One of the great liberating and ennobling teachings of the Gospel of Jesus Christ is that God is the Father of our spirits (Heb. 12:9,10), and we are His children (Romans 8:14-17), beings with an eternal destiny, sons and daughters of our Heavenly Father. We are sons and daughters, not just generic sexless spirits, but beings of specific gender going back long before our birth into these frail, imperfect mortal shells. Our gender predates our birth. In the premortal existence where we dwelt as spirit sons and daughters of God, we waited and were willing to be born into mortality and take on all the challenges and pains this brief trial brings.

Latter-day Saint theology helps us understand that we are more than our physical bodies. Much more. Our immortal spirit bodies, male or female, is at the core of the "real us." It is now housed in a wonderful but deliberately limited and fallible device, the mortal body, which is designed to be temporary and to ultimately perish. Not only will it die, but it is subject to all manner of afflictions and trials. Pain, disease, deformity of all kinds, wounds and damage in endless ways are possible. Every gene, every organ, every part of the body is subject to risk and harm. These problems may arise from random mutations, from radiation, from chemicals, from physical injury, gaps in nutrition, threats in the environment, and a host of other factors from the moment of conception onward. What a miracle it is that so many of us can walk, see, taste, bear children, and enjoy the pleasures and wonders of life as we do. May we always be sensitive to those whose struggle is different.

Latter-day Saints of all people should be prepared to understand that our gender is determined by something other than the physical appearance of our body. When we consider how variable this mortal shell is and how many things can confuse and confound these mortal shells, we should be well prepared to understand that there may be instances where a male or female spirit is in a body that, due to the random challenges of mortality from mutations or other issues affecting physical development, does not fully or accurately match the gender of the spirit. That this problem can occur is perhaps most easily understood by considering the case of individuals who are obviously born with both male and female attributes. In some cases, doctors make an assignment through surgery to specify which gender such individuals will have. It's possible for us to grasp, then, that the assignment may be incorrect, resulting in a female or male spirit assigned to a body that doesn't match the true gender of the soul. This error in assignment may happen through other means. There are other stories and pathways for us to consider.

I used to be skeptical about such possibilities until I met a valiant Christian woman and learned about her life-long struggle. From birth to about age 50, she was in a body assigned to the male gender, possibly due to problems associated with harmful medications her mother was taking during pregnancy. She is now physically female. I have shared her story on this blog before. Today I'd like to share something kindly written by another voice, the faithful and valiant Christian and Latter-day Saint who is the Webmaster of one of the voices associated with LDSGender.com:
The more I study this issue the more it seems to me like it really is purely a medical one. There is a general medical term called "intersexed" which applies to anybody who has physical characteristics of both males and females. The exact arrangement amongst individuals so affected can vary greatly. Traditionally people limit the application of the term to characteristics that are readily apparent by viewing a person's outer physical characteristics, conditions such as undescended testes or any other number of variations on the genitalia that don't point obviously to the individual being male or female. But then there are other conditions that you can't perceive by simply viewing somebody's body with your eyes but that medical science allows us to see with relatively routine tests.

Examples of this include phenotypical males who are later found to have ovaries and/or a uterus and/or Fallopian tubes, females who are found to have internal testes, phenotypical females who have the DNA of a male and phenotypical males who have the DNA of a female or the combined DNA of a male and a female. The fact that there are numerous readily recognized conditions such as this should show that we tread on somewhat slippery ground when we insist "gender is determined by genitalia." The International Olympic Committee used to think that way, then "advanced" to supposing that "gender was really determined by DNA" until it became clear that even that was not 100% reliable. Now they are not quite sure what to think. Beyond what physical sight can tell us about gender and what current medical science can tell us about gender there is also what future medical science may be able to tell us about gender.

