“If God is perfect, why am I in the wrong body?” a transgender patient recently asked a hospital chaplain I know. It was late one Saturday night, and the chaplain was unsure how to respond. The patient had been raised Catholic and still had strong religious beliefs but now felt anguish.

The patient’s statement reflected several major questions, including why someone is transgender, why, ultimately, any of us are the way we are, and what role, if any, God might have in all this.

The chaplain stammered out that God created this patient's soul, which was perfect in God’s eyes, but that in creating a body, “billions of little things happen as cells divide,” and “for some reason, some people’s bodies don’t match what they feel to be their soul, but that luckily, treatment today can help them match.” The patient felt better, though the chaplain remained troubled, feeling that her answer was inadequate and that larger tensions underlay the question.

This LGBTQ Pride Month, I have been thinking a lot about their interaction.

This chaplain told me about their interaction as I conducted research for a book,........

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