Should a child be allowed to undergo gender-affirming surgery?
Introduction
Gender-affirming surgery for minors (individuals under 18) is one of the most contentious issues in modern bioethics. While such procedures are increasingly common in secular medical contexts, the Christian must evaluate them based on the authority of Scripture concerning the body, medical prudence, and the sanctity of life-altering choices.
For the Christian, the answer to this question is consistently No, due to the permanent nature of the procedure coupled with the immaturity of the individual.
Main: Three Biblical Principles Opposing Surgery for Minors
The ethical opposition to gender-affirming surgery for children is built upon the biblical view of the human body and the responsibility of parents.
1. The Sanctity of the Created Body (Permanence)
The body is viewed in Scripture as a divine gift, reflecting the image of God.
God’s Design is Binary: God created humanity in two distinct, complementary sexes: “male and female he created them” (Genesis 1:27). This binary structure is established as the fundamental reality of human biology, which is intentionally purposed by God.
Irreversible Alteration: Gender-affirming surgeries (such as mastectomies, hysterectomies, or genital reconstruction) permanently alter primary and secondary sex characteristics. For the Christian, this constitutes a profound intervention that seeks to permanently restructure the body in opposition to its God-given design, often resulting in sterility and lifelong medical reliance.
The Body as a Temple: The Christian body is the “temple of the Holy Spirit” (1 Corinthians 6:19-20). Willfully causing such permanent, non-therapeutic damage (damage not related to disease or immediate threat) is seen as poor stewardship of the sacred gift of the body.
2. The Lack of Mature Consent (Prudence)
Christian ethics mandates that irreversible decisions be made with wisdom, prudence, and full understanding.
Cognitive Immaturity: Adolescents and children are not considered mature enough by the law (or Christian prudence) to make fully informed decisions about things like voting, signing contracts, or drinking alcohol because their prefrontal cortex (the area of the brain responsible for long-term consequence assessment and impulse control) is still developing.
The High Rate of Desistance: Studies show that a significant percentage of children experiencing gender dysphoria, if allowed to pass through puberty naturally without medical intervention, desist (revert to identifying with their biological sex) by young adulthood. Performing irreversible surgery on a child eliminates this possibility and forces them onto a path they may later deeply regret.
Parental Stewardship: Parents are called to protect their children (Ephesians 6:4). Allowing a child to consent to a procedure that carries lifelong physical and psychological risks, when they lack the maturity to understand those risks fully, is considered a failure of responsible parental stewardship.
3. The Focus on Spiritual and Psychological Healing
The Christian response to gender dysphoria prioritizes addressing the spiritual and mental distress rather than altering the physical body.
Healing the Heart: The ethical goal is to treat the underlying cause of the suffering (the feeling of disconnect between mind and body), not to physically mutilate the body to conform to the feeling. The preferred Christian response is compassionate counseling, therapy, and spiritual care that helps the individual find peace and reconciliation with their biological identity.
Rejecting Expedience: Allowing permanent surgery to satisfy temporary distress is viewed as a capitulation to a cultural trend rather than a commitment to the person's long-term, whole-person (body and soul) health.
Conclusion
Should a child be allowed to undergo gender-affirming surgery? No.
The Christian ethical consensus strongly opposes gender-affirming surgery for minors because it is an irreversible, non-therapeutic procedure that compromises the biblical sanctity of the body and is undertaken without the full, mature consent necessary for such a life-altering decision. Compassion must be shown through counseling and spiritual care, not through surgical alteration.
