Transgender-Affirming Pastoral Care

OtherWise Christian is very much focused on making resources related to transgender-affirming religion (and Christianity specifically) more accessible at the grassroots. Meanwhile,  I am also moving into academia! The complexity of this dance will likely show up here in some subtle ways, though I expect my focus here will remain oriented toward the grassroots.

That said, a prominent research topic now that I have some access to academic databases, journal articles, and a theological library is transgender pastoral or spiritual care. For a research class, I was able to spend some time digging. Unfortunately, there was very little transgender-specific content out there. There is much work to be done!

I have a longer “bibliographic essay” under peer review right now available (April 2022) at the publisher as well as in an extended version with discussion at the OtherWise Academy. It’s important to get these resources into academic journals and databases to impact theological education. That means some seriously delayed gratification. But there are a few general purpose articles I want to highlight here in the meanwhile…

Pastoral Care with Transgender People” by Sarah (Ivy) Gibb (Millspaugh, 2003)

Sarah (Ivy) Gibb (Millspaugh)’s article is an important early intervention and it seems nothing has displaced it in nearly 20 years. So much of transgender education focuses on theo-ethical considerations (Bible, apologetics, definitions) or personal narrative (biographical or auto-biographical reflections). However, this chapter provides a foundation for transgender pastoral care. As with many ground-breaking publications around transgender concerns, some of the language in this chapter is becoming dated. This is a particular concern in introductory sections which offer definitions. For instance, the inclusion of “transvestite” language and absence of “nonbinary” language makes the article seem mildly outdated, even though it was appropriate at the time of the original publication.

The pastoral concepts and examples offered provide a solid foundation for pastoral care, particularly in a congregational context. Sarah leans into Margaret Kornfield’s metaphor of the pastoral care provider as a gardener who should tend to both the community/soil and the individual/plant. She positions the pastoral care provider explicitly in support of resistance to oppression and reclamation of spiritual resources. Anecdotes ground this advice in real world oppressive circumstances faced by transgender populations. The chapter has appeared in 3 places that I’ve found so far.

“Spirituality, Transgender Identity, and Coming Out” by Walter O. Bockting and Charles Cesaretti’s (2001)

This article appeared in the Journal of Sex Education and Therapy and is cited regularly in academic articles, but lives behind the academic paywall. While it is similarly quite dated in terms of terminology and shifts in the field over the last 20 years, it nonetheless remains remarkably good resource for thinking about how spiritual themes can impact development around gender transition. The article invoked spirituality as individual meaning-making at a critical time when transgender communities were still extremely isolated around issues of religion/spirituality. Again, I have not found any pragmatic resources to displace this article’s significance.

Drawing on T. Byram Karatsu’s ideas about “spiritual psychotherapy” and “six tenets of transcendence,” Bockting and Cesaretti provide two vignettes and use them to illustrate how Karatsu’s framework may prove useful in support of transgender care recipients. The authors embrace the integration of spirituality and mental health as a response to the very real spiritual distress they have found among transgender care recipients. Their approach (following Karatsu) points to working with the care recipient around love of others, love of work, love of belonging, belief in the sacred, belief in unity, and belief in transformation as a way to do “psychotherapy in the context of love and belief beyond oneself.”

  • Walter O. Bockting & Charles Cesaretti (2001) Spirituality, Transgender Identity, and Coming Out, Journal of Sex Education and Therapy, 26:4, 291-300, DOI: 10.1080/01614576.2001.11074435

Transition and Beyond: Observations on Gender Identity by Reid Vanderburgh (first edition 2007, third edition 2018)

Reid Vanderburgh’s book, Transition and Beyond: Observations on Gender Identity  (Vanderburgh 2007) is another key resource in the field. Now, in its third edition (Vanderburgh 2018), this resource provides a broad introduction to themes of gender transition with a “When Worlds Collide: Religion and Transition” chapter focused specifically on working with care recipients around conservative/fundamentalist religion.

Vanderburgh acknowledges that religion may not be a stumbling block for every care recipient, but that ideas about “sin,” “reparative therapy,” and other religious beliefs may get in the way for some. Vanderburgh offers six guidelines for helping fundamentalist care recipients, from recognizing how important religious/spiritual beliefs may be for some care recipients to helping care recipients cope with the anger that arises as they come to terms with the impact judgemental beliefs have had on them. Vanderburgh expands this list from six to seven guidelines in the third edition. He also adds an additional section about reconciling with religious families. Vanderburgh’s observation from his years of work with care recipients is that those who come from “fundamentalist” religious backgrounds strongly benefit from “reinvent[ing] their spirituality in a manner that affords them a healthy, positive, self-perception.” (274) These care recipient’s needs are not met simply by rejecting religion entirely or by ignoring the conflicts with their past beliefs.

  • Reid’s current website:
  • Reid Vanderburgh. Transition and Beyond: Observations on Gender Identity. United States: (self-published, 2018). First edition by Q Press, Portland, OR, 2007.

“Living in the Image of God: Transgender People in Pastoral and Spiritual Care” by Laura Thor (2013)

This article offers reflections on spiritual direction and pastoral care with transgender people. It appeared in Presence: An International Journal of Spiritual Companionship (which is a publication from Spiritual Directors International), on Thor’s blog, and in the newsletter of Dignity USA (which represents LGBT+ Roman Catholics in the U.S.). Thor’s reflection is unique in terms of advancing spiritual direction as a medium-term to long-term intervention for transgender populations beyond typical medical, psychological, and congregational contexts. Because of that context, Thor provides particularly deep insight into the spiritual dynamics of her case studies and their experience over time. In addition to sharing introductory details about scriptural and scientific resources, Thor highlights some of the challenges for transgender adults in community and demonstrates how spiritual accompaniment can foster individual resilience in the face of such challenges. As the title suggests, Thor explores Genesis and the paradigm of creation as a key resource for understanding the unfolding of transgender identity. Thor draws from Jewish commentary and Shabbat practices in a way that would also be useful to Christian care recipients.

Additional Resources

“Pastoral Care in Transgender Experience” by Erin Swenson (11-page PDF introduction)

“Providing Pastoral Care to the Transgender Community” by Phyllis Pennese (2-page PDF reflection) [in HRC Gender Identity and Faith Communities]

David Weekley. Exploring Transgender Spirituality within a Retreat Setting: Theological Action Research. Doctor of Ministry dissertation. Boston University, 2016.

David Weekley. Retreating Forward: A Spiritual Practice with Transgender Persons. Portland, OR: Wipf and Stock Publishers, 2017.

Chaplaincy Innovation Lab. “Best Practices in the Spiritual Care of Transgender and Gender Non-Conforming Patients.” YouTube video, October, 19, 2020,

The Center for Spirituality and Health at Mount Sinai, “Spiritual Care for Transgender Patients,” Facebook video,, June 16, 2017.

Transgender Spiritual Care Initiative at Sojourn Chaplaincy:

Related Resources

There is also a growing area of content out there around transgender spiritual care, such as might be offered in a hospital or similar setting. There are some lifespan articles focused on children, adolescents, or elders. And there is a constellation of studies trying to look variously at transgender religiosity, spirituality, and resilience. There is also a significant literature around LGBT pastoral and spiritual care which may or may not address transgender concerns. If I have missed any important general resources focused on transgender pastoral or spiritual care, I would love to hear about them!

ALSO: Transgender and the (Christian) Bible resources

ALSO: Transgender and Religious Curriculum

Compiled by Mx Chris Paige on July 11, 2021. Please be in touch with feedback and corrections. This blog is a work in progress!

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