This past year at the PCA’s General Assembly, we decided to send a letter to the President and other government officials asking them to stop the practice of sex-change operations for minors. Since we debated the wording so much, we did a very Presbyterian thing and let a committee appointed by our moderator write it.
What follows is that letter and a cover letter from our Stated Clerk.
The letter itself:
(It’s addressed to the President and other “leaders of the United States Government.”)
We, the Presbyterian Church in America, the largest body of confessional Presbyterian and Reformed churches in North America, consisting of more than 1,500 congregations and 374,000 members across the United States and Canada, humbly petition you to protect the lives and welfare of minor children from the physical, mental, and emotional harms associated with medical and surgical interventions for the purpose of gender reassignment. Furthermore, we call upon you to use your positions to promote the health, bodily integrity, and wellbeing of minors who are suffering from gender dysphoria and related conditions.
We recognize the growing nationwide distress and concern over interventionist practices targeting children. While we acknowledge complexities around these issues, we share those concerns and urgently appeal to you to protect the Nation’s children. The basis for our appeal is that all people—young and old, male and female—are created in the image of God (Genesis
1:26–27; James 3:9). This unique status accords all human beings with inherent dignity, a dignity that extends to both soul and body. For over two thousand years, the Christian Church in all her branches has stood on the teaching that the value of the human body arises from its source, which is from God, and its purpose, which is to bear God’s image. We believe current gender reassignment interventions for children are not in keeping with the high value of human bodies—a value determined not by circumstance, ability, or human judgment, but by the determination of our wise Creator who constituted each person a body-soul unity (Genesis 2:7; Psalm 139:13–16).
We also ground our humble petition in God’s love for children. He expressed his love when the Son of God said, “Let the children come to me; do not hinder them, for to such belongs the kingdom of God” (Mark 10:14 ESV). Indeed, his deep love for children is revealed in comparing them to those who are greatest in the kingdom of heaven. Because of this love, it is a grave sin to harm children (Matthew 18:1-6). In his kindness, God has provided parents and the civil magistrate for the protection of children (Ephesians 6:1–4; Romans 13:1–4).
Until recently, an obligation to protect children has been widely acknowledged in Western society. The duty to protect children from harm is to be met by authorities in familial and civic contexts who recognize the vulnerabilities unique to childhood. While these vulnerabilities can be preyed upon by powerful external forces, they are also susceptible to the internal confusions and instabilities often accompanying childhood.
As Christians, we recognize that we live in a fallen world in which some children and adults experience a perceived incongruence between their biological sex and their internal sense of gender. These feelings of gender incongruence cause severe psychological distress often associated with debilitating anxiety and depression. We genuinely sympathize with the parents and loved ones of those who experience this kind of suffering—many of them in our churches.
However, experts disagree on the nature and causes of gender dysphoria. Persons who try to change their biological sex through the process of transitioning—including psychotherapy, lifelong hormonal treatments, and extensive nongenital and genital surgeries—are attempting the impossible. This reality merely reflects the divine design, as God created human beings distinctly male and female (Genesis 1:27; Matthew 19:4; Luke 10:6). Since the sexual binary is rooted in creation and determined by God, it cannot be changed; therefore, it is not surprising that transition attempts carry many long-term risks. Among these risks, which are often irreversible, include conditions such as sterility, infertility, cancer, cardiovascular disease, strokes, blood clots, pituitary apoplexy, pseudotumor cerebri, and diminished bone density.
For children, the stakes are even higher. Since the brain has not yet fully developed during puberty and adolescence, minor children are not mentally and emotionally ready to give informed consent to life-altering and non-reversible medical procedures. And with the increase in depression, anxiety, isolation, and alienation of children and adolescents in the United States and Canada—exacerbated by the use of social media and, more recently, COVID-19 policies—young people often experience fluctuating emotions and internal confusion. Teenage girls especially have been susceptible to rapid onset gender dysphoria, a recent phenomenon involving large numbers of teen girls claiming to have gender dysphoria. The increased diagnosis of gender dysphoria in girls has been driven by social contagion from current social, educational, and cultural influences. Children whose minds and personalities are still developing do not yet possess the perspective or maturity to make these irreversible decisions; they should be given time to accept their biological sex, which occurs in the majority of teens allowed to progress through natural puberty.
Although we respect the expertise of medical professionals, it is striking that traditionally, medical students had to affirm the Hippocratic Oath, which includes the commitment: “I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman.” This priority of not harming others is ultimately grounded in the triune God who is love (1 John 4:8), from whence he calls us to love each other. Reflecting this nature of God, one of the greatest commandments is that we love our neighbors as ourselves (Matthew 22:39). As Scripture states, “Love does no harm to a neighbor” (Romans 13:10 NIV; cf. Exodus 20:13). Providing medical intervention for the purposes of transitioning does irreversible harm and injustice to all people, but especially minor children.
For these reasons, we condemn the practice of surgical and medical gender reassignment, especially of minors, and we humbly petition you to protect the lives and welfare of minor children.
Sincerely,
The Presbyterian Church in America
I’m listing the Cover Letter after the main letter because the theological content was mostly contained above. This letter is intended to be used by individual presbyteries to contact their government officials. Our stated clerk of Rocky Mountain Presbytery will be sending something like this, with the above letter, to government officials in Colorado, Wyoming, and Montana. Here’s the Cover Letter:
Dear [name and title of government official],
The attached letter has been prepared by a commission of the Presbyterian Church in America (PCA), the largest body of confessional Presbyterian and Reformed Churches in North America, consisting of more than 1500 congregations. In the letter we humbly petition our government officials to protect the lives and welfare of minor children from the irreversible damage associated with the medical and surgical interventions of gender reassignment.
We ground this humble petition in God’s love for children and in your and our government’s commitment to their welfare. We deeply respect the weightiness of the obligations of your office in the light of our culture’s difficulties in determining what voices to heed on so tender and difficult an issue, but our petition asks that you consider the decisions that children are capable of making about permanent physical changes that will affect the rest of their childhood and adult lives. We ask that you read this petition with an understanding of the humility and respect that we desire to express, even as we speak unreservedly in behalf of those who are not yet ready to make adult decisions.
Sincerely,