Talking about LGBT identities
Fasten your seat belt. This issue is a tough one — but one we need to get out on the table and discuss.
Even that list of letters —LGBT — is new, unknown to some, and still changing. The term represents a broad group of people with various sexual identities and expressions — lesbian, gay, bisexual and transgender — covering all the way from same-sex attraction to gender dysphoria (previously called gender identity disorder). LGBT is the broad title used by many in today’s world, to which some now add Q, for queer or questioning, and I for intersex.
Few issues have divided religions, cultures, society, and especially families, more than this one.
As an academic health sciences center, Loma Linda University Health serves individuals representing all aspects of the LGBT spectrum, for we are called to meet the world where it is. It is critical that we understand, treat and support everyone whom we encounter, regardless of their hereditary, cultivated, assigned or self-assumed sexual identity. That is what we do as health professionals. It is what our code of conduct expects of us. I don’t think anyone can argue with that. And in this meeting, this dialogue, we come to know LGBT people as individuals facing their own struggles and pathways through life.
As with so much of our knowledge in medical science today, our understanding of sexual identity is rapidly changing. When I was in medical school, we were taught that homosexuality was caused by an overbearing father, or was it the mother? Now we know that besides the few clear cases caused by abnormal X or Y sex chromosomal expression, there are many more genetic variations that modify various hormonal pathways and result in a broad spectrum of psychological and physical changes.
What used to be a “binary” view of gender — you are either male or female — is now considered by many a “non-binary” model, where there is a whole spectrum of sexual identity and expression between the typically understood male and female ends of the spectrum. These variations make sexual identity and practices difficult to understand, accept and navigate for many. For example, we have biological boys at birth with the strong and persistent sense that they are really girls “trapped in a boy’s body,” and vice versa. This comes so early in life that it cannot be considered a choice they are making but rather an internal identity caused by their particular genetic code and its expression.
As I have tried to get my mind around such fundamental questions, one of the most helpful books I’ve read was recommended by a church committee on which I serve. The book is “Understanding Gender Dysphoria” by Mark Yarhouse, a Christian psychologist trained at Wheaton University. As one reads through the many case histories he shares, you have to be filled with both confusion and compassion for the huge dilemmas many people find themselves in as they seek to understand and deal with their sexuality/gender identity. The January 2017 issue of National Geographic, titled “Gender Revolution,” tells stories from around the world detailing how different cultures have treated these individuals. This is clearly not just a Western phenomenon, but part of the entire human experience.
This new reality and understanding now presents us with the need for a major paradigm shift in our relations with each other. How do I relate to someone who is different from me in such a fundamental way, yet deserves my care and friendship as much as anyone else? My own interactions suggest that most LGBT individuals are not trying to stand out, or fly a flag — they are longing to be accepted as a part of the human race and community they find themselves in, fellow travelers on this earth, just like the rest of us.
Yarhouse suggests that transgender individuals have three choices for understanding themselves and how to live their lives — as the traditional (to identify with one’s birth anatomy), as understanding one’s self to have a disability (a variation from normal) or to see oneself as representative of the great diversity in the world. What we know with certainty is that the emotional stress on LGBT individuals, particularly those dealing with transgender issues, leads to a very high suicide rate. Higher than normal rates of depression and social isolation are also widespread among others identifying under the LGBT umbrella.
Now, hang on, I know all about the Bible texts that talk about sexual variations, their sinfulness and results. But I also know that Christ Himself spent His time on this earth reaching out to individuals who were marginalized during His day — prostitutes, lepers, the lame, blind, demon possessed, tax collectors and the poorest of the poor. While the Bible doesn’t give us a specific story about Jesus relating to an LGBT person, individuals under this umbrella would certainly fit into His lexicon of those deserving His compassion and care. The question of causation asked of Him about the blind man — “Who sinned, this man or his parents?”— seems very pertinent here. Christ’s answer — “Neither, but to glorify God” — acknowledges His acceptance regardless of causation.
So what are we to do? What am I to do? What is Loma Linda University Health to do when LGBT individuals seek out our campus as a place of understanding and healing? They are certainly here, some we know about and I am sure many we don’t. Do we accept or reject? Do we brand and watch, or integrate and care? It seems to me the old acronym WWJD (What Would Jesus Do?) comes to bear here as we acknowledge each individual as a child of God. It seems to me that this is not a time for judgment, but rather a time for acceptance, a time for offering emotional support during a difficult journey. What better role can you and I play than to relate to LGBT individuals as part of the family of struggling human beings to which we all belong?
Richard Hart, MD, DrPH