you do measures of arousal? But the way that those studies tend to be done is through, you know, showing people explicit images and then measuring arousal. And so the ethics of that with a Christian sample whose own ethical conclusions would be that they not look at explicit images. So how could you justify it? So there were a lot of things that we were grappling with that were good lessons for me as a young researcher. How do you even do stuff like this? But I think you had to rely on self-report for that kind of thing. Yeah, you're being pretty PG, but I've read some stuff, I think by Michael Bailey and others, a secular psychologist who's done similar studies where you can plug somebody into a machine and have them watch certain kinds of porn and actually measure blood flow and stuff. Yeah. It's got to be, would you say, more reliable than self-report? I mean, but again, there's some, obviously some major ethical questions with,

with those methods, but, um, I guess just to ask the million dollar question, I mean, in your opinion, based on your research, can people, or do people change their sexual orientation? How, how would you, if someone asks you that, like, Mark, don't you think, can't God change people? You know, like how would you respond as I'm sure you've had to do many times to, to that question based on your research? Well, I mean, stepping away from being a researcher for a second, just being a Christian in this space, I mean, I've known people who have said, that's my testimony. So I don't, you know, Christianity is a religion of testimonies. I mean, I don't like look at that and say, that's not possible. It didn't happen. But you do research to say, how likely is it to be

the next person's experience? Because there's a sense of responsibility I think you have with that. And I'm less likely to say that that's a likely outcome for people. But I also respect Lisa Diamond's work. I respect demonstrating fluidity in this space. So the question is whether you can manipulate the outcome, different means, or whether it's a natural place of fluidity for some people. And I'm more comfortable with the natural fluidity. Manipulating the outcome, we've heard from a number of people how difficult that was or how shame producing that was. If it didn't produce the outcomes, how much that affected their faith, their relationship with God, the expectation of sanctification associated with it.

There are all kinds of unintended consequences of going down that path that has raised a lot of concerns for me anyway. Have you seen that pretty extensively? I've seen it anecdotally. Anecdotally, like lots of friends that I know that have been through some kind of reparative or conversion therapy. I mean, in everything you said, the damage to their faith, the shame, the didn't help their sanctification kind of growth. Is that a pretty widespread, maybe unintended consequence of these efforts? Yeah, I think many people have reached that conclusion. have reached that conclusion. So some of it's in research, but a lot of the design is convenient samples of people who are likely to be drawn to a study to make those statements. Doesn't mean it didn't happen, but I don't know how likely it is to have. It's the likelihood

that we're really talking about. Like in our study, we didn't really show harm. Now, the kinds of things people were doing, again, they were praying together, they were reading scripture together, they were in corporate worship together, going through a workbook together. And even the 2009 APA Task Force report, when it talked about, it was a report on the appropriate therapeutic responses to sexual orientation, and it was against sexual orientation change efforts. But it looked at these ministries and said, you know what, there's good things that come out of these ministries. There's a space here between the church where people don't always feel safe emotionally and spiritually to attend

and not having anything. And so they find themselves in these church kind of ministries, and they find fellowship, they find social support. So there were some elements of that that were actually noted to be positive, which I was really surprised to see documented there. But I think some studies have shown that, but a number of studies have shown the unintended consequences as well. And I think those are important to weigh in this conversation. the unintended consequences as well. And I think those are important to weigh in this conversation. Another question you've addressed, I mean, in several of your books, I believe, is the question of causation. Are people who are gay, are they born gay? Is it nature? Is it nurture? What are your, I guess, maybe just give us your own perspective, but also just

maybe more of a global, like, where is the science at on that? I know there's been loads of studies done on causation. Can you give us a summary of where the data is on that? Yeah, it's not the rest of our podcast. No, it's, I mean, honestly, the short answer is we don't, we don't know. I mean, it's, you know, probably the last largest study that was done was just, what, 2018 or so. It was the half a million participants, the genome study. Oh, yeah. So it just was showing five areas that were suggestive, but they just weren't really showing. I mean, if you're looking for like a gene, I don't think you're going to see that.

I think you're going to see markers that are suggestive. I think that is what we're seeing. The way that I've often talked about it is that it seems that some people receive a push in this direction, but the push is not determinative like eye color or hair color. And so there have to be other things going on. What are those other things? Well, we don't really know what they are. So clinically, most of my effort when I meet with like parents, especially because I work with a lot of Christian clients, is helping them not feel the guilt like they did something that caused their child to be gay, or they didn't do something, or we should never have moved as much as we did, or you shouldn't have worked so much outside the home, or you shouldn't have all these different, because we're meaning

making creatures. And so parents will find meaning, even if there's no support for it to say, okay, at least this makes sense. Why our son, why our daughter? And so, and they often go to ministries to get help. And they often, the fingers often pointed at them like they did something because a lot of the theories in Christian circles implicate the parents. So I do a fair amount. Now, you know, I don't know what caused their loved one to be gay, but I really don't think the parent did something or failed to do something. And I think that taking that burden off the parents is actually a good clinical pastoral use of not understanding really what causes sexual orientation to develop. So we can't reduce it all to biology, nor all to environment.

