Written by Ryan T. Anderson |
Wednesday, February 22, 2023
Children who feel deep discomfort with their bodily sex should be treated with kindness, respect, compassion, and love. They need to be protected from bullying, teasing, and any form of mistreatment. But they deserve to know the truth and to be guided to embrace the truth with whatever assistance we can give to help them feel comfortable with their bodies.

Every newborn child is either a boy or a girl, just as every human adult is either a man or a woman. This is a biological reality. Boy and girl, man and woman, are just the age-specific terms for human males and females. Sex for human beings, like all other mammalian species, is binary. And stable. Sex does not exist along a spectrum, nor is it fluid. That’s why activists use different words—gender, and gender identity—to make those claims.
But stick with sex for a moment. The reason we can confidently say that sex in humans (like other mammals) is binary and stable is because there are two ways of being organized for sexual reproduction. What do I mean by that? Organisms are organized. Human beings, like other organisms, are composed of parts—organs—that work together as an integrated unit (a whole or complete entity). The various organs perform various functions, but not in a haphazard or disorganized way. They are, rather, organized. All of us humans—male and female alike—are organized the same way when it comes to our respiratory system and the function of breathing, and our circulatory system and the function of pumping blood. But we are organized differently in one key respect—sexual reproduction. So when we say there are male and female human organisms—people—we are talking about two ways of being organized sexually—that is, in respect of sexual reproduction and the reproductive system.
Sex is not “assigned at birth,” nor at a twenty-week ultrasound. It is identified, that is, recognized, based on the organization of the organism. Sex—in terms of male and female—is determined by the organization of the organism for sexually reproductive functioning. So sex as a status—male and female—is a recognition of the organization of a body to reproduce in a certain way. More than simply being identified on the basis of such organization, sex is a coherent concept based—and based only—on that organization. The fundamental conceptual distinction between a male and a female is the organism’s organization for sexual reproduction.
Why say it’s binary and stable? It’s binary because there are only two types of sexual organization, and their component parts. There are two gametes, two genitals, two sets of reproductive organs, and two reproductive systems. That is, there is sperm and egg, penis and vagina, testicles and ovaries. There is no third genital, no third gonad, no third gamete, no third reproductive organ, no third reproductive system. That’s the binary. It’s stable—rather than fluid—because unlike some other species, the human being does not—indeed cannot—change sexes, morphing from male to female and vice versa. Nor do truly “intersex” people or “hermaphrodites” exist. Yes, there are disorders of sexual development, where someone may develop without a complete reproductive system and perhaps even with vestigial aspects of the other reproductive system, but these people truly are—and they know themselves to be—male or female—that is, their bodies are fundamentally organized for either the male or female role in procreation. Not both, not neither, and not somewhere in between. (For more on this, see Chapter 4 of When Harry Became Sally.)
“Gender Identity” is Gender Ideology
Of course disorders of sexual development are not what is driving modern transgender ideology. When you see someone appeal to so-called “intersex” conditions, it is a red-herring. What’s taking place today is not the question of how to identify sex in cases where it’s not fully formed and thus hard (at least early on) to classify.[1] No, instead a new ideological framework is being imposed, one where sex is said to be merely “assigned at birth” and then something called “gender identity”—one’s inner sense of something called “gender”—determines one’s sex. On such a theory, there is no intrinsic meaning or importance to the sexed body. Instead, subjective feelings determine reality, so that all of us must adopt a “gender identity.” The end result is that identifying as a boy or a girl, or a man or a woman—or both, or neither, or somewhere in between—is what makes you a boy or a girl, a man or a woman—or both, neither, or somewhere in between. That’s the new dogma, rather than boys being immature human males, and men being mature human males; and girls being immature human females, and women being mature human females. We’ve moved from an objective recognition of reality to a subjective assertion of identity—and to ruthless demands that everyone affirms these identities.
But what could determine this so-called “gender identity” as an inner sense of “gender” distinct from sexual identity and bodily sex? The answer is simple: Social and cultural assumptions based on stereotypes. Stereotypes about how boys and girls, men and women, are supposed to behave, what they’re supposed to be interested in, how they’re supposed to look. Some claim that with “gender identity” there’s an inner truth that is “discovered” (and then asserted) while others say “gender” is a self-created “performance.” What is discovered or performed, however, will be the result of cultural assumptions. In this sense, “gender identity” is a social construct. And today, many new “gender identities” are an explicit rejection of the stable sex binary itself: hence the rise of non-binary identities. Indeed, increasingly it appears that many young women are just opting out—rejecting—their femaleness without any real sense of what it is they’re embracing.
