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.

The Christian perspective on affirming pronouns balances the truth of creation (Genesis 1:27) with the command to love one's neighbor (Mark 12:31). While traditional views do not require affirming identities that contradict biological sex, respect and dignity are mandatory in all interactions.

The Bible teaches that God created humanity as two complementary sexes: “male and female he created them” (Genesis 1:27). Traditional Christian thought views gender identity as inextricably linked to biological sex, established by God. The internal conflict of gender dysphoria is acknowledged as part of the Fall’s corruption (Romans 7:22-23), and the call for the Christian is to find ultimate identity and wholeness in Christ (2 Corinthians 5:17).