Wisdom from Above
We want to sow in our minds and in our relationships what we want to harvest in our lives. The seed we reach to scatter must be taken from the bag marked “wisdom from above,” not “wisdom that is demonic.” Both stand open before us.
But the wisdom from above is first pure, then peaceable, gentle, open to reason, full of mercy and good fruits, impartial and sincere. (James 3:17, ESV)
Contrasted with demonic wisdom is wisdom from above (Jas. 3:15). James gives us a bio of genuine wisdom that has its source in God.
He begins by describing genuine wisdom as pure, even giving purity a position of first importance. We might think of purity in terms of chastity where we are fully and exclusively devoted to God. Everything about us is sacred, set apart as holy to our God. That’s how wisdom operates from the perspective of the fear of the Lord. Purity contrasts with what is defiled.
From the starting point of purity the operating system of wisdom works itself out in all the fruit of saving faith forged by the Spirit of God and founded in the person of Christ. Gentleness serves well as a trait of the tongue. Listen to how Paul uses gentle as a governor to our speech: “to speak evil of no one, to avoid quarreling, to be gentle, and to show perfect courtesy toward all people” (Titus 3:2).
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God’s Blueprint for His Mission
If we are to do well at church planting, denominations, presbyteries, synods, or networks will be needed for spiritual, prayerful, and financial support. When Jerusalem was destroyed in AD 70, God’s plan continued to be revealed. Christians fled Judea. The temple could no longer be the focal point of assembly. The church was decentralized, and this proved to be a blessing. The many small local churches were places of hospitality and refuge for Christians, who were increasingly being persecuted. Local churches became known for their love and good works and for their care for slaves, widows, orphans, and the weak. In time, those churches would grow and would begin to send out missionaries to continue the cycle of life.
There was a time when the Western world seemed to be saturated with churches. The diligence and prayers of former generations had led to skylines filled with steeples. Even small villages were dotted with chapels. Then, some people began to think that bigger was always better. We were impressed by massive crusades and megachurches. It was assumed that we would be best served by the most programmed church with the most articulate preacher in our region. Many people left for seemingly greener pastures, while others fell away entirely. Many faithful churches were shuttered and sold off. Some did not realize that we were retreating. In the midst of it all, we seemed to lose God’s blueprint for His mission.
Regardless of how big or small a church is, what matters is that it is faithful and fruitful. We should rejoice whenever and wherever Christ is preached (Phil. 1:18). The broader trends of the past century, however, should compel us to revisit God’s blueprint for His mission. Iain H. Murray, in his book Evangelicalism Divided, gave a careful analysis of the impact of twentieth-century evangelical missions. He showed that those who were reached by broader missions efforts needed not just to be called to repentance and faith in Christ but also to be personally discipled in the context of faithful local churches. When this did not happen, many left Christianity behind, more confused and jaded than before.
More is required than broad scattering of seeds. Watering, fertilizing, and careful pruning are also vital components of missions. Believers need to worship alongside neighbors who we know love the Lord. Office bearers need to give personalized edification, encouragement, loving rebuke, and tender restoration. There is a need to be salt and light among our neighbors. This means that existing churches need to focus their efforts on planting new local congregations that worship reverently, preach the gospel faithfully, administer the sacraments properly, and discipline their members lovingly. If the church is to regain lost ground, we need to return to God’s blueprint.
When we step back and look at the broad themes of the Bible, we see that God calls His people out again and again. He called Adam and Eve out of hiding. He called Noah to build an ark and escape an evil world. He called Abraham out of the east, away from the worship of other gods (Josh. 24:2). He called Israel out of Egypt (Hos. 11:1). Christ called His disciples to leave everything behind (Mark 10:21). God’s people are called out of “Babylon” (Rev. 18:4). A foundational part of being the church means being called out. God’s people have been summoned to the throne of grace. It means abandoning hope in this world itself and casting ourselves on Christ alone. It also means being called into a visible expression of Christ’s body: a local, faithful church.