There is growing evidence that the prime determinant of gender rests in a person's brain (which may be the physical organ most closely connected with a person's spirit) and that no amount of nurturing, upbringing or socialization to the contrary, hormone therapy or surgery can fundamentally change. At this point in time we can't really tell if a person has the physical structure of a male brain or of a female brain . . . until they are dead, and studies have shown that those who were phenotypically male in life but who reported having a female identity were indeed found to have a female brain structure upon post-mortem examination. But even with the limitations of current medical technology we can get a decent idea of what gender a person is by doing something rather simple . . . we can ask them. Self-reports, especially self-reports made persistently over a period of time tend to be the best possible determinant of a person's actual gender. And to have a female brain in a male body (and vice versa) is coming to be seen as an actual intersexed condition, even if the actual physical incongruity is known to nobody but the individual. I believe there is already medical evidence to back this up and that growing medical evidence will eventually make it close to irrefutable.

The absolute most humane approach at any point in time is to respect what an individual says about their gender. When a person lives against their actual gender it causes untold stress that takes an additional toll beyond what they are already physically experiencing.

In the Lord's restored and eternal gospel gender is exceedingly important. Eternal unions are formed when a male and a female are sealed by proper priesthood authority. Additionally, sexual sin (including some forms that confuse gender differences) is rampant in our society. It is easy to see how anything related to "sex" can be a very touchy subject. It can also be easy to think of those who are intersexed in the manner spoken of above as loose, degraded, immoral, hyper-homosexual, deviant, on the fringe of Gospel activity (if anywhere near it), etc. Mine is one of a number of voices out there showing that there are those with gender issues who are imperfect but who do not fit that stereotype. I am a lifelong true-blue, through and through, dyed-in-the-wool Mormon born in the covenant to two active LDS parents from good pioneer stock. I have served an honorable mission and have always been temple-worthy and I also enjoy frequent temple attendance. I do my hometeaching, read the Ensign all the way through every month as well as reading all the Priesthood/RS and Sunday School lesson material ahead of time before it is discussed each Sunday. I have strictly observed the law of chastity and have never partaken of drugs or alcohol. I also have never encouraged immoral behavior in anyone else. I have a profound testimony of the gospel of Jesus Christ that has been revealed to me by the Holy Ghost and a fixed determination to live up to all of my covenants, no matter the cost. None of this seems to have changed the reality of the gender issue I face where having a male body doesn't seem to be the correct mortal shell for an apparently female spirit.
I'll have more to share on this topic shortly. There is a great deal of medical research that can give us insight into these complexities, and with that insight, perhaps compassion and understanding may grow. These instances may be rare and unusual, but where they occur, great sensitivity and kindness is needed in a world that can be quite cruel.

This is a sensitive topic and I still have much to learn since it is so outside my experience. Only recently did I chose to confront it and learn more from others. Just as we need to be loving toward those whose struggles are different, we need to be loving and tolerant of those in the Church whose viewpoints are different. There is a diversity of opinions that will be expressed from various leaders of the Church when they touch upon this topic, if at all. This is an area where slow, gradual development of understanding is likely to occur, and where patience and faith is needed for those struggling with this complex issue and for their friends and families. Bitterness and militancy is not the Lord's way of dealing with tough issues, but are crucial tools for the Adversary who delights in contention, anger, and mocking.

Update, Sept. 10, 2012: Some useful resources to understand the issues related to the complexity of gender can be found at http://ldsgender.wordpress.com/2012/06/13/transsexuality-is-one-form-of-intersexuality/ (great discussion occurs there, too). Also check out the excellent resources listed at http://ldsgender.wordpress.com/resources-and-links/. One publication that I found especially interesting and thoughtful was "Developmental, Sexual and Reproductive Neuroendocrinology: Historical, Clinical and Ethical Considerations" by Dr. Milton Diamond, Frontiers in Neuroendocrinology, Volume 32, Issue 2, April 2011, pages 255-263. Also see the AAAS news item, "New Research Casts Doubt on Surgery for Infants Born with Male and Female Traits."
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