Religion vs. Transgender Mental Well-Being

My role as a psychotherapist is to understand and learn as much as I can about my patient’s life, help them explore their gender identity and be with them as they explore themselves in totality. Oftentimes, this means I must work hard to understand the patient’s history and background. I believe it’s important to understand the cultural foundations of a patient’s life because it is vital to understand where they have been in order to move forward. During the intake process, which can be dry, religion and spirituality come up but I usually don’t spend enough time here. Religion and its impact on a transgender or gender non-binary person seeking treatment can be tricky.

To present this challenging issue with some specificity, I’ve been given permission, on condition of anonymity, by a former patient to briefly describe one person’s plight. She was a product of a small, southern town — completely segregated, very conservative, dominated by an evangelical Christian Church. Although the New Testament talks about brotherly love, much of the teaching is grounded in shame, guilt, and fear. Any deviation from the norm is considered a sin and would result in eternal damnation. Thus, I think most people can appreciate the hard work it must take to learn to love and accept oneself under these conditions.

To offer more substantive conversation and additional context about religion and its relationship to transgender people who are/have been raised as “followers,” I think it’s helpful to present links to a few articles that I have found.

One good resource about Evangelical Christianity and being transgender is the writing of Reverend Dr. Paula Williams. Williams worked with the Orchard Group, a church-planting ministry in New York. She once served as a weekly columnist and the Editor-At-Large for Christian Standard Magazine. She was also a teaching pastor for two mega churches. Those responsibilities ended when she transitioned from Paul to Paula.

What’s important about reading her blog and visiting her website is that she shares some compelling scientific research. One of the findings she discusses — that I suggest you look for — comes from Richard Friedman, M.D., a psychiatrist at Weill Cornell Medical College who spoke about two studies that have shed light on the transgender experience. Without going into detail here, both support the hypothesis that gender dysphoria is neural in its origins.

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What’s important for me as a therapist is to understand and address the obvious — and not so obvious — barriers that torture people’s lives while helping them to heal. There is an incredible amount of exploration, vulnerability, fear, anxiety, depression, purpose, possibility, etc., that goes into considering/moving forward with a transition. For anyone who believes it is a lifestyle “choice,” I can tell you from 25 years of experience, that it isn’t. One may opt to not transition but it is likely that the feelings never go away.

In general, I encourage my patients to make peace within themselves. When religion complicates this process, I try to help them recognize the hypocrisy and unfair judgement that sometimes takes place in religious teachings. It’s important to understand how it keeps some from moving forward and that it is possible to learn to move beyond what they have been exposed to and raised with. The past haunts so many to the point where transition is stalled or abandoned all together. Sadly, some people decide to remain in the closet. Rev. Paula discusses this in her blog and offers a unique, empathetic point of view. She understands the loneliness and suffering of not transitioning. She came to the conclusion that she lost a lot but gained much more after she transitioned.

While every person’s story is different, there are all-to-familiar themes that all of my trans* patients experience. It is important for me to provide support, encouragement, and create a safe space so they can share their thoughts and feelings, their hopes and dreams, their fears and self-loathing — en route to becoming their authentic selves.

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Here are some other resources on this topic that I think you might find interesting reading:



Casey Weitzman of Gender Wellnes of LACasey Weitzman is the President of Gender Wellness of Los Angeles and has been a licensed marriage and family therapist for almost 25 years, counseling children and adults who are exploring gender identity and/or sexual orientation issues.