Being “called out” means leaving behind sinful attachments to this world and instead being joined to the body of Christ (Eph. 2:19–22). Being the church means that we must leave behind any worldly motives or practices that are rooted in trendiness, pragmatism, or showmanship. It means putting the worship of God above all else. This does not mean, however, abandoning the lost who live around us. To seek them out and call them in brings glory to God (Luke 15:7, 10, 32). The lost need to come under a local ministry where their particular sins and struggles will be addressed. They need neighbors who love them and who will show them the love of Christ. This will mean taking up our cross and making God’s ordinary means for missions central. Being “called out,” for some believers, may also mean being called out of a larger church and into a church plant or smaller local church. It may mean a calling to an area where churches are few. It may mean becoming part of a church that is small or struggling.
Woven through the biblical theme of being called out is another theme: being “gathered in.” The Israelites were called out of their homes and gathered to worship the Lord at His house (Ex. 23:14; Ps. 95). Their calendar was designed to revolve around the routines of feasts and sacrifices. Sadly, they lost this privilege during the exile. Yet even when they were scattered across the world by evil empires, they began to meet in local synagogues to read God’s Word and pray. Usually these gatherings were Sabbath meetings held within walking distance of most of the believers in a region.
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I Thought I Was Saving Trans Kids. Now I’m Blowing the Whistle.
Some critics describe the kind of treatment offered at places like the Transgender Center where I worked as a kind of national experiment. But that’s wrong. Experiments are supposed to be carefully designed. Hypotheses are supposed to be tested ethically. The doctors I worked alongside at the Transgender Center said frequently about the treatment of our patients: “We are building the plane while we are flying it.” No one should be a passenger on that kind of aircraft.
I am a 42-year-old St. Louis native, a queer woman, and politically to the left of Bernie Sanders. My worldview has deeply shaped my career. I have spent my professional life providing counseling to vulnerable populations: children in foster care, sexual minorities, the poor.
For almost four years, I worked at The Washington University School of Medicine Division of Infectious Diseases with teens and young adults who were HIV positive. Many of them were trans or otherwise gender nonconforming, and I could relate: Through childhood and adolescence, I did a lot of gender questioning myself. I’m now married to a transman, and together we are raising my two biological children from a previous marriage and three foster children we hope to adopt.
All that led me to a job in 2018 as a case manager at The Washington University Transgender Center at St. Louis Children’s Hospital, which had been established a year earlier.
The center’s working assumption was that the earlier you treat kids with gender dysphoria, the more anguish you can prevent later on. This premise was shared by the center’s doctors and therapists. Given their expertise, I assumed that abundant evidence backed this consensus.
During the four years I worked at the clinic as a case manager—I was responsible for patient intake and oversight—around a thousand distressed young people came through our doors. The majority of them received hormone prescriptions that can have life-altering consequences—including sterility.
I left the clinic in November of last year because I could no longer participate in what was happening there. By the time I departed, I was certain that the way the American medical system is treating these patients is the opposite of the promise we make to “do no harm.” Instead, we are permanently harming the vulnerable patients in our care.
Today I am speaking out. I am doing so knowing how toxic the public conversation is around this highly contentious issue—and the ways that my testimony might be misused. I am doing so knowing that I am putting myself at serious personal and professional risk.
Almost everyone in my life advised me to keep my head down. But I cannot in good conscience do so. Because what is happening to scores of children is far more important than my comfort. And what is happening to them is morally and medically appalling.
The Floodgates Open
Soon after my arrival at the Transgender Center, I was struck by the lack of formal protocols for treatment. The center’s physician co-directors were essentially the sole authority.
At first, the patient population was tipped toward what used to be the “traditional” instance of a child with gender dysphoria: a boy, often quite young, who wanted to present as—who wanted to be—a girl.
Until 2015 or so, a very small number of these boys comprised the population of pediatric gender dysphoria cases. Then, across the Western world, there began to be a dramatic increase in a new population: Teenage girls, many with no previous history of gender distress, suddenly declared they were transgender and demanded immediate treatment with testosterone.
I certainly saw this at the center. One of my jobs was to do intake for new patients and their families. When I started there were probably 10 such calls a month. When I left there were 50, and about 70 percent of the new patients were girls. Sometimes clusters of girls arrived from the same high school.
This concerned me, but didn’t feel I was in the position to sound some kind of alarm back then. There was a team of about eight of us, and only one other person brought up the kinds of questions I had. Anyone who raised doubts ran the risk of being called a transphobe.
The girls who came to us had many comorbidities: depression, anxiety, ADHD, eating disorders, obesity. Many were diagnosed with autism, or had autism-like symptoms. A report last year on a British pediatric transgender center found that about one-third of the patients referred there were on the autism spectrum.
