Then God said, “Let us make man in our image, after our likeness. And let them have dominion over the fish of the sea and over the birds of the heavens and over the livestock and over all the earth and over every creeping thing that creeps on the earth.”

So God created man in his own image, in the image of God he created him; male and female he created them. —Genesis 1:26–27, ESV

What is your sexual orientation? What is your gender identity? Are you cis gender? These are all questions you will likely be asked if you are filling out a form for hospitalization or medical insurance. So, how should a Christian answer these questions? I submit that it is impossible for a Christian to answer the questions because the questions assume a worldview that is neither Christian nor biblical. These questions arise out of a postmodern worldview. They make assumptions that are contrary to a Christian witness.

To ask, “What is your gender identity?” for a Christian is like asking “Are you a human or a zebra?” Both questions assume that my will determines reality. But my will does not determine reality. It is God’s will that determines reality. The form for my insurance carrier on medical information never technically asks, “What is your gender?” It asks what is your legal gender, what gender do you identify with, and what is your sexual orientation. But it never asks,

“What is your gender?” This last question assumes that you have a gender that is based on a view of the word that fits with the fact that God ordained my existence and I recognize what he created. It fits with a Christian worldview. It fits with science.

You are not the the gender you choose. You are the gender you are given by God. The gender you are born with. In rebellion against God, people attempt to change the gender God gave them, but rebellion does not change reality. It does not change what is observable and verifiable. That is because the basic assumptions of medical science fit a Christian worldview. Ultimately medical practice cannot operate out of a postmodern worldview. A postmodern worldview is one in which individuals redefine reality. A Christian worldview is one in which individuals recognize the reality God created. So, for a Christian to even answer the question, “What gender do you identify with?” is to compromise with the world. It is at best an accommodation to rebellion and at worst promotes the rebellious, nonsensical, unscientific, postmodern worldview of a significant portion of our current culture. We can answer the question, “Are you male or female?” But we ought not to answer the question, “What gender do you identify with?”

If we are asked, “What is the god you have brought into existence?” we would say the question is wrong. The question makes assumptions that are false. The question makes man the source of a god, rather than recognizing that the one true God is the source of man. To answer this question, we must confront the presuppositions in the question. In the same way, even in our answering a form for medical insurance, we must confront the worldview those questions raise. How can we do this?

We can refuse to answer the question. If there is an “other with comments” option to questions like “What is your gender” we could write in “my gender is God-given” or “Created male in the image of God.” You could also write to the insurance company. Recently I wrote something like this to the post-modern questions asked by my insurance company:

Your questions about sexual orientation and gender identity do not fit my worldview. Both questions imply that I have a choice in these matters. From my worldview these questions are like asking, “Are you a human or a zebra?” God made me male. I am born human. I am born male. I recognize this physical reality. A good question from a Christian worldview would be, “What sex did God give you at conception?” Please change your questions so that I can answer them. The questions you are asking are related to a secular, postmodern, unscientific, irrational world worldview. This is not my worldview.

Witness the truth of the created order, the Christian worldview, and ultimately the gospel that can set people free from their enslavement to themselves, repent of their sin, and bow their knees before the Creator God, maker of heaven and earth, male and female.

Casey Freswick is minister emeritus, Bethany United Reformed Church, Wyoming, MI, and vice president of the board of Reformed Fellowship.