It's not all nature, nor is it all nurture, some kind of complex blend of both. nurture, some kind of complex blend of both. But there does seem to be in many, if not most cases, at least some kind of biological push. Is that the right phrase to use? I mean, without saying there's like a certain gay gene or something. Yeah. I mean, it seems to be people's self-report of like earliest experiences of attraction at puberty, not really having any say in that. I think, you know, one of the mistakes that we make in Christian circles still to this day is that we act like it's something the person chose, that chose to have these attractions or, and I, you know, apart from rare examples from radical feminism, there really just aren't documented examples of people saying that they chose to have these types of experiences.

So I usually look at the question more as what is volitional? Like what does a person have say over? Of course you have say over behavior and identity, and you can reinforce patterns of behavior throughout your life. But to say that you said, I'm going to set the course here to be gay through the pursuit of these attractions. I'm going to create these attractions for the first. I mean, that just is a really naive view of it. And I think it leads a lot of people to just find the church to be so

irrelevant to them. Because if you say that about me, why would I trust you with anything else? Because I know that that's not true. I've often used the analogy. I would love to hear your thoughts on it. Even if something isn't all biology, it doesn't mean it's there for a choice. For instance, I have nothing in my biology that has wired me to be an English speaker. And yet I didn't wake up one day to choose to speak English over Spanish, whatever these, this is a 100% my environment. There's nothing in my biology to be just,

just, you know, predisposed to speak English. So just because it has no biological roots, doesn't mean it has any, anything to do with a choice on my part either. Like, um, the whole nature nurture thing is a lot more complex than people make it out to be. Is that a good analogy? Again, showing the point that even if it's not total biology, it doesn't therefore mean it's kind of a raw choice. Right. Absolutely. That's a good example. Oh, yeah.

We have a slew of controversial stuff to talk about. I want to know about the posture you've taken. I mean, you're so, if anybody knows your work, they know that you have cultivated this extremely gracious, fair, kind posture in what is a very heated conversation. Does that come naturally to you? Is there a story behind that? Why have you really been committed to taking that kind of approach to this contentious topic? Yeah, I mean, part of it, I think, is my temperament, my personality. I actually don't, like, seek out conflict. A lot of people think you must,

you know, really, like, love controversy. Actually, that's actually not, people who know me know that that's actually not the case. And as I mentioned, I didn't get into this with an ax to grind saying I've got to study this. I've got to defend. I've got to do this. I just, you know, happenstance or providentially, I was I was in a situation of being mentored in an area of research that had been neglected by Christians. And I felt like I should be a good steward of that. So I think I entered into the conversation with a more dispassionate tone. I did research. And so I would present it research. You know, people sometimes expect an evangelical Christian to show up at APA with their Bible.

And like, but I would come with, you know, my PowerPoint slides and my findings and things like that. It doesn't mean everybody agree. I mean, there's plenty of people who would dismiss me at APA. But coming with research and having a conversation about research certainly puts you in a better position to dialogue. And I have often been sought out dialogue partners, either at APA or other venues, just to talk through these things, in large part because of that early session I sat in on and some other relationships like that that were formed. I got to know people who were

fairly prominent in the LGBTQ community as part of the APA. And some are good dialogue partners and some are not just like Christians. Some are good dialogue partners within Christian communities and some you cannot dialogue with. They just would not have a healthy conversation with you. And that's the same, I think, across the board. So that helped. And I had, you know, one of my person who hired me in my first academic position said, you know, I love the work you're doing. I'll support you in that, but you have to make a decision. We can either kind of hide you in your office and you can kind of do your work quietly, or you can lean in and be a part of the academy, a part of APA, you know, and be more visible in that way. And if you do, I will support you in that. And I'd kind of like,

I think that would be, I want you to think about that and pray about that. And I'd kind of like kind of, I think that would be, I want you to think about that and pray about that. And I ended up going that route is, you know, being a part of different task forces, doing different consultations for, you know, the National Institute of Corrections or other organizations that are secular, being active in APA in my division. So, but I think when you do that, you have to decide, are you going to come in looking for a fight? Are you going to come in trying to be, and I've made mistakes. So it's not like I've learned some valuable lessons, but then over the years, you have people who want to research with you, study with you. It's either part of their story or it's someone close to them. So those relationships have deeply influenced me.

