Review: “Intersex in Christ” by Jennifer Anne Cox

Intersex in Christ: Ambiguous Biology and the Gospel
Jennifer Anne Cox
Publisher: Cascade Books (July 20, 2018)
Paperback: 188 pages

Reviewed by Michelle O’Brien


My perspective in addressing this book is not as a theologian, but as an intersex person who has studied, researched, and taught in a range of subjects, including logic & philosophy, sociology, social theory, social anthropology, post-modernism, sexology, gender & transgender studies. I have been involved in the church for over fifty years and spent time as a religious novice; so I have studied scripture and theology as well. I have written, blogged and published on these matters. So I am approaching this book with more than just a casual interest.

From that viewpoint, my first impression of this book was that it is simplistic. It is highly selective, at times confused, and partial, because it is biased towards promoting a particular Evangelical view about sex and gender. As that theology cherry-picks scripture, so the literature on intersex is cherry-picked to promote binarism, while explaining intersex people’s rejection of this as being part of a non-binary LGBT/queer agenda. But, just as some advocates in that community may have appropriated intersex, and specialists and experts have co-opted intersex for their own theories and agendas, this author has done little different from what most non-intersex commentators do – appropriated intersex people and their experience for their own agenda.

For the author, being intersex is not a lived experience, but a political/theological problem. Intersex is the “elephant in the room,” because it challenges certain understandings about sex and gender, male and female, and her focus is to dismiss and explain away such concerns.

Jennifer Cox has appropriated intersex people and their experience for her own agenda. For the author, being intersex is not a lived experience, but a political/theological problem.

The author started to lose me at the start of chapter two where she maintains that the root cause of intersex variations lies in original sin.

I won’t go into detail as to why I find this problematic, except to say that the biological processes common to higher mammals precede human beings, and did not begin with humans; but then for me, evolution is where we come from, and human biology cannot be understood any other way. Rather than looking to the way biological development can become disrupted, the author lays the blame for intersex conditions on “the fall,” and lists it as “physical evil” which includes “sickness,” “cancer,” “horrific accidents,” “congenital defects,” “disease, mental illness, fatigue, aging, disability,” etc., of which “congenital defects in newborns” are the most shocking and disturbing – particularly intersex.

This reveals much about the lens through which the author views intersex people and where she locates us. She stresses that it is not our sin that made us this way, it’s the sin of mankind, for which all humans are responsible.


Chapter Three is a somewhat esoteric and circular exposition about the relationship between the Trinity, the two sexes, and marriage. It appears to be highly speculative, but the main problem is that certain “truths” about sex and gender are stated as fact, while at the same time trying to establish those “facts” as truths. The author seeks to prove what is true by stating that contrary views are wrong, while not using evidence to support the argument, other than what she contends is fact, based on certain things inferred from scripture, and speculations built around this.

There is discussion around the sex/gender of the godhead, and in particular the establishing of Jesus’ masculinity, while explaining away the frequent use of the gender-neutral “anthropos” to refer to him. Much seems like what I would call “smoke-and-mirrors.”

The author argues that by taking an egalitarian, rather than complimentarian, approach, intersex people should be able to function and take on leadership roles within the church, as is the case for women. Similarly, there is nothing preventing intersex people from becoming like Jesus, because discipleship is not restricted by gender. Jesus himself behaved in both masculine and feminine ways, so intersex people should be able to become like him too. In the Bible we are all, both men and women, exhorted to virtues for both men and women, so this also applies to intersex people. She cites Galatians 3:28 to push the point home that discipleship is not dependent on gender, and applies this to intersex people.

The author denies intersex as being a third sex, or part of a continuum between the sexes, yet the way she talks about intersex people and their eligibility for progress towards salvation is as though it were.

The good news for intersex people, according to Cox, is that there is already a category for those of us who fall outside the sexual binary within the Bible: that of the eunuch.

The discussion about marriage has a strong focus on celibacy and singleness, and seems (to her) appropriate for intersex people. The good news for intersex people, according to Cox, is that there is already a category for those of us who fall outside the sexual binary within the Bible: that of the eunuch. She points out that intersex people are included in Jesus’ description of the types of eunuch, and that he promotes the eunuch as a role-model of one who helps build the Kingdom of God. Acts 8 makes clear that it is by faith we are included in that Kingdom, not sexual anatomy. Being unable to marry (the prerogative of men and women alone), does not mean we are second class citizens in that Kingdom.

It is a pity pity that the author seems to be unaware that some intersex people find being likened to a eunuch nearly as offensive as being referred to as a “hermaphrodite,” or “pseudo-hermaphrodite.” But not all.

Some intersex people have married, she says, but many have been unable to. Males have been surgically modified to make them female. Some are incapable of penetrative sex. Others are too confused or ashamed about their gender to marry, while many are simply asexual. Infertility is a problem. Legally, intersex people’s marriage may not be valid. The author does not suggest that intersex people cannot marry: some may. But some may be unable to.

The problematic practice of infant genital surgery to make intersex people marriageable is questioned, and found to be unnecessary from a Christian understanding of marriage. “Intersex bodies are acceptable without surgery, and it is quite acceptable for people, intersex or otherwise, to be unmarried.” Celibacy and singleness is as important as marriage, she explains, and there are other forms of relationship through which we become people, as well as marