Tag Archives: Christian

Integrity and “Gender-Affirming Care”

In the current issue of the Journal of Medical Ethics, Dr R Rowland argues that mentally healthy people have a right to “gender-affirming healthcare” (i.e. hormone therapy or surgery to appear like the opposite gender), because they have a right to live and act with integrity. Rowland argues that “to live with integrity is to live in line with one’s ideal of what a good or meaningful life for one looks like.” This requires “authenticity” that can be understood as self-discovery of one’s “inner voice” or as self-creation. If someone’s idea of a good and meaningful life includes being perceived as the opposite gender, then to live with integrity he must overcome his natural limitations and change his appearance. 

This article, which claims to represent the “standard view,” seems to be written from an existentialist worldview. According to this view, humans are not bound by their own nature, but define for themselves what a good and meaningful life looks like for them. Our bodies are limitations that should be overcome to fulfill the wishes of our “inner voice.”

True Integrity

The Lord tests Job’s integrity by allowing Satan to ruin his life. Job passes the test because he is “a blameless and upright man, who fears God and turns away from evil” (Job 2:3). The standard is not Job’s inner voice, but his complete conformity with what a man ought to be. His wife speaks with authenticity but not integrity: “Do you still hold fast your integrity? Curse God and die.”

Job describes his integrity in detail in Job 31. He is free from lust and deceit (1-12). He listens to the complaints of his slaves, shares every meal with widows and orphans, and clothes the naked (13-23). He does not trust in wealth or worship the sun (24-28). He loves his enemies, confesses his sins, and does no injustice (29-40). This integrity is rightoeusness, internal and external, that conforms to God’s standards of what a man should be.

Gendered Integrity

A man of integrity will act as a man ought to act, and a woman of integrity will act as a woman ought to act. God made men and women different because they have different roles, so integrity will not look exactly the same for them. Humans are not souls trapped in a body; our gendered bodies are an integral aspect of our humanity. To act with integrity, a man must become the kind of man God created him to be, and not abdicate his role in an attempt to become something else.

Boaz shows integrity on his farm and at the city gate, and Ruth shows integrity in her relationship with her mother-in-law. They both fulfill their distinct gendered duties by raising their firstborn son: Boaz preserves a dead man’s name and strengthens Bethlehem, and Ruth cares for her mother-in-law and for the next generation (Ruth 4:9-22). Integrity looks different in the roles of husband and wife (1 Peter 3:1-17). Paul’s commands to old men, old and young women, young men, and pastors are related, but not identical (2:1-8).

Gendered integrity begins on the inside, but is expressed in external appearances. A man should look and act the part of a man, and a woman should look and act the part of a woman, from the inside out. This is why cross-dressing is considered an abomination under the law of Moses (Deut 22:5), and why Paul speaks confidently about hair length and head coverings for women (1 Cor 11:2-16).


Integrity does not begin with introspection or self-creation. A man of integrity conforms body and soul to what a man ought to be. A woman of integrity conforms body and soul to what a woman ought to be. The Bible has no category for a man trapped in a woman’s body; there are only men and women, whose gendered bodies are integral to who they are and to who they are called to be.

Isaiah 49:9-13 and the Christian Life

Our security is not found in abundant circumstances, but in the care of our Shepherd. Today we look at the New Testament fulfillment of an Old Testament description of Jesus’ salvation. If you haven’t already, start with Isaiah 49:1-7 and the Servant’s Mission and Isaiah 49:8 and Three Ways Jesus Has Begun to Fulfill the Land Promises.

saying to the prisoners, “Come out,” and to those in darkness, “Appear.” They shall feed along the ways; on all bare heights shall be their pasture;

Isaiah 49:9

Jesus came to heal those oppressed by the devil (Acts 10:38), and the church continues to free people from Satan’s power through repentance and forgiveness (Acts 26:18–20). We come out of Babylon now, so we are safe when she falls (Revelation 18:4–8).

In Isaiah, darkness represents ignorance, sin, and judgment. Jesus is the light who gives us knowledge (2 Corinthians 4:6), righteousness (1 John 2:8–11), and life (John 8:12).

I’m no shepherd, but roads and “bare heights” don’t sound like the best place for sheep to graze. Our security does not come from abundance in our circumstances, but from the care of our Shepherd.

they shall not hunger or thirst, neither scorching wind nor sun will strike them, for he who has pity on them will lead them, and by springs of water will guide them.

Isaiah 49:10

The fulfillment of this verse is explained in Revelation 7:16–17. Our security is not found in physical circumstances, but in God’s seal that prevents us from worshipping the beast. The beast and the harlot might physically starve us or kill us, but we will escape the wrath of the lamb and enjoy the living waters of eternal life.

And I will make all my mountains a road, and my highways shall be raised up. Behold, these shall come from afar, and behold, these from the north and west, and these from the land of Syene.

Isaiah 7:11-12

The Lord will remove every obstacle to His people’s journey. The road to salvation is hard, but nothing can stop us if we just stay on the path.

The final place God’s people come from is unclear. “Syene” (an ancient Egyptian city) comes from the dead sea scrolls. The Masoretic text reads “Sinim,” which might mean China. The Septuagint says Persia. In any case, the picture is of the dispersed Israelites returning from every direction, and the final fulfillment is found as God gathers his elect from the ends of the earth into His kingdom.

Sing for joy, O heavens, and rejoice, O Earth; break forth, O mountains, into singing! For the Lord has comforted his people and will have compassion on his afflicted.

Isaiah 49:13

This passage ends with creation worshipping God for the compassion He shows in the salvation of His people. The servant’s work will glorify God (Isaiah 49:3) because it will demonstrate God’s character and inspire everlasting praise. The creation that was cursed because of sin will fulfill its ultimate purpose of glorifying God.