to them. So those relationships have deeply influenced me. You read, you know, thousands of pages of transcripts of people that have been interviewed. You work with families over 25 years. It does lend itself to being, I think, more pastoral, more therapeutic. How do I walk with people in this space? And I think that just lines up pretty well with my temperament. I think you've used, said APA, I think most people know what that is, but the American Psychological Association, what is it? The biggest psychological organization in the country? Is that the best way to describe it? And not a particularly conservative group of people. And you've been a part of it for a long time. What's that been like being an evangelical to describe it or and not a particularly conservative group of people what's it and you've been a part of it for a long time what's that been like being an evangelical christian in

a space that i mean are you the only one one of the only evangelical christians that's a part of that and are you well respected or do people kind of look at you funny or what's that experience like yeah it's mixed i mean there are definitely a lot of other Christians in APA, but proportionally, psychologists tend to be less religious than the general population. Among those who are religious, fewer would be necessarily identified as Christians or evangelical for sure. There are definitely some. I mean, a number of the integration programs, their faculty and their students are part of APA. So when you think of integration doctoral programs like the one at Wheaton or at Regent University or Fuller Theological Seminary, Rosemead, you know, George Fox, these different institutions

are all active at APA. And they're developed programs that are accredited by the accrediting bodies there and things like that. So that's I mean, it's a challenging space. Not many are in LGBTQ studies and that's a whole other thing. But a lot of other Christians are really well respected in APA. But there's not that many of them and they're not you know, they have different different lines of research and things that they do. I think for me, it's been mixed. I mean, some people really would denigrate me or anything that I would produce. They would be very skeptical of me because of that first study that I did, because I'm an evangelical, because I teach at a Christian college. Those types of things would just be right out of the gate. We can't trust, you know, that. Others have been very positive. Even people that started off in a tense relationship have developed into good relationships. So like when I've served on a consensus panel from the American

Psychological Association that gave input to SAMHSA, the Substance Abuse and Mental Health Services Administration on care for LGBTQ youth. So I've done that a couple of times. And so to be invited into that is through relationships of people who at high levels are making those decisions and they're looking for people who are subject matter experts in these areas. Who can we trust to be in a good faith dialogue about the science and its application to this population? So I'm not really brought in so much because of expertise in LGBTQ issues, but because of the intersection between conventional religiosity and LGBTQ issues. So the fact that I work with Christians in particular and navigating the intersection of people of faith, like that's a, that's an, that's an underrepresented population in some ways in these conversations.

And I think that's sometimes why I get invited into that. So those, those would be very positive views of my work and, um, but I wouldn't want you to think that it's always positive. It's kind of a mixed bag yeah well yeah and again the fact that you're an evangelical christian that space is one thing but the fact that you're dealing you know extensively with sexuality and gender questions from a more evangelical perspective i i would i can only guess that there's some people that would be pretty not excited about that but um i'm curious i mean so you there i'm sure there's some tense times you've had in that space but then also on the other side of the aisle you know there's been

probably a lot of tense conversations and dialogues you've had from other evangelicals who don't for whatever reason don't like your approach i would imagine you've received a lot of criticism over the years. How have you handled that? And what are some of the maybe critiques you've received? And you still have your sanity, I think. I should probably talk to your wife about that. Right. Well, I think people have been, for the most extreme views in the Christian circles, have been wanting me to just be an echo chamber for reorientation efforts, those types of things, because I did do that study. So, you know, I get criticized on the one hand for doing the study,

on the other hand, not really landing in the way people want me to say things when I'm looking at the data myself and saying, I don't think it says what you want it to say. And so I think I get criticism on that end. That's died down a bit. That was hotter when I started my, you know, maybe 10, 15 years ago. But I think the ex-gay narrative has diminished some in our, even in Christian circles to some extent. But I think on the transgender conversation, I have viewed that differently than sexual orientation. I think gender identity is a different conversation than sexual orientation. I think it's different theologically in scripture. I think it's different from a scientific research standpoint, clinically. There's so many layers. And we just say it, LGBTQ plus.

But the differences there are significant. And I think sometimes people want me to say certain things about transgender experiences, particularly right now when things are so heated and so divisive in our society. People want me to land on say this, say that. And I don't say exactly what people want me to say. And I'm not meaning to do that. I'm just meaning to be honest about my answers. Because I've honestly, Preston, I've always seen people in that space. Even when I

started my career, as rare as it seemed to be at the time, I would often see children and adolescents who were gender atypical. Now, some of them developed a sexual orientation identified as gay or bisexual, but others were dealing with gender identity issues. And so it's not like it's, even though it's feels like it's a new thing, in some ways, there are some new elements to it. It hasn't been a new thing. It's always, it's been there throughout my career, preceded me. It's going to, it's going to be far beyond my time here. Yeah. So let's, let's transition to that then. You entered into the gender conversation as an evangelical. I think your book in 2015, Understanding Gender Dysphoria, what, what, way ahead of its time. I mean, I was only a few years

ago, but I mean, this is, now there's a lot of secular writers that were, you know, in the, yeah, Bailey and Ann Lawrence and, oh, who am I? Ken Zucker and other, you know, in the 80s and 90s doing research on gender dysphoria. But from a Christian perspective, there's a national youth worker convention that was happening. And I would do these pre-conference workshops, five hours, maybe an hour and a half regular workshop, all on, you know, sexual identity, sexual minorities, gay youth, things like that. And then about 2012, 2013, all of the questions were about gender. All of them were on transgender. And of course I'd worked in that space, not really done research in it, but I'd worked with people clinically and I was really just struck. And I realized then, and I reached out to my editor and I said, I submitted a book manuscript and I said, this wave is going to crest on the evangelical church and we're not ready for this conversation. And so he, you know,

