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.

The Bible teaches that humanity is created as male and female (Genesis 1:27), providing a binary foundation for human existence. Historically, human communication relies on using visual cues (appearance, voice, clothing) to make assumptions about a person's sex and gender identity for the sake of social interaction. However, Christian ethics requires that these assumptions be guided by love, respect, and dignity. It is unethical to insist on an assumption or use a person's appearance to deliberately disrespect, mock, or invalidate their self-identification. The Christian response should prioritize showing honor to all people (1 Peter 2:17) while seeking wisdom on how to communicate truthfully and graciously in a complex cultural landscape.