Q&A: Transgender identity — sin, mental illness, or both?

Mike resists the binary framing. He argues that mental illness and sin are not mutually exclusive categories. Using a hypothetical: a person with a mental illness might have delusions that cause them to take sinful actions (e.g., believing they are God); the delusion may be psychiatric, but the resulting attitudes and actions can still be spiritually wrong. He characterizes transgender identity as fundamentally delusional — having a belief about oneself that does not correspond to reality — while also expressing pastoral compassion for people experiencing it, noting they often carry significant burdens. The societal and legal pressure to affirm the delusion (e.g., California legislation restricting counseling) troubles Mike. His pastoral framework: rather than arguing about sin vs. illness, the question should be reframed around truth — can we help this person align their self-perception with reality?