he passed it around to his board when they make these decisions and they came back and they said, look, all of us know someone who's gay, family, extended family, whatever, but none of us knows anybody who's transgender. Are you sure there's a readership for this book? And it does sound really funny today, given how, you know, the transgender tipping point, Laverne Cox, all of it. But at the time, it was like, do we roll the dice? I think they, I'd written for them before. I think they just said, let's give them a contract to kind of placate. But then, you know, the book actually is published the same month that Caitlyn Jenner transitioned is when it came out. It was so the timing of it was was really worked out really well. But, you know, since then, you know, I've published a couple other books in that area.

I never thought I would write a book in this area because it's, I mean, it was such a rare phenomenon early on in my career. Never thought it would rise to the level of the kind of cultural salience that it has today. And, you know, it's not, that first book was just to explain to evangelicals, what is gender dysphoria? What is transgender? What does this mean? And I didn't want the church to make some of the same mistakes they made around gay and lesbian issues by making hyperclaiming about causal theories, hyperclaiming about change. And I wanted the church to sort of respond to this with a little more nuance. And that's kind of what led to that book. Does the Bible support same-sex marriage? That's a question that many

people are wrestling with today. And there's, you know, people who hold passionately to different answers to this question. Now, most dialogues about same-sex marriage, they end with divisiveness and confusion instead of clarity and a better understanding of the other person's position, and even a better understanding of your own position. This is why I wrote a book titled, Does the Bible Support Same-Sex Marriage? 21 Conversations from a Historically Christian Perspective, which comes out in August this summer. So what I do in this book is I first talk about how Christians should even go about having a profitable conversation about contentious issues. I really want us to cultivate a better posture and how we even go about defending our points of view or trying to refute others. I then lay out a biblical theological case for the historically Christian view of

marriage. And then for the rest of the book, I take what I see as the top 21 arguments for same sex marriage. And I respond to each one in a way that's both thoughtful and thorough. Some of these arguments are, you know, since some people are born gay, then God must allow for same-sex marriage, or, you know, the word homosexual was only recently added to the Bible, or the traditional view of marriage is harmful to gay and lesbian people, and many other arguments that I wrestle with in this book, Does the Bible Support Same Sex Marriage? So if you're looking for a theologically precise and nuanced approach to these arguments, one that doesn't strawman the other view to make it look bad, then I would

encourage you to please check out my book, Does the Bible Support Same Sex Marriage? You can order it now on Amazon or wherever books are sold. What are some of the big picture differences between LGB and T and some of the, you know, cause you've said a few times, you know, there's just a lot of more complexity here that people don't understand. What, what are some of those things that people should understand about the T? Yeah. I mean, just the basics between sexual identity conversations are about how you identify yourself based on your sexual attractions or orientation. So someone says they're gay or they're lesbian or straight for that matter. They're using sexual identity categories.

Gender identity is your experience of yourself as a boy or a girl, a man or a woman, or a different experience than that. And that brings you into the transgender conversation. Does my gender identity correspond with my biological markers or is it different than that. And that brings you into the transgender conversation. Does my gender identity correspond with my biological markers or is it different than that? And so that's the biggest difference just to get right out of the starting point. But then I think, and this is obviously also contested, but I think scripture is clear about sexual behavior. I don't think scripture really addresses gender identity in

the way, I mean, I think it assumes it, but it doesn't really speak to it in the same way. That doesn't mean, I mean, people respond to that with, okay, that anything goes. I'm not saying anything goes, but it just means we have to do a little bit more, you know, a little more thought about that than if scripture doesn't directly address something. So I think those pieces, I think it's, you know, when you think of someone saying, well, maybe my attractions don't change, but I could be chaste as a single person, that would mean pursuing celibacy. Well, we can look at that. How is that for people who go down that path? But I do think it's, those are achievable things. I mean, I think people can be, people can refrain from sexual behavior as difficult as that may be.

What's the equivalent around the gender question? What is permissible for Christians? What's impermissible? What guidance do we get from scripture scripture i think those are just more complex questions and so much of our the way people present themselves is through clothing and hairstyle things that are definitely culturally situated um do we want to make universal claims about hair length about the clothing we wear in one society i mean what what becomes morally problematic? I think I've always struggled with where's the line exactly for people in this space. So anyway, I think those are some important differences. I agree. And some people get troubled when I say exactly what you said, that there is more clarity, I think, in Scripture when it comes to what are the created boundaries for sexual expression and relationships. I think we have, again, people debate this obviously,

but I think we have a fairly clear definition of marriage. Maybe not definition, but I mean, it seems that when marriage is talked about, sex difference is part of the biblical expression of what marriage is. There's passages that talk about, you know, purposes of marriage, themes, you know, certain sexual expressions that are out of bounds. So we have those kind of like just actual verses, you know, that are addressing directly the questions we're asking. Whereas with gender, it's just, it's a lot more complicated. I've often said that I think that where the theological discussion needs to be had has to do with like a theology of the body or themes surrounding just theological anthropology. Your colleague, Mark Cortez, has done some great, great work there.

