The norms of society with respect to gender and sexuality have changed in recent decades. It can be confusing to know what to say to those who enter your orbit with a completely different outlook on the topic. Naomi Graham and David Straiton explore the cultural and medical dimensions to the subject as you navigate present and future conversations in ways that can further relationship and God’s work in young people and children’s lives
As awareness of gender issues increases within society there is a greater expectation to approach these issues with sensitivity. It is particularly hard to know how to support children and young people in the midst of this, when the topics polarise opinion and potentially lead to feelings of pain, anger, fear and avoidance. However, we see throughout the Gospels that Jesus wasn’t afraid of facing the difficult conversations.
Therefore, when discussing these issues with children and young people we can seek to be Christ-like in our engagement. The purpose of this article is not to argue a position but to give space, whatever our theological views, to think through how we can take a Christ-like posture towards children and young people as they encounter questions around gender and sex identity. We want to encourage everyone to reflect, listen and journey with children and young people. We would recommend that you read around the subject and engage fully in the nuances of the topic by reading materials you many not necessarily agree with.
We write as Christian healthcare professionals who support children, young people and adults with a range of needs. We’re involved in running a charity, Growing Hope, which provides free therapy for children and young people with additional needs in partnership with local churches across the UK. One of Growing Hope’s aims is to encourage and enable accessibility within churches. Enabling church to be accessible requires many facets but the starting point (and the starting point for the topic of sex and gender identity) is that everyone is welcome. We have a God whose love is for all people (John 3:16), his perfect love casts out fear (1 John 4:18) and he chooses all of us to be a part of his kingdom. We have the privilege of expressing God’s love to whoever comes into our churches.
When facing such a challenging topic the first thing we can do is to reflect. It’s something that we’re encouraged to do constantly as healthcare professionals to help us understand our thoughts and behaviour, how they might impact our practice and whether, by reflecting on these, we can improve our care. It can help us to think beyond ourselves as we attempt to understand other people’s perspective. The starting point is to ask yourself some questions. Whether issues of sex and gender have come up already in your work or not, it is likely to be a topic you encounter and the best thing to do is to think it through before you find yourselves in a conversation. As you sit with your cup of tea or coffee, why not take a journal and have a think through these questions (adapted from a reflection model):
- What do I think and feel about sex and gender identity? How much have I explored this subject? What is stopping me?
- Do I have a particular situation or experience in mind? What was good or bad about it?
- What can I do to understand the experience of people struggling with issues of sex or gender identity?
- What will I do differently next time I find myself in a conversation with someone on this subject?
The Church of England has recently published Living in Love and Faith, which you may find a helpful resource in unpacking in detail some of the conversations around identify, sexuality, relationships and marriage. Within the book they suggest six principles for living well together: “To acknowledge prejudice, to speak into silence, to address ignorance, to cast out fear, to admit hypocrisy and to pay attention to power.”
Reflecting on our own attitudes, and inevitable prejudices, will help us have a better understanding of what we are bringing to the conversation or topic. It will also enable us to respect others when we disagree. As we engage with young people who will be sharing from a place of deep vulnerability, we can address our ignorance and seek to learn and understand more. To help you navigate the issues and begin the journey of reflection, the next section gives a broad overview of different areas of sex and gender identity that children and young people may encounter.
“So God created mankind in his own image, in the image of God he created them; male and female he created them’ (Genesis 1:27).
Biological sex is defined by sex-specific variation of hormones, chromosomes and anatomy. Most females have two X chromosomes and most males have an X and Y chromosome. We have 23 pairs of chromosomes in every cell in our body, these are made up of DNA which contains thousands of genes (find out more about genes and chromosomes here).
The majority of the population has a clear biological sex. In a small number of children and young people individuals will have differences in sex development. This refers to a group of congenital conditions characterised by differences in chromosomes, hormones and anatomy. This may be identified at birth or as young people experience puberty. Many research studies discuss the psychological challenges for parents, carers and children and young people who have disorders in sex development. Directing children, young people and parents to specific support groups (see the links from the NHS website) as well as taking time to listen to people’s experience can be helpful in these situations. All individuals will be assigned a sex at birth.
Gender – how do you identify?
The majority of people have an internal identity aligning with their sex – this can be referred to as cisgender or ‘cis’. Some individuals identify their gender with the opposite sex, this this referred to as transgender or ‘trans’. There are also many variations of gender identity including ‘gender fluid’ and ‘non-binary’. Gender identity is generally accepted as an individual’s internal perspective of their gender.
The Gender Identity Development Service (GIDS) is a national specialist service for children and young people, and their families, who experience difficulties in the development of their gender identity. There are helpful resources on their website for children and young people who are questioning their gender identity. The service highlights the importance of families listening to and discussing children’s feelings. They also discuss the importance of taking time in making decisions around social transitions, particularly for young children, because of their stage of brain development: “We know that in early childhood, children view the world in concrete terms and do not easily reason about abstract or hypothetical issues. They have not yet developed the cognitive and social maturity that will emerge later in childhood, and they find it difficult to see any given decision in a larger time context.”
Gender dysphoria or gender incongruence are terms used by medical professionals to describe a significant difference between an individual’s assigned sex and experienced gender; this is not considered a mental disorder. Research suggests that the majority of children experiencing gender incongruence do not remain gender incongruent after puberty.
