How Blood-Earnest Should a Preacher Be?
If we fixate upon the tone of the service—stamping out laughter and mirth—making sure we have the proper atmosphere of being around the holy, we’ll never arrive at anything more than contrived stillness. Because when you focus upon being blood-earnest you’re no longer really preaching.
C.S. Lewis once spoke about the difficulty of sustaining worship. Worship by it’s very nature is a looking outside of ourselves. As soon as we start thinking about worship we end up not worshipping, this is how Lewis said it:
The perfect church service would be the one we were almost unaware of; our attention would have been on God. But every novelty prevents this. It fixes our attention on the service itself; and thinking about worship is a different thing than worshipping.
I was thinking about that Lewis quote recently while thinking through this address by John Piper on The Gravity and Gladness of Preaching. Piper is trying to make an argument for a seriousness to our preaching that conveys both the gladness and happiness and joy that we have in Christ but which moves away from frivolity or levity.
I’ve gleaned so much from John Piper over the years. I believe his blood-earnestness in preaching has had such a great impact upon me. The seriousness with which he considers the glory of God is helpful and challenging. And that is, I believe, what Piper is attempting to communicate in this lecture on preaching.
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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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God’s Word is Necessary
Our God speaks, and he speaks not simply to be heard and not merely to pass along information. He speaks so that we can begin to know the unknowable and fathom the unfathomable (1 Cor. 2:9; cf. Isa. 48:8). You may think you’ve seen it all, and you’ve heard it all, and you’ve experienced everything there is to experience. But you haven’t seen or heard or imagined what the God of love has prepared for those who love him (1 Cor. 2:9).
What We Want Most
Most of us, deep down, want the same things out of life. Of course, I’m talking about ultimate things, not immediate things. On the immediate level, people have a wide variety of desires. Some people like to travel. Some people like fine dining. Some people prefer indoor plumbing and a comfortable bed. And other people like camping. There are a million different tastes, interests, and hobbies. But if we get to the level of the heart, I think people all around the world generally want the same things: We want purpose. We want to be happy. We want to know we are okay. We want to be a part of something bigger than ourselves. We want to be known by someone bigger than ourselves. We want to live forever.
And if you dig around in those desires, you’ll find that most people are waiting for some word from somewhere so that they can finally know this good life. They want a law or a list that will tell them steps to take to get there. They want their teacher to say, “You’ve passed,” or their parents to say, “I love you.” They want to get a call from their dream job or their dream date. They want to hear good news about their retirement fund or their health or their kids. Many of them are listening intently to hear from the most sacred voice they know: their own. And some are desperate to hear from God.
The doctrine of the necessity of Scripture reminds us of our predicament: the One we need to know most cannot be discovered on our own. And it assures us of a solution: this same ineffable One has made himself known through his word. As the Westminster Confession of Faith explains, “Although the light of nature and the works of creation and providence do so far manifest the goodness, wisdom, and power of God, as to leave men inexcusable; yet are they not sufficient to give that knowledge of God, and of his will, which is necessary unto salvation.” Holy Scripture, the Confession goes on to say, is therefore “most necessary” (WCF 1.1). The Scriptures are our spectacles (to use Calvin’s phrase), the lenses through which we see God, the world, and ourselves rightly. We cannot truly know God, his will, or the way of salvation apart from the Bible. We need Scripture to live the truly good life.
We need Scripture to live forever. “Lord, to whom shall we go? You have the words of eternal life” (John 6:68). There is no other book like the Bible. It reveals a different kind of wisdom, comes from a different source, and tells of a different love.
A Different Source
So where do we go to learn the things God has revealed? Do we look to the trees? What about the inner light? How about community standards? Maybe human reason and experience? The clear testimony of 1 Corinthians is that only God can tell us about God. Just as the spirit of a person discloses the thoughts and feelings and intentions of that person, so also no one can make known the thoughts of God except the Spirit of God (1 Cor. 2:11). The only Being knowledgeable enough, wise enough, and skillful enough to reveal God to you is God himself.
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Christians Should Rejoice over Dobbs
Written by Carl R. Trueman |
Tuesday, July 12, 2022
The coming months will be fascinating, and I suspect rather depressing, to watch. When it comes to abortion, especially after Dobbs, Christians face a choice of social respectability or religious fidelity. And the Christian commentariat already seems divided on which way to go.The Dobbs decision has revealed fault lines in American Christianity. These fault lines lay just below the surface for a long while, but are now clearly exposed. As long as abortion was legal by Supreme Court decree, it was possible to identify as pro-life but keep that commitment at the level of theory; one could hold pro-life views but not be perceived as a threat. All that has now changed. To identify as pro-life post-Dobbs is not simply to hold an opinion many regard as wrong; it is to be part of an act of political and social “oppression.” And predictably, many Christians are feeling the need to “nuance” their relationship to the overturning of Roe.
The National Catholic Reporter has excelled itself in this regard. The strangest argument in its pages was made by Fr. Thomas Reese. He studiously avoided any expression of gratitude for the decision, and said it is a result of America’s domination by big corporations. The response of big business to Dobbs would seem to indicate his case is, to put it charitably, a little overstated.
Then, in an article attributed to “editorial staff,” the Reporter revealed the real reason for its nuance about Dobbs: Donald Trump appointed the Supreme Court justices who made it possible, and Trump was “arguably the most corrupt and morally degenerate president in history.” That claim may or may not be true—the competition for the title is a little stronger than the Reporter acknowledges—but the argument is specious at best. As to the article’s later assertion that “women will die without Roe’s protection,” one wonders whether the editorial staff of this prominent Catholic magazine are as familiar with their own church’s teaching on life and personhood as they are with Twitter (which has clearly had a baneful effect on otherwise intelligent people’s ability to construct an argument). It would seem not. By the standards of Catholic teaching, women have been dying by the millions for decades thanks to Roe.
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