The world is changing. There is male, there is female, and there is something in-between, at least in the minds of many who have exchanged what is black and white for a sliding scale of gray.

As Christian counselors seek to help people struggling with gender identity issues, they face obstacles—not only from the culture at large but from their own profession and sometimes from laws that limit what they may say.

Consider:

• The American Psychiatric Association’s official tool for classification and diagnosis, The Diagnostic and Statistical Manual of Mental Disorders, no longer speaks of “gender identity disorder,” but rather of “gender dysphoria.” The APA now says it is not a disorder to feel that one’s gender identity and biological sex don’t match. The problem, these psychiatrists say, is simply the distress and anxiety that accompany that condition.
• France and the United Kingdom have both instituted similar policies regarding mental health professionals, and several nations now include a third, nonspecific gender on their official documents.
• California, New Jersey, Oregon, Vermont and Washington, D.C., have all passed laws that prohibit state-licensed mental health providers from helping a minor to change his or her sexual orientation, gender identity or gender expression—even if both the minor and his or her parents desire such counseling.

“There is a really tough bind that the Christian counselor is in sometimes, due to state regulations,” said Stephen Arterburn, a veteran counselor and cofounder of New Life Clinics. “It’s a very tough bind, wanting to help somebody live out Christian values that are in conflict with the sexuality that they are feeling. And of course that feeling comes from the influence of the secular world.”

David Janvier, a licensed counselor in Pennsylvania, agrees that adhering to state licensing regulations may be in direct conflict with Biblical values.

“The field is so much part of the mass cultural delusion that blinds people to what the research really says around these things,” Janvier told Decision. “I think it’s a matter of time before we will not be allowed to do anything around changing anyone’s gender identity issues or sexual orientation.”

Janvier points out that state laws, and policies such as that of the APA, are self-contradicting. On the one hand, they say that a therapist should not impose his or her own belief on a client, that the client has “full agency” to make decisions about the treatment they will receive. But then the option of resolving the issue in a Biblical way is prohibited, even if that’s what the client desires.

Not all psychiatrists have bought into the APA’s new policy. Richard B. Corradi, professor of psychiatry at Case Western Reserve University Medical School, writing in First Things, said: “It is lamentable that American psychiatry has abrogated its professional role and allowed public hysteria to define the transgender phenomenon. This deprives people of treatment that could lead them to understand themselves and take control of their lives.”

Still, the reality is that counselors now must decide what to do in an increasingly restrictive climate.

Some choose to forego state licensure. Although this means the counselor will be unable to bill a client’s insurance or be recognized by courts or public schools, these counselors say it is worth it to avoid being put in a position where state regulations restrict the ways they may counsel clients.

“I don’t want to say anything against my dear friends who are state-licensed,” said James Newheiser, director of the Christian Counseling Program at Reformed Theological Seminary’s campus in Charlotte, N.C. “But my analogy would be that I don’t want the government licensing preachers and governing how they do their job. And from my standpoint, spiritual counsel is in the same category. I think it hinders ministry if you put yourself in a situation where a non-Christian authority structure that is opposed to your worldview is telling you how to practice your spiritual care of people.”

Deborah Dewart, an attorney from North Carolina, agrees. “Counseling is not religiously neutral,” Dewart said. “It can’t be, because you’re talking to people about how they ought to live and how they ought to change. When you cut God out of that picture, it’s not good news.”

In states with less restrictive laws, counselors like Janvier still feel some freedom in helping clients who want to overcome their gender identity crisis.

“I tell people upfront where I stand,” Janvier says. “I point out that there is nothing in the research that supports that people are born this way. Ultimately, God allows us to make our own choices, so I can’t impose. But even though people who come to my office are not necessarily Christians, I’m still trying to discern what the Holy Spirit wants me to do in the moment.”

For Christians who have a family member or friend struggling with gender identity, counselors offer some practical advice.

First, approach the person with both candor and compassion, says Janvier. Understand that the person’s struggle is real and that he or she is in turmoil, and be a loving representative of Christ’s presence. But at the same time, do not support the person’s sin or decisions that take them further from how they were created to be, in union with Christ.

Also, our presence must involve more than just speaking, Janvier says. “It has to be, ‘I’m in this with you. When you are called names at school, I’m still going to be here for you. Even though I don’t agree with your decisions, I still love you, and I’m still here for you.’”

Finally, Newheiser points to 1 Corinthians 6:9-11, which names various kinds of people who will not inherit the Kingdom of God.

“The one solution for these people is the Gospel of Jesus Christ,” Newheiser says. “It’s not reprogramming them or reparative therapy. Jesus not only forgives sin; He also gives people new hearts, so that what they were is no longer what they are. ‘Such were some of you,’ says 1 Corinthians 9:11. I think any method that isn’t redemptive is kind of like cleaning the outside of the cup. It is not dealing with the heart of the issue.”

 

Scripture quotations are taken from The Holy Bible, English Standard Version.