“Extremely toxic and evil” reflections on gender identity change efforts by Christian religious leaders: Implications for therapy with transgender and nonbinary clients

Given the religious groundings that support the practice of gender identity change efforts (GICE), we sought to explore the beliefs of Christian religious leaders about this practice and their understanding of marginalized gender identities. Nineteen religious leaders mainly from diverse Mainline Christian Protestant traditions were interviewed. Queer theory-informed thematic analysis revealed two themes related to participants' beliefs about transgender and nonbinary identities: (1) Transgender and nonbinary identities are normative and authentic and (2) God created gender diversity. The analyses also highlighted two themes reflecting the pastors' beliefs about GICE: (1) GICE is harmful and (2) Therapy should affirm transgender and nonbinary identities. Finally, the thematic analysis exploring participants' messages for couple and family therapists could be organized into two themes: (1) Christian religious beliefs do not justify the use of GICE and (2) Therapists should be helpful and not harmful. Implications for couple and family therapists are also discussed.