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Contrary to the false hopes encouraged by agnostic modern thought and modern medicine, the death of the body is only the beginning of sorrows for those who have been so foolish as to live apart from God and continue in sin. After death there is a day of judgment slated on the calendar of God; all must appear before His tribunal, and none shall be spared (2 Corinthians 5:10).

There is a remarkable difference between how an unbeliever and a believer look at dying, death, and the afterlife. For the unbeliever or the agnostic, death is mysterious and the afterlife is even more dubious. For the believer, death is not an extinction or a terminus but only a transition, a junction. Though solemn, it is demystified in Christ and the afterlife is the best life. Let’s consider this contrast.
After Death—Agnosticism’s Version
Sally, the hospice nurse, stood by Bruno’s bedside.1 Bruno was a prisoner with amyotrophic lateral sclerosis (ALS), who had been transferred to the hospital with his fifth bout of pneumonia in the past six months.2 He was serving a life sentence for the murder of his elderly neighbor, who had attempted to stop him from stealing his narcotic pain medications. While incarcerated, he developed ALS, underwent a tracheotomy, and became dependent on a ventilator to breathe.3 Bruno had a choice: return to prison on the ventilator until suffering the next bout of pneumonia with the possibility of dying by suffocation; or, have the ventilator withdrawn, receiving medications to manage his respiratory distress, and dying in the luxury of a hospice facility. Needless to say, Bruno, who thought he was the victim of injustice, did not like his choices.
As he lay silent with expressive eyes, paralyzed, his right wrist handcuffed to the bedrail, and a prison guard by his side, Sally presented her case for hospice care: “Bruno, I know this is a difficult choice to make, but we will keep you comfortable after the ventilator is removed. You won’t have to go back to prison—you won’t suffer anymore.”
Sally was presenting the common view that what happens after death is in some way better than persisting in this present state, even for unrepentant murderers who see themselves as victims of the system. In Europe and America, it is quite acceptable to choose or create a self-customized hereafter. If one wants to believe in nirvana, reincarnation, a happy hunting ground, heaven, any combination of these possibilities, or else simple annihilation, the modernist will not object—provided the belief is not imposed on others. According to the modern mindset, no one really knows what happens after death. “What is emphatically clear is that everyone is dying, and one day, we will all die,” says the modernist, “so why not permit the imagination to wander when it comes to the hereafter?”
For many centuries the church was the predominant institution addressing dying, death, and what happens after death, not hospices and medical institutions that could be indifferent to or at odds with traditional Christianity. Following the beginning of the scientific age in the seventeenth century, the medicalization of death in the nineteenth century, and the increasing effectiveness of medical science in the decades that followed, the church was pushed aside. A paradigm shift occurred. The church is now on the periphery and modern medicine has shifted to the center. Moving into the twentieth century, many hospitals in the West, once Christian institutions in purpose, ethics, and practice, have become Christian in name only. Influenced by the rise of higher criticism, liberal theology, and the social gospel, these hospitals no longer affirm a supernatural-natural Christ-centered worldview grounded in Holy Scripture. In the twenty-first century, modern medicine is eager to fill the void left by the traditional, confessional, and biblical church.
Since the two absolutes of dying and death have become medicalized—that is, as aspects of human experience to be addressed by doctors and nurses rather than by ministers of the Word or one’s fellow Christians—it is not surprising to see healthcare professionals, like Sally, asserting an unqualified view of what happens after death to provide answers, comfort, and hope. This position is commonly referred to as agnosticism, which is derived from the Greek agnosis meaning “a state of unknowing,” that is, with respect to metaphysical questions such as the existence of God or an afterlife. Thus, an agnostic claims not to know matters beyond his or her ability to observe or quantify them. This approach to empirical or scientific facts has the appearance of humility. As a philosophical system, however, agnosticism is a proud and unconditional assertion in which all that can be known with certainty must be measured, tested, demonstrated, and verified by hands-on experience. Agnosticism is an outright rejection of non-empirical truth, which claims, without empirical validation, the impossibility of knowing truth outside the process of scientific investigation!
Two major issues stand behind agnosticism in the contemporary West: pluralism and the eventual failure of medical science to sustain life. In western democracies, citizens have a right to believe what they choose, so long as they do not act on their beliefs in violation of civil law and they tolerate other people’s beliefs. All of these personal views address the hereafter in some way, so agnosticism provides a vehicle for tolerance and affirmation.