And so it's more of these broader theological themes that I think do give us probably more a stronger theological foundation than some people might give credit to. But it's just, yeah, I'm very happy to say there is no clarity. God has given us guidance, but it's not of the kind of real chapter verse explicit sort that we have in sexuality. So gender dysphoria in particular, can you just describe maybe, yeah, again, kind of a one-on-one foundation? What is that? And I ultimately want to get to the nitty gritty questions surrounding how do we alleviate gender dysphoria? that psychotherapy is just not going to do anything for them? Or have we not explored those avenues as far as we should? Is transitioning, aside from the moral question, is that an effective means to address gender dysphoria? And each one of these questions I know it's debated and complex, but that's why we brought you on. Yeah. So gender dysphoria is, so if you think of euphoria as a positive emotional state, dysphoria is a negative emotional state.

And it's associated with when your experience of your gender identity doesn't correspond with your biological markers. So for the majority of people, your experience of yourself as a man or as a woman corresponds with biological markers like chromosomes, gonads, genitalia. But for a percentage of people, there's a discordance there. And when that discordance is painful for them, we call it gender dysphoria. And that pain can be mild, can be moderate, can be severe. So if I had 10 people in front of us, you could have 10 different levels of severity of dysphoria from mild to severe. And if you had one person in front of us, you could have 10 different levels of severity of dysphoria from mild to severe. And if you had one person in front of you and they had dysphoria throughout their lifetime, you could have different levels at different times. And so people kind of intuitively try different things in a kind of a stepwise fashion to see if it helps. And the things that people generally gravitate towards

to help are things like wearing clothing that expresses something that they experience inside, or they do their hairstyle shorter for a natal biological female or biological male might wear his hair longer or wear light makeup. And, you know, again, they have to ask, okay, is that, I mean, we let people do that, like pair their hair or wherever, however they want. And it's not typically a moral issue, but what if it's actually helpful for them? It alleviates distress. Is that okay? And that brings you to the question of on a continuum of efforts. And I usually think least invasive, you know, hairstyle to most invasive surgical interventions, you know, and I, and I, what I would argue is the way that our culture sometimes talks about and presents people who are transgender

in social media entertainment, we almost treat it like a mountaintop experience that everybody moves towards medical interventions. And it almost becomes this, yeah, mountaintop experience that everybody should sort of hike towards. And the reality appears to be that most adults plateau at some point short of any of those mountaintops. If you think of one mountaintop is, you know, cross-sex hormone treatment, Another one is gender surgeries. Many people seem to plateau at other places. And I'm basing this on a couple of studies that have been done with adults where they've asked them about this and they've, you know, only, you know, like I think it was 44% of adults reported using hormone treatment in the U.S. transgender survey that was done

in 2015. Twenty-five percent used any gender confirmation surgeries. The Kaiser Family Foundation just put out a study maybe two months ago. It's much smaller, like 500 adults, but it was even smaller percentages who used hormones or who used surgeries. Now, we don't always know why, or it could be that they don't have good adequate coverage, and they would if they had better health insurance. It could be the cost, could be concerned about the long-term side effects. There's a lot of those things to look at. But I wouldn't want us to talk to people as though it's a foregone conclusion that everybody does those things. It's just not the case. Those percentages are small. I mean, I knew it was smaller than what people would expect,

but those are lower than I would even have expected. 44% in that one study pursued some kind of hormone therapy. Yeah, I would have, if you just asked me to guess, I would have said like 70, 80% or something. Yeah. And the Kaiser one, I think it was even lower. It was like 31%, something like that with hormones and maybe like 16% with surgeries. So I'm not sure we're always getting the most representative samples that's hard to get at. And then what would people do if they had the option, if they don't have the option, but I just think, you know, if we, if we continue to talk about it as a foregone conclusion, I just don't think it captures the landscape right now. And I think giving people more options along that continuum is probably wise. And I think for Christians, especially, I think we struggle with what is okay to do in that space, maybe more than other. Do you find that, you know, like, so in the sexual orientation conversation, you know,

we've learned that it can be kind of problematic to try to identify something in your past that might have caused this or whatever. I found that with gender dysphoria, though, there is a – and I guess I'm going to state it like a statement as if I know what I'm talking about, but I would love your critique or pushback or correction. It seems to me like there is at least a higher percentage of people that if they experience gender dysphoria, they're sometimes maybe even oftentimes, there are past traumatic episodes or, you know, things that, again, if they work through, that gender dysphoria might be linked to and if they work through something they haven't worked through, it actually reduces dysphoria. There was one, a study, an online study, it wasn't peer reviewed, so I don't want to bolster it, but it was a study of over 200 biological females that experienced gender dysphoria. And one of the questions was, what are some things you do that helps

mitigate or alleviate, reduce your dysphoria? And the number one response, I think 88% said dealing with internalized misogyny. So there's something in their environmental, maybe with a domineering father. It almost sounds like you're going back to the kind of ex-gay narrative, but it could be, you know, in their environment, being a woman was seen as bad and low and shameful.

