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Gender Identity and Faith: Clinical Postures, Tools, and Case Studies for Client-Centered Care
Helping people navigate gender identity questions today is complex and often polarized work. For clients and families who are also informed by their faith, some mental health approaches raise more questions than answers. Clinicians need a client-centered, open-ended approach that makes room for gender exploration while respecting religious identity. Gender Identity and Faith carves out clinical space for mental health professionals to help people who wish to take seriously their gender identity, their religious identity, and the relationship between the two. Drawing from their extensive research and experience with clients, Mark Yarhouse and Julia Sadusky provide a timely, practical resource for practitioners. This book
emphasizes respect for clients' journeys, without a single fixed outcome, toward congruence between their gender identity and faith describes effective clinical postures, assessment and therapeutic tools, and numerous case studies covers needs and characteristics of children, youth, and adult clients includes worksheets and prompts for clients and family members Integrating personhood and values is no easy feat, especially in our current cultural landscape, the authors write. Those navigating this intersection need clinicians who seek to understand their unique context and journey with them with empathy. This book helps point the way.
emphasizes respect for clients' journeys, without a single fixed outcome, toward congruence between their gender identity and faith describes effective clinical postures, assessment and therapeutic tools, and numerous case studies covers needs and characteristics of children, youth, and adult clients includes worksheets and prompts for clients and family members Integrating personhood and values is no easy feat, especially in our current cultural landscape, the authors write. Those navigating this intersection need clinicians who seek to understand their unique context and journey with them with empathy. This book helps point the way.
224 pages, Paperback
Published May 3, 2022
13 people are currently reading
130 people want to read
About the author
Mark A. Yarhouse
33 books69 followersMark A. Yarhouse is a professor of psychology and the director of the Institute for the Study of Sexual Identity at Regent University. He is also part of a group practice in the Virginia Beach area, providing individual, couples, family, and group counseling. Dr. Yarhouse received his PsyD from Wheaton College and has worked collaboratively on a number of books. He and his family live in Virginia Beach, Virginia.
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Displaying 1 - 6 of 6 reviews
July 5, 2022
I’ve just finished Gender Identity & Faith: Clinical Postures, Tools, and Case Studies for Client-Centered Care by Mark Yarhouse and Julia Sadusky. The book focuses on how mental health and other professionals can support those with faith backgrounds or commitments who are exploring their gender identity. Some may identify as transgender, while others may be simply trying to manage gender dysphoria or coming to a healthy relationship with a sexed body with which they struggle to identify.
Some Catholics will recognize Sadusky through her work supporting “side b” Christians, Christians who uphold a “traditional Christian sexual ethic.” She has been featured on the Life on Side B Podcast, promoting the need for an attentiveness to mental health and well-being in order to have an integrated and healthy life.
At the same time, she and Yarhouse have recognized the challenges for some Christian communities to find the support they need from mental health professionals. They write in Gender Identity & Faith:
“[For a mental health professional t]o steamroll over deeply held religious convictions, or to discount medical and mental health perspectives [clients hold] as a matter of principle, is to fail to adequately address the real challenges families face. If as clinicians we do not offer a posture of cultural humility to the families we work with, they will come to fear mental health professionals and deem us incompetent to support them on their journey. Failure to exhibit cultural humility has had catastrophic consequences in the past; some families have chosen not to seek out any mental health support for their child because they fear their beliefs will be pathologized or outright negated.”
Consistent with the role of the therapist or psychologist, Yarhouse and Sadusky emphasize the need to understand a client’s religious background and commitments when addressing the exploration of gender identity. For some, religious convictions will provide the boundaries for the interventions the client will find acceptable. For others, a knowledge of religious background will help to unpack how clients have been formed to view themselves and the world around them, and how they have established themselves in relation to the various religious messages they have received.