Another primary factor already alluded to is the innate human need for answers, comfort, and hope. Dying and death are absolute—we are dying, and one day we will cease to be as we are now. This is mysterious, uncomfortable, and even dreadful. Someday medical science will fail us, when the doctor says he can do no more for us. After all the optimistic counsel from well-meaning healthcare professionals and hopeful state-of-the-art medical treatments, dying and death stand firm and fixed on our human agendas—then what? In modern medical practice a referral to hospice is made, and end-of-life experts come alongside to support individualized answers, provide comfort in the midst of suffering, and affirm one’s self-customized hopes for some good or life after death.
Death as a Natural Part of Life
In a similar way, modern medicine commonly promotes the view that death is a natural and normal part of human existence. Since dying is a process running parallel with life, in modern medicine the death of the body has become associated with the outworking of natural laws of life. In medical literature, one will often find dying and death associated with pregnancy and birth, or as a stage in a natural process, much like a caterpillar emerging from a cocoon as a butterfly. This interpretation is rooted in the rise of evolutionary biology in the late nineteenth century. According to this viewpoint, no line exists between dying and the death of the body, because they are both the outworking of natural laws of survival occurring in the larger cycle of life. Thus, people facing death should accept and even welcome death with optimism as a transition to a self-customized hereafter.
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It is the hope you have in the Lord Jesus that enables you to persevere, to endure to the end. Knowing the glory that he has stored up for us, the home he has prepared for us, the welcome that is waiting for us from the Lord Christ himself. Knowing that all who are joined to the Son have that promise of joy in our Father’s presence, of eternal pleasures with him. This is what can keep us going, enduring, in serving the Lord and serving others.

1 Thessalonians 1:2-3:
We always thank God for all of you, mentioning you in our prayers.
We continually remember before our God and Father your work produced by faith, your labour prompted by love, and your endurance inspired by hope in our Lord Jesus Christ.

There can be a view of the apostle Paul that he is this huge head full of theological concepts like predestination and election, mortification and sanctification, and a heart that is two sizes too small. That he cares about lofty ideas, but not really about people.
It’s certainly true that in the Lord’s unique gifting of Paul, as well as his providence in the training the apostle had even before he came to Christ, Paul does have this immense God-given wisdom, so that his Spirit-inspired letters have been a guide to God’s people for close to two thousand years.  His God-breathed writings have been used by the Lord to keep Christ’s church on the rails for two millennia.
But the idea that Paul didn’t care about people is just blown away, all the way through his letters and the book of Acts. I love it in Acts 20 when Paul is saying goodbye to the Ephesian elders, and we’re told ‘They all wept as they embraced him and kissed him. What grieved them most was his statement that they would never see his face again.’
This isn’t how you respond to a man who doesn’t care about people. This is how you respond to someone who loves people so much that he is delighted to share not only his words, but his whole life with them – in order that they might see the truth and the goodness and the beauty of his Saviour. This weeping on the beach is how you respond to someone who is able to say, in all seriousness, ‘we ALWAYS thank God for ALL of you, mentioning you in our prayers’.
This is a man who cares about people, knowing that in God’s glorious and glorifying plan of salvation, it is PEOPLE that Christ came to rescue. And in these verses, we see a man who cares for and gives thanks for specific people. A people he cares for deeply. There’s three specific things he gives thanks for in the Thessalonian believers. And you’ll see that they relate to that trio of Christian virtues that are in First Corinthians 13, and come up many times in Paul’s writings – faith, hope, and love.
Let’s look briefly at each one – and may they fuel our prayers.
Work Produced by Faith
Paul and his companions were continually remembering before God how the Thessalonians worked, and that these good works they did were produced by their faith in Christ. Coming from a Catholic upbringing, where I genuinely thought I needed to work really hard in order to be in with a shot of God’s favour and mercy and grace, it was so precious to me when I realised the truth of the gospel. When I realised that we are made right with God by faith, apart from works. It took away so much uncertainty and anxiety, about whether I’d been good enough. Whether I’d done enough. Perhaps I felt a little something of what the Reformer Martin Luther felt when he discovered the gospel of grace, and said: “I felt that I was altogether born again and had entered paradise itself through open gates.”
But of course, because we’re saved by faith apart from works, that doesn’t mean there’s no place for works.
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