And then that, when they looked at their female body, it was, it kind of exacerbated this like, ah, I don't like this because I'm being told that being a woman is not a good thing. Is that, is that an accurate perception that gender dysphoria does have a higher percentage of possible connections to life experiences than what we found to be in sexual orientation over the years? Well, certainly some studies are showing that. Again, I'm not sure that they're representative studies. They're not all well-designed. They're often convenient samples, but there are correlational studies like the one you're describing. I'm not sure exactly that

study, but there are other studies that have correlates like that. There was even a study that I think I cited in my book about parents wanting to have a child of one gender, child of the other gender. It was correlated with later dysphoria. I think the mistake I want to help Christians avoid is hyperclaiming a theory of causation as though we're certain it's that. Now, you did a good job of setting that up. That's not what we're saying here, but there are suggestive correlates that say, we should probably study this some more. We should look into this more. We should do better design studies to look at that. I think that's a great idea. I don't know if they'll be done or if they'll be funded, those types of things, but I think it's a good idea.

So we should avoid hyper-claiming theories of causation. And I think we should avoid claiming theories of resolution that, like, let's say there is trauma in their history. And I've known a number of people with trauma histories in this space, for sure. I wouldn't say the trauma caused this, but I would look at that with them. I don't know. I don't know what caused this, but, okay. But then I would also treat the negative sequelae from that trauma. But I wouldn't say that if I did that, this would all resolve. I would just say it's good to do that.

Like, that's a good thing to do. It's always good to deal with undealt with trauma. Absolutely. Absolutely. And it's probably a good reason to slow down if they're saying, I want to make these jumps in medical interventions and those types of things. I mean, there are some reasons, I think, why some people should slow down in that decision. Now, I don't, you know, we're not in a place of mental health professionals functioning as gatekeepers for adults in this

space the way that they have in the past. But I think for people to look at that, look at those, in the past. But I think for people to look at that, look at those, like even like autism spectrum disorder is correlating with gender dysphoria. So we've been encouraged to assess for that and to address that. And so you always try to look at these co-occurring issues and say, okay, have we adequately addressed these other issues before you jump into things that would be really dramatically life-changing? So obviously it's more contentious with minors. And when I started my career, generally, if you saw a minor, you know, you help them as best you could, you help their family, their parents respond, but you sort of saw them going to adulthood, then you'd refer them to an adult gender clinic.

There really wasn't as much emphasis on what do you do at 13 or 14? These newer interventions of blocking and transitioning and things like that really weren't there in the U.S. when I started my career. Okay. You brought up youth culture. In my experience, it just seems when people ask me, you know, but okay. You brought up youth culture in my, in my experience, it just seems when people ask me, uh, you know, kind of a broad brush, you know, the transgender conversation, I almost went early on in that conversation to say, okay, are we talking about like youth culture or are you talking about like the broader, you know,

gender dysphoria adults who, you know, have tried everything to alleviate their dysphoria, they ended up transitioning and, and, you know, live in that way or whatever. But like, there has been an explosion, right. Of youth, especially natal females identifying as trans. Um, I guess, yeah, there's so many questions I have the, the question of, is there social influence here to me? It just seems like an obvious yes not in every case whatever and that you do anytime we talk about society influencing that that's a complex conversation okay but to say that there is no social influence in the rapid rise and people identified to me it just doesn't seem scientifically valid am i right to assume that i know we have to be very careful about how we

go about this and i don't want to i don't want parents to like walk away saying, see, I knew it. My kid was just chasing some trend or like, no, no, no, no, no. I don't know your kid. I'm not saying that at all. But from a scientific perspective, do you feel like there is social influence in the rise of teens identifying? Yeah. Unfortunately in our, in our, in the U S culture right now, we politicize everything. And so everything becomes this it's this or this and we politicize everything. And so everything becomes this, it's this or this, and we polarize around it. So right now I would say the two polarizing positions would be, this is just self-awareness. People just are aware they were always there. They didn't have the language for it, the social support for it, but this is who they are. They always were that way. And I think

that's definitely true. That does account for some rise, no doubt. But to say that's all that's going on, I think, is naive. The only other explanation that's really on the table is social contagion. So it's just this virus that's being passed along between peers. well-documented. It comes out of the eating disorder literature. It's more well-documented as a phenomenon where eating disorders can, people can struggle more with body weight, shape and size, body image. And those messages are communicated in a society about standards of attractiveness and so on and so forth. And the adolescent females tend to be more susceptible to that than adolescent males. And it can lead to and maintain eating disorders at higher rates for adolescent females. So some people have kind of copied and pasted that over to this conversation and said, that's what's going on here. So I'm not prepared to say that because it's not as well researched, but I'm not saying it's wrong. I'm just saying I don't tend to use that phrase right now because we're very polarized. It's one or the other. I do think there are societal influences, some peer group