Among the most helpful images in the book is the image of the mountaintop and the plateau. Many clients struggling with their gender identity are inclined to seek the “mountaintop,” the perceive end-point of their gender exploration which will include maximal changes. But Yarhouse and Sadusky recommend seeking a “plateau,” the least invasive interventions that allow the client to “stabilize in terms of their self-understanding and their use of management strategies.” This might include changing name or pronouns or dressing more in accordance with the client’s identified gender. Spending time on this plateau can help a client identify whether they truly desire more invasive interventions, or whether this place is a place in which they can thrive. Some will find that they can thrive in this place for a period of time, and then will desire additional interventions in search of a better plateau for them.
As mental health professionals, Yarhouse and Sadusky emphasize the need to focus on the journey, rather than the destination, while a client explores their gender identity. They warn professionals to push neither for full medial transitions nor for a denial of the experience of gender dysphoria. Instead, they argue for a full awareness of the benefits and challenges associated with various interventions, starting first with the least invasive interventions and exploring whether these are suitable long-term solutions, and working to understand the client in their entirety, including in their religious contexts.
This is a book I will be recommending to friends and family who work in medical and mental health, and also to priests, pastors, and Church leaders. Because the book is balanced and thoughtful, I don’t think it will be as popular as other recent books by Christian authors on gender identity. But that’s exactly why you should read it.
Some Catholics will recognize Sadusky through her work supporting “side b” Christians, Christians who uphold a “traditional Christian sexual ethic.” She has been featured on the Life on Side B Podcast, promoting the need for an attentiveness to mental health and well-being in order to have an integrated and healthy life.
At the same time, she and Yarhouse have recognized the challenges for some Christian communities to find the support they need from mental health professionals. They write in Gender Identity & Faith:
“[For a mental health professional t]o steamroll over deeply held religious convictions, or to discount medical and mental health perspectives [clients hold] as a matter of principle, is to fail to adequately address the real challenges families face. If as clinicians we do not offer a posture of cultural humility to the families we work with, they will come to fear mental health professionals and deem us incompetent to support them on their journey. Failure to exhibit cultural humility has had catastrophic consequences in the past; some families have chosen not to seek out any mental health support for their child because they fear their beliefs will be pathologized or outright negated.”
Consistent with the role of the therapist or psychologist, Yarhouse and Sadusky emphasize the need to understand a client’s religious background and commitments when addressing the exploration of gender identity. For some, religious convictions will provide the boundaries for the interventions the client will find acceptable. For others, a knowledge of religious background will help to unpack how clients have been formed to view themselves and the world around them, and how they have established themselves in relation to the various religious messages they have received.
Among the most helpful images in the book is the image of the mountaintop and the plateau. Many clients struggling with their gender identity are inclined to seek the “mountaintop,” the perceive end-point of their gender exploration which will include maximal changes. But Yarhouse and Sadusky recommend seeking a “plateau,” the least invasive interventions that allow the client to “stabilize in terms of their self-understanding and their use of management strategies.” This might include changing name or pronouns or dressing more in accordance with the client’s identified gender. Spending time on this plateau can help a client identify whether they truly desire more invasive interventions, or whether this place is a place in which they can thrive. Some will find that they can thrive in this place for a period of time, and then will desire additional interventions in search of a better plateau for them.
As mental health professionals, Yarhouse and Sadusky emphasize the need to focus on the journey, rather than the destination, while a client explores their gender identity. They warn professionals to push neither for full medial transitions nor for a denial of the experience of gender dysphoria. Instead, they argue for a full awareness of the benefits and challenges associated with various interventions, starting first with the least invasive interventions and exploring whether these are suitable long-term solutions, and working to understand the client in their entirety, including in their religious contexts.
This is a book I will be recommending to friends and family who work in medical and mental health, and also to priests, pastors, and Church leaders. Because the book is balanced and thoughtful, I don’t think it will be as popular as other recent books by Christian authors on gender identity. But that’s exactly why you should read it.
August 19, 2022
A 2021 Ipsos poll found that Gen Z individuals were four times as likely to identify as transgender, nonbinary, gender-fluid, or some other genderqueer categorization. Gender identity has become part of the culture wars with battles being fought in the courts and in society about gendered sports, bathrooms, and more. There’s a lot of vitriol, a lot of ignorance, and a lot of unhelpful dialogue. What can we do better? How are we to act as people of faith?
For years now, Mark Yarhouse has been at the forefront of the Christian discussion on sexuality and gender. As director of the Sexual and Gender Identity Institute at Wheaton, his academic focus has been to create a compassionate and helpful structure for Christian therapists and counselors to discuss sexual and gender identity with those who come to them for help. Gender Identity and Faith: Clinical Postures, Tools, and Case Studies for Client-Centered Care is an academic work geared toward therapists and other professionals, but also has value for those in ministry and laypeople wanting to learn more about diverse gender identities.
The book is divided into four sections. The first provides an overview of gender identity in therapy and how to assess gender identity in a therapeutic setting. In particular, they advocate really listening to the individual, asking them to provide a narrative account of their story. Getting people to tell their story often helps the clinician understand the client’s motivations, the length of time they’ve felt a certain way, and why they’ve felt that way. A couple of things where I think Gender Identity and Faith could have done better would have been to acknowledge that not all diverse gender identities are dysphoric. Gender dysphoria describes a sense of unease due to a difference between biological sex and sociological gender. Not all individuals have this sense of unease or locate that sense of unease within themselves. Yarhouse and Sadusky would have done well to better delineate, or at least mention, the sociocultural constructs of gender and how that plays into dysphoric feelings or feelings of gender diversity (i.e. One does not fit cultural stereotypes of a certain gender, therefore they must be gender diverse.)
The second part deals with therapy postures when it comes toward children. Yarhouse and Sadusky, correctly in my estimation, advocate for what they call “gender patience” and do not usually recommend the use of puberty blockers. For them, this is too big of a decision based on a child’s understanding of gender and/or sexuality and the long-term effects of puberty blockers are yet unknown. While this goes against the trend in current secular therapy, Gender Identity and Faith carefully lays out their position and reasoning and I find it compelling. I do wish that they had talked about instances in which prepubescent gender confirmation surgery is appropriate, such as in cases of intersexuality.
The largest part of the book is spent on therapy tools for adolescents and adults. Yarhouse and Sadusky intersperse their clinical advice with vignettes and case studies, offering real-life examples of how to provide care for those working through gender identity issues. Through this section, they show that gender dysphoria or genderqueer identity comes in many ways and in many different contexts. There cannot be a “one size fits all” answer because individuals are, well, individual. The fourth part of the book is an appendix of sorts that provides clinicians with some larger case studies.
Despite being for a professional audience, Gender Identity and Faith is accessible and understandable. Yarhouse and Sadusky treat the topic compassionately and with nuance, even—perhaps especially—when they diverge from mainstream secular thought. Anyone who might be in a position to work with transgender or genderqueer individuals, particularly adolescents, will highly benefit from this book. I especially appreciated the advice for dealing with parents of children or adolescents expressing a diverse gender identity. If all Christian conversations about gender identity were like this, it would greatly benefit the Kingdom.
For years now, Mark Yarhouse has been at the forefront of the Christian discussion on sexuality and gender. As director of the Sexual and Gender Identity Institute at Wheaton, his academic focus has been to create a compassionate and helpful structure for Christian therapists and counselors to discuss sexual and gender identity with those who come to them for help. Gender Identity and Faith: Clinical Postures, Tools, and Case Studies for Client-Centered Care is an academic work geared toward therapists and other professionals, but also has value for those in ministry and laypeople wanting to learn more about diverse gender identities.