Frequently, our patients declared they had disorders that no one believed they had. We had patients who said they had Tourette syndrome (but they didn’t); that they had tic disorders (but they didn’t); that they had multiple personalities (but they didn’t).
The doctors privately recognized these false self-diagnoses as a manifestation of social contagion. They even acknowledged that suicide has an element of social contagion. But when I said the clusters of girls streaming into our service looked as if their gender issues might be a manifestation of social contagion, the doctors said gender identity reflected something innate.
To begin transitioning, the girls needed a letter of support from a therapist—usually one we recommended—who they had to see only once or twice for the green light. To make it more efficient for the therapists, we offered them a template for how to write a letter in support of transition. The next stop was a single visit to the endocrinologist for a testosterone prescription.
That’s all it took.
When a female takes testosterone, the profound and permanent effects of the hormone can be seen in a matter of months. Voices drop, beards sprout, body fat is redistributed. Sexual interest explodes, aggression increases, and mood can be unpredictable. Our patients were told about some side effects, including sterility. But after working at the center, I came to believe that teenagers are simply not capable of fully grasping what it means to make the decision to become infertile while still a minor.
Side Effects
Many encounters with patients emphasized to me how little these young people understood the profound impacts changing gender would have on their bodies and minds. But the center downplayed the negative consequences, and emphasized the need for transition. As the center’s website said, “Left untreated, gender dysphoria has any number of consequences, from self-harm to suicide. But when you take away the gender dysphoria by allowing a child to be who he or she is, we’re noticing that goes away. The studies we have show these kids often wind up functioning psychosocially as well as or better than their peers.”
There are no reliable studies showing this. Indeed, the experiences of many of the center’s patients prove how false these assertions are.
Here’s an example. On Friday, May 1, 2020, a colleague emailed me about a 15-year-old male patient: “Oh dear. I am concerned that [the patient] does not understand what Bicalutamide does.” I responded: “I don’t think that we start anything honestly right now.”
Bicalutamide is a medication used to treat metastatic prostate cancer, and one of its side effects is that it feminizes the bodies of men who take it, including the appearance of breasts. The center prescribed this cancer drug as a puberty blocker and feminizing agent for boys. As with most cancer drugs, bicalutamide has a long list of side effects, and this patient experienced one of them: liver toxicity. He was sent to another unit of the hospital for evaluation and immediately taken off the drug. Afterward, his mother sent an electronic message to the Transgender Center saying that we were lucky her family was not the type to sue.
How little patients understood what they were getting into was illustrated by a call we received at the center in 2020 from a 17-year-old biological female patient who was on testosterone. She said she was bleeding from the vagina. In less than an hour she had soaked through an extra heavy pad, her jeans, and a towel she had wrapped around her waist. The nurse at the center told her to go to the emergency room right away.
We found out later this girl had had intercourse, and because testosterone thins the vaginal tissues, her vaginal canal had ripped open. She had to be sedated and given surgery to repair the damage. She wasn’t the only vaginal laceration case we heard about.
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Marriage Matters More than Ever
Today, more kids grow up in single-parent homes in America than in any other country in the world. No wonder we’re flailing and falling behind in so many ways. Strong marriages build strong families and strong societies. Humans were created with a desire to love and permanently connect and procreate within the institution of marriage. We should still encourage that as a society, especially because it’s an even healthier partnership than before.
It’s no surprise that marriage matters for the well-being of children, but a new report from the Institute for Family Studies finds that it matters now more than ever before.
A study comparing intact and broken families between two generations—boomers and millennials—found that the correlation between two-parent families and life success has dramatically increased with millennials.
For example, growing up with an intact family increases millennials’ odds of graduating from college by 163 percent, compared to just 78 percent for boomers. And 77 percent of millennials from intact families achieve middle or higher income by their mid-30s—a figure that is 20 percentage points higher than for their peers from non-intact families.
Children’s financial, social, and emotional welfare is on the line when it comes to marriage, and it’s worth Americans of all political stripes taking note. Thankfully, some progressive academics are getting on board.
“Denying that marriage has major consequences for the economic and social well-being of individuals and society is dishonest and counterproductive, especially when it comes to how children are being raised,” wrote Melissa Kearney, a senior fellow at the Brookings Institution and author of The Two-Parent Privilege.
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