influences. I would locate that in a larger explanation of what's going on. So I write about that in a book called Emerging Gender Identities that I wrote with Dr. Julia Sadusky. And it has to do with what's called a looping effect, but it has to do with how in society people respond to the categories that are used to categorize them. And so one of the main ways we categorize people in our society today is diagnostic labels. And so when we use even a label like gender identity disorder, you would have thought about yourself differently if you were given that diagnosis than if you're given the diagnosis of gender dysphoria. Because the one says, I have a fundamental identity problem that I need to address. The other one says, I have distress and I need to alleviate that. So even that way of categorizing would lead you to think about

yourself differently. And you as a group of people who have this experience would think about yourself as a people group differently. So anyway, we walk through kind of how that happens for people in this space. And I do think peer group influence is a part of that conversation, but it wouldn't be the only thing. And I think that's part of what social contagion maybe gets wrong is that it, it reduces it to nothing but this, just like self-awareness reduces it to nothing but this. I think it's a more complex understanding of what's going on, but definitely younger people today. Yeah. You know, the book

gender emerging gender identities is so different than understanding gender dysphoria because one was explaining the phenomenon of transgender experiences. The other one's like, what's going on the last five years? Like, why are we seeing this rise and what do we do about it? Younger people are exposed to a much wider array of gender possibilities than you and I never would have experienced growing up. If you're 14 today, you have so much more exposure to different linguistic constructs than their parents or their grandparents ever would have even imagined around gender. So it's very difficult to then minister to, care for someone whose exposure to language and categories is so different than your own.

That splintering of gender categories is really unheard of and should be of some concern, I think, to Christians. That's super helpful. I've actually tried to, I mean, you and I both, and I've learned this from you, you know, language is so important like can we can we use for use the best most accurate phrase that has the least possible stigmatization stigmatization stigmatizing people or or shaming people and so even the phrase social contagion and i used it in my in my book um i think i did i've tried to use it less and less. Like, do I need to use that? Because it does have this kind of like disease kind of negative connotation. Like, can we talk about think I'm pretty sure I'd be like, they never use the phrase social contagion. And I know you guys are very, very careful with language. Yeah, I think we're careful.

I mean, we name it to name the issue because it's a very common explanation. I think we should be conversant as Christians that that is on the table, just like self-awareness is on the table. What do both of those proponents get right? What are they getting right that they're observing? And then where are the gaps? Because right now we're so polarized. Whenever you're polarized, you can almost put money on it that neither one explanation is it.

There's probably something else going on that carries some elements of both of those polarized views. These are thoughtful people in both of those camps, but they're doubling down on this is the only account. This is what's going on. And I think when you do that, you get into politics and not really helping people at that point. I feel like the people that say there is zero social influence, this is all self-awareness, that has to be in the minority, right? I mean, I just think that most people are like, no, teenagers are impressionable. The numbers are way too high. It has to be more than just only self-awareness.

just only self-awareness and there is a in many especially more progressive cities for lack of better terms a glamorizing of of you know sexual and gender minority identities um you know when i when i go speak in like iowa you know they'll have some trans kids in youth group and then i go to like seattle well i just i was at a church you know several different churches in the last couple years and it's like there's so many lg kids in the youth. They're almost asking the question, like, how do we reach the straight kid that, you know,aho which is one of the more conservative cities in america 13 of the 15 girls in the theater class went by they them or he she they like nobody had just pronouns that match your biological sex like am i really is that no social influence like to me it just doesn't sound like reasonable to say there is no social influence am i right to say that that really is kind of a minority maybe loud loud, but most people don't.

It's hard for me because the waters that I swim in are in the community of mental health professionals who view it that way. So I would say that's the overarching view in LGBTQ circles that I'm a part of in mental health societies. But if you got them in a private room with no tape recorder,'m a part of it at, at, in mental health societies. But if you got them in a private room with no tape recorder, maybe a couple of beers,

like would they really say, yeah, there's no, yeah. 13 of the 15 kids. That's an interesting, that's an interesting qualifier there. Cause I think,

I think part of holding onto certain positions can be fear-based on both sides. Sure. Because you're trying to protect kids you think are vulnerable. And both groups are doing it. Both groups want to protect kids. And so if you're self-awareness only and you concede social influence, will people be dismissive of the actual kids who need to be protected? I think there's that in the circles, secular circles I'm in. In the social contagion circles, I think there's also a fear

that our kids are young and impressionable. They're being influenced by an agenda or ways that it's been portrayed in social media and entertainment. So we need to protect them as well. So I think both groups are trying to protect kids. So those are good impulses, but they can't both be right or they're both contributing something right to a more complex hole. Yeah. I have one more question, Mark. It might, it might not be a short answer, but this is a, I mean, this is the most genuine question I could possibly ask because it's a question I get all the time and I don't have a good answer. The parent that comes to me, and there's been many, and I know I'm almost going to assume you've had probably 10 times more than I've had. Parent comes to you saying, you know, they had that kind of deer in the headlights look saying, you know, my 13, 14, 15 year old.

