Why did the transgender movement catch us by surprise, and how should we respond now? That's the theme this week on the podcast, and with that goal in mind, we welcome Rob Smith to the podcast. Rob is a theologian who lectures in systematic theology and ethics at Sydney Missionary and Bible College in Australia.

He also serves as an honorary assistant minister at St. Andrew's Anglican Cathedral in Sydney. Rob approaches the topic of the transgender revolution as a biblical theologian, as a historian of the movement as well, and as a pastor whose own family has been touched by gender dysphoria. It hits rather close to home for him.

And we are all being hit by what he has called a "transgender tsunami" of gender fluidity in Western culture. Rob has completed extensive research of the history of how we got to now. The transgender movement, as you will hear, did not appear out of nowhere. There is a backstory.

And to tell it, here's Rob Smith. Yes, well, thank you, Tony. That's a marvelous question. It certainly didn't come out of nowhere. You can trace the roots right back, really, I think. Well, you can go back to Genesis 3 if you want to, but certainly in the modern period, you can go back to the Enlightenment and then various developments subsequent to that.

But you're right to focus on the 1960s. That's certainly where a number of revolutions came together. And I guess we're familiar with the label of the sexual revolution, which is, of course, this sort of broad umbrella. But there are a number of things going on there, I think, that really set the stage, as you say, for the transgender revolution.

Let me just run through a number of aspects, I think, that are relevant. You've got the advent of the contraceptive pill in 1961, which has the effect of severing sex from procreation. And that itself then changed people's view of sex. It became a leisure activity and something for pleasure rather than having a procreative purpose embedded in it.

And that, of course, then, I guess, opened the door to increased sexual freedom in a very new and pronounced way. So that's one factor. Also on the medical front, you've got the development of antibiotics. I mean, they've been around for some decades before the '60s. But I guess the more effective treatment of various sexually transmitted diseases and a perception that therefore developed that really people didn't need to worry about the danger of STDs.

And that, again, increased sexual experimentation. So those things are going on in the broader society, and I guess you could say sort of pushed on by medical development. Alongside of that, you've got various social revolutions, the feminist revolution, perhaps is the most obvious thing to pinpoint here. And again, at the heart of that, you've got a, well, I guess the deconstructing of the way that people tended to think about sexuality and gender.

You've got Simone de Beauvoir's very famous statement that one is not born a woman, but one becomes a woman. That becomes very, very important for later queer theory and transgender ideology. You've of course got the problem that feminists are grappling with, that biology equals destiny, although they're trying to work out how to stop biology equaling destiny.

And one of the solutions, of course, advocated by various feminist writers at the time was to eliminate sex distinctions. So that's, again, a big part of the background to the transgender phenomenon. And then, of course, you've got the homosexual revolution, which is happening again in the late '50s, '60s, and '70s.

I guess there's a broader acceptance of sexual nonconformity. You've got the idea that biological sex perhaps does not determine a person's sexual orientation, and therefore begs the question, well, does it then in fact determine a person's gender? Does there really have to be this necessary connection between biological sex and gender identity?

So all of those things, I think, are bubbling out of the sexual revolution of the '60s and paving the way for the transgender revolution. You asked the question, why didn't we see it coming? It was there to be seen, interestingly. One of the things I've done is sort of trace back some of the history over the last 100 years or so of the development of the transgender movement.

I mean, back in 1964, you've got the creation of the Erickson Educational Foundation, which was designed to promote both gay equality and transgender equality. And that was set up by a trans man named Reed Erickson. In '66, you've got a significant publication of a book called The Transsexual Phenomenon, as well as the famous Compton Cafeteria Riots in San Francisco.

So there are things happening there in the '60s. Even '68, you've got the International Olympic Committee wrestling with, well, what do we do with transsexuals who want to compete in the Olympics? And they had to make a determination about that. And then perhaps the little known fact is that in the Stonewall Riots in '69, there were transgender patrons involved in that whole episode.

And so the transgender revolution, same-sex revolution, they've really been tied together in a variety of ways from the start. But I think it's just a prominence of the homosexual revolution that perhaps has obscured the transgender revolution that was, as it were, just tucked in behind. And now that same-sex marriage has been realized in many parts of the Western world, it's in some ways moved to one side so that the transgender movement is now, as it were, stepped forward to be the sort of major point of social and legislative and other kinds of engagement.