The book is divided into four sections. The first provides an overview of gender identity in therapy and how to assess gender identity in a therapeutic setting. In particular, they advocate really listening to the individual, asking them to provide a narrative account of their story. Getting people to tell their story often helps the clinician understand the client’s motivations, the length of time they’ve felt a certain way, and why they’ve felt that way. A couple of things where I think Gender Identity and Faith could have done better would have been to acknowledge that not all diverse gender identities are dysphoric. Gender dysphoria describes a sense of unease due to a difference between biological sex and sociological gender. Not all individuals have this sense of unease or locate that sense of unease within themselves. Yarhouse and Sadusky would have done well to better delineate, or at least mention, the sociocultural constructs of gender and how that plays into dysphoric feelings or feelings of gender diversity (i.e. One does not fit cultural stereotypes of a certain gender, therefore they must be gender diverse.)
The second part deals with therapy postures when it comes toward children. Yarhouse and Sadusky, correctly in my estimation, advocate for what they call “gender patience” and do not usually recommend the use of puberty blockers. For them, this is too big of a decision based on a child’s understanding of gender and/or sexuality and the long-term effects of puberty blockers are yet unknown. While this goes against the trend in current secular therapy, Gender Identity and Faith carefully lays out their position and reasoning and I find it compelling. I do wish that they had talked about instances in which prepubescent gender confirmation surgery is appropriate, such as in cases of intersexuality.
The largest part of the book is spent on therapy tools for adolescents and adults. Yarhouse and Sadusky intersperse their clinical advice with vignettes and case studies, offering real-life examples of how to provide care for those working through gender identity issues. Through this section, they show that gender dysphoria or genderqueer identity comes in many ways and in many different contexts. There cannot be a “one size fits all” answer because individuals are, well, individual. The fourth part of the book is an appendix of sorts that provides clinicians with some larger case studies.
Despite being for a professional audience, Gender Identity and Faith is accessible and understandable. Yarhouse and Sadusky treat the topic compassionately and with nuance, even—perhaps especially—when they diverge from mainstream secular thought. Anyone who might be in a position to work with transgender or genderqueer individuals, particularly adolescents, will highly benefit from this book. I especially appreciated the advice for dealing with parents of children or adolescents expressing a diverse gender identity. If all Christian conversations about gender identity were like this, it would greatly benefit the Kingdom.
December 14, 2025
This book pushed me to slow down and listen more carefully. It is written squarely from a clinical perspective, and the authors are clear that their goal is to help families and individuals without a fixed outcome. They aim to help clinicians, pastors, and caregivers respond to gender related distress with wisdom, humility, and genuine care.
What I appreciated most was the tone. The book is filled with real-life case studies, and you can feel the tension and care in complex situations that affect real people. They emphasize ethical practice and consistently return to the responsibility of the helper, not to coerce, correct, or impose, but to accompany.
As someone who works in multiple relational settings, this book helped me think more clearly about how to care well in different roles, clinically, pastorally, and personally. It affirmed that there is room for both personal convictions and compassionate, ethical care, and that thoughtful presence often matters more than tidy answers.
What I appreciated most was the tone. The book is filled with real-life case studies, and you can feel the tension and care in complex situations that affect real people. They emphasize ethical practice and consistently return to the responsibility of the helper, not to coerce, correct, or impose, but to accompany.
As someone who works in multiple relational settings, this book helped me think more clearly about how to care well in different roles, clinically, pastorally, and personally. It affirmed that there is room for both personal convictions and compassionate, ethical care, and that thoughtful presence often matters more than tidy answers.
June 2, 2022
The advantage of a book like this is that Yarhouse and Sadusky bring a considerable amount of clinical experience to their writing. And that is also its deepest problem. Certainly there is need for great wisdom, compassion, and pastoral sensitivity in addressing questions of gender dysphoria. Yet to state at the outset that the goal of counseling will be "without a fixed outcome" is to concede too much. Either Scriptural convictions that define our gender identity are true (and therefore must be followed, no matter how challenging the pastoral path), or they are not true - and some other account of what it means to be a flourishing person must be followed. To attempt to remain neutral is itself a choice.
March 9, 2025
Very deliberate. I see resonance with the lenses they talk about in relation to sexuality. Not sure I fully grasped the concept of plateaus.
October 15, 2025
a very very very good resource
Displaying 1 - 6 of 6 reviews