The Bible emphasizes the sanctity and binary nature of the body (Genesis 1:27) and mandates prudence in making irreversible decisions. Gender-affirming surgery (which includes permanent surgical alteration of primary or secondary sex characteristics) for minors is ethically opposed by most orthodox Christian bodies because it is irreversible, highly invasive, and performed on individuals (children and adolescents) who lack the full cognitive maturity to consent to such life-altering procedures. The Christian response emphasizes addressing the underlying distress (gender dysphoria) through pastoral care, counseling, and spiritual support, rather than through permanent medical interventions that contradict the biological sex assigned by God.

Counseling someone considering gender-affirming surgery requires a response rooted in radical compassion and biblical conviction. The Gospel perspective affirms the reality of the person's deep, genuine suffering (gender dysphoria) while upholding the truth of God's design: humanity is created immutably male and female in His image (Genesis 1:27). The counseling focus is not condemnation, but inviting the person to find their true, secure identity in Christ, allowing the Holy Spirit to transform the mind and soul rather than seeking to physically reconstruct the body.