In 2014, the Royal College of Psychiatrists banned the practice of conversion therapy, or any approach which aims to persuade trans people to accept their birth sex (this was originally banned in relation to trying to change an individual’s sexual orientation). A medical research paper discussing the law and summarising the current evidence around gender and identity is found here. This is a topic which is currently being debated within parliament.
Within the population of children and young people experiencing gender incongruence there is often noted to be a high incidence of other mental health needs such as anxiety, low mood and experiences of bullying prior to feelings of gender incongruence. There is also a high incidence of autism in individuals who are transgender. In addition, there is sadly a high suicide rate in individuals experiencing gender incongruence.
As youth and children’s pastors, you are not there to a healthcare professional. If you are concerned about a child or young person’s mental health you should refer to your organisation’s safeguarding policy and follow the appropriate procedure. This may include seeking support from their GP or a charity such as Young Minds. As an individual you can provide a safe space for young people where they can be listened to and heard in all they’re feeling. It is a great act of trust for a child or young person to make a decision to share questions around gender and mental health – by choosing to actively listen rather than to give advice we are enabling a young person to feel more understood.
Gender expression – how do you express your gender?
Individuals will express their gender differently, this may or may not conform to societal expectations or ‘typical’ presentations of gender. This expression can involve clothing, voice, hairstyle etc.
For children and young people working with the Gender Identity Development Service they may choose to socially transition, use puberty blockers and then after the age of 16 may take cross-sex hormones. Surgical procedures for gender identity do not currently take place in under-18s in the UK.
Some children and young people may choose to express their gender through asking to be called a different name or by different pronouns (he / she / they). In the posture of listening to and journeying with young people accepting young people as they choose to express their identity can help young people to feel welcome. However, this is something you may wish to discuss and decide upon as a church or organisation. On a practical level, changes to toilets so that they are not gender specific will help every individual to know they are welcome within your church building. The Evangelical Alliance have produced a resource called Transformed, providing theological discussion; it is a practical and informed resource which may be helpful.
We can reflect on our own attitude towards gender stereotypes before hosting a conversation which enables young people to think through and talk about what this may look like for them. As Christian youth and children’s workers we can set a culture where young people feel able to fully express their identity. Creating a place of acceptance is important for young people as they explore their identity. From this place we can then listen to children and young people and host conversations which give the opportunity to reflect on challenging topics.
Sexual orientation – who are you attracted to?
Sexual orientation reflects the gender and sex to which attraction is experienced. There are a broad range of terms used to define individual’s sexual orientation and some individuals would view this as a continuum. Sexuality is about the human experience of being sexual and includes gender identity, sex and sexual orientation. Some terms used when talking about sexual orientation include ‘heterosexual’ – being emotionally, physically and or sexually attracted to people of a different sex or gender; ‘same-sex attracted’, ‘homosexual’, ‘gay’ or ‘lesbian’ – being emotionally, physically and / or sexually attracted to people of the same sex or gender; ‘bisexual’ – being emotionally, physically and / or sexually attracted to males / men and females / women.
It is possible you will be the first person a young person comes to speak to about their internal wrestling with sex or gender questions. This is a huge honour to be trusted in this way. The way in which we listen is vital and will affect whether they find you a safe person to process with.
However, not all of us are naturally good at listening. The good news is that we can all develop our listening skills. Consider the type of listener you are – what does it currently look like to be on the end of a conversation with you? How can you create more safety and space?
Active listening is often talked about within healthcare settings – it’s about being able to show that you’re really listening to the individual in front of you. If we choose to actively listen, we are able to put aside any distractions, listen and reflect back both what is being said and the emotion that someone may be experience in what they’re saying. Active listening often involves long pauses where we give people space to say what they want to say before repeating back so that they know that they are heard. Active listening enables individuals to feel heard and understood and can often be helpful for processing big things we are facing.
As children’s and youth workers trying to navigate this topic, active listening is a great skill to practise. Listening first and building relationship before giving advice will help children and young people to feel loved, valued and supported.
Choosing the way of Jesus is hard. It means loving people, even if we don’t agree with their choices. This is after all, how Jesus has treated us. As we journey with children and young people, our love for them cannot be conditional upon whether they agree with us or not. As we wrestle with these subjects in groups or with individuals, they need to know that you are committed to them regardless of what they believe.
There is a lot of theological discussion within the areas of sex and gender identity. Wherever you sit theologically, it is important that we give young people space to reflect on and explore what the Bible says and how this relates to the biblical narrative of God’s kingdom coming on earth. There are several resources mentioned above which discuss different theological perspectives. You may find it helpful to read books which reflect people’s personal stories; books such as A War of Loves by David Bennett, which discusses his experience of being same-sex attracted and following Jesus. Or Undivided by Vicky Beeching, who talks about her painful experiences in church. Your choice to journey with children and young people in their own personal stories will help them to know they’re not alone.
Acting in love
Through all that we’ve discussed we want to end coming back to where we started. God’s heart is for all people to know and experience his love that knows no borders. We are all welcome in God’s kingdom and if we love one another as Jesus has loved us (John 13:34) that is the best place to start.
Dr Naomi Graham is founder and CEO of Growing Hope & Dr David Straiton is specialty doctor in psychiatry and chair of trustees, Growing Hope King’s Cross.