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.

The Christian perspective on transgender athletes in school and sports must be guided by two principles: upholding the biological reality of male and female as God’s design (Genesis 1:27) and treating every individual with Christ-like love and dignity. Dialogue should center on fairness and safety for all female athletes, recognizing that male biological advantages persist across hormone treatments, and advocating for solutions that protect the competitive integrity of female sports.

When a child comes out as gay or transgender, the Christian response must immediately prioritize unconditional love and affirmation of the child's identity as a person made in God’s image (Genesis 1:27), while simultaneously upholding the biblical definition of marriage and human sexuality. The goal is to keep the relationship open, grounded in grace, and centered on Christ, reflecting the Father's love (1 John 4:8).

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).