So there you go. It's just an attempt to try and make sense of how we've got here, how this has sort of come upon us seemingly out of nowhere, but in reality, not out of nowhere. No, that's a great summary of the backstory. I wish we had time for more of the history, but I want to stay focused on the here and now from here on.

As you can imagine, we get a lot of questions on transgenderism in the inbox of this podcast. And one of the most common questions, it seems, is that many Christians who are so far removed from transgender impulses themselves ask whether gender dysphoria is itself a phantom impulse, something that's merely culturally engendered, or is it real?

Is it tangible? And if so, how real is it? You're not far removed from this question. I mean, in your own pastoral care and your personal experience, is gender dysphoria a real condition? Yeah, well, thank you for that. Let's perhaps just be clear for the listeners about what we're talking about here.

Gender dysphoria, that expression is really, I guess, it's the latest medical diagnostic term for the experience of distress, which some people have when their psychological or emotional gender identity or sense of gender doesn't match up with their biological or birth sex. Previously, and certainly in earlier versions of what's called the Diagnostic and Statistical Manual of Mental Disorders, that phenomenon was referred to as gender identity disorder.

But I guess there was a move, again, amongst the American Psychiatric Association to try and destigmatize that disorder. And now it's, I guess, being normalized in society. And so what's happened is that it's simply now the distress that the person feels it's being focused on. If a person has a mismatch between their sense of gender and their biology, and they're not distressed by it, then they don't have any condition according to the APA.

They don't have gender dysphoria. Gender dysphoria focuses in on the distress that a person may feel, and of course, most do feel if they have this mismatch. So I hope that wasn't too convoluted, but it's just important to understand what exactly we're talking about. Now, is it a real condition?

Well, certainly it's a real experience condition for those who have this sense of mismatch. For many, if not most, it's profoundly distressing and anxiety producing and shame producing and depressive. It's an awful condition or affliction to bear. But I guess the key question lurking in there is what kind of condition is it?

This again, I think, is where our culture is easily confused. And one of the perhaps confusing factors is that there is a number of conditions that fall under the umbrella of intersex, where a person is born with some kind of genital or biological ambiguity, and that certainly can give rise to gender dysphoria.

Or you've had some tragic stories, for example, of a circumcision gone wrong and then doctors making a decision to turn a boy into a girl, as it were, trying to deal with their mistake. And then this boy later on, of course, he's going to have profound gender dysphoria. So there are those kinds of, I guess, biologically created instances of gender dysphoria.

But for those for whom there is no biological ambiguity or any kind of intersex ambiguity or anything of that kind, then we need to ask, well, what is gender dysphoria for them? Well, I think the answer is quite clearly it's a psychological condition, not a biological or you might even say ontological condition.

The problem is in the psychology, they feel like they're in the wrong body. They're not actually in the wrong body. It's not that you've actually got a man inside a woman's body or a woman inside a man's body. But clearly the person feels as if they've been perhaps given the wrong body or they feel that mismatch.

And as I said, a very distressed by it. So if we understand that and understand that people really do suffer from this, it ought to evoke our compassion because it's a horrific affliction to bear. That's one of the reasons why the suicide or attempted suicide rate for those with gender dysphoria is as high as it is.

So I hope that sort of helps perhaps. I know it's not a simple answer, but I hope it perhaps clarifies issues. - Yeah, it does. It does, yes. So is it safe to assume the biological ambiguity is the minority condition with the psychological condition being in the majority of cases?

- Yes, I think that that's certainly true. I mean, it's enormously difficult to get accurate figures, but I think that is certainly the case. - Interesting. Thank you, Rob. We have only begun the week. Rob will be with us all week answering a number of questions, and there are many.

So what causes gender dysphoria? That's the next question I have for him tomorrow. Thanks for listening to the Ask Pastor John podcast with guest Rob Smith from Sydney, Australia. For more details about this podcast, to subscribe to the audio feed or send us a question of your own, go to our online home at desiringgod.org/askpastorjohn.

I'm your host, Tony Reinke. I'll see you tomorrow.