Typically it's going to be a female, you know, daughter came home, told me they're trans. They're demanding I use they, them pronouns or opposite sex pronouns. or opposite sex pronouns. They're maybe even demanding that I not just like use the pronouns, but actually believe certain things that, you know, I am a boy, even though they're biologically female. Maybe they're even demanding hormones.

Like I need, I need hormones now. And if the parent does anything but full affirmation, they feel like I'm going to lose this relationship because my kid's being told that if a parent doesn't affirm you, then they're toxic. They're probably going to lose this relationship because my kid's being told that if a parent doesn't affirm you, then they're toxic. They're probably going to increase your suicidality. What do you say to

that parent that isn't wanting to give blockers to their 13, 14-year-old kid who may even be nervous about using pronouns, chosen pronouns with a younger teen at that age? What's the, have you, I would love to hear if you've encountered this scenario and how do you respond? What's your advice? Yeah. So definitely see a lot of parents, a lot of families like this. We do have a, we do have an outward facing clinic connected to the work we do here where we evaluate people and evaluate for gender dysphoria. And most people who come to see us want to know, is this gender dysphoria? Are there other things going on, like co-occurring depression, autism spectrum disorder, things like that? Where do we go from here? What do you recommend? And then how do we improve family relationships if they've been

strained because of this whole process? Those are probably the four leading reasons people come to see us or some combination of that. So to a parent, you know, part of me says, let's see if this is gender dysphoria or not, because it could be, right? I mean, it's probably not in every case, but it could be in this case. So a good, careful evaluation of that would be warranted. Are there other things going on? You and I talked about trauma earlier. We mentioned, I mentioned autism spectrum disorder, depressive disorder. The guidelines that we have are to make sure that those things are well managed before

people make other decisions around this. So kind of develop a bit of a plan here. on this. So kind of develop a bit of a plan here. Certainly, if you think there's entertainment, social media, peer group influence, we'd want to slow down and look at that. How is that affecting this experience? If parents have their own genuine skepticism about this, then I think you need to slow down and look at this together very carefully. So I think those are some things that you can do. I think you could review the data on what leads to people having a harder time with this. I'm thinking here of like Caitlin Ryan's work. You know, she has a list of like accepting behaviors and rejecting behaviors. And my understanding of her data and having spoken with her about this

is that the thing you really have to avoid is the rejecting behaviors. So those are things like physical altercations, verbal abuse, spiritual abuse, you know, things of that nature. That's what puts kids at risk for self-harm or suicidal ideation and intent and things like homelessness. And most Christian parents that I see, vast majority would say, of course, absolutely, that's off the table. We're not going to, that's a self-selected group who come to see a mental health professional. I'm sure there's others who do those behaviors. And then there's accepting behaviors, but the accepting behaviors are not associated

with those outcomes in the same way. Like parents don't have to do X, Y, and Z to keep their kid from certain outcome. That does not appear to be from my understanding of her data as important as avoiding the rejecting behaviors, getting those out of what's happening at home. So I think being able to review that, being able to, now at the same time, if there is genuine dysphoria and certain things help mitigate that, then we look at, should we consider doing those things? What have you already tried? I mean, every 14, 15, 16 year old that comes to my office has already tried things. You can tell by the way they dress, you can tell by their hairstyle, you can tell by a lot of things that they do. They're completely reversible.

They try things out to see if it helps them or not. And then you can look, do we, is that a plateau? Could we plateau there? Or do we need to look at another plateau? Now they might be thinking mountaintop, but I'm teaching a little bit about that analogy. One of my colleagues uses a different analogy. It's not a mountaintop and plateau, but it's a train. And she says, if I give you the diagnosis of gender dysphoria, I don't want you to think it's a gender train that you get on. And the only stop is at the end is medical interventions. There are a lot of stops along the way for people to manage this. And that's the plateaus, right? So we're just using different metaphor there.

But so then we try to work with that family on where could you plateau? What's in a plateau could last for six weeks, six months, six years. You just don't know. Yeah, I think that's super. I feel like I owe you whatever your clinical rate is for that advice. Yeah, that's really helpful. And those, I think the parent child relationships for me are always as a parent for kids, like it's sure, man, my heart just goes out and I, I, I wish I had a better kind of, you know, they look at you like fix it. Like what's the, what's the magic bullet here? I'm like relationships, especially

parent child, especially parent transtrans child relationships don't have that quick fix. But Mark, I've taken you past the hour. Thank you so much for giving us your time and your wisdom. Thank you so much for all of your steady devotion to this topic. I mean, your books have been immensely helpful for all of us in this area, especially for me. So thank you so much for your work and your time. I appreciate it, Preston. Thanks for this time together. This show is part of the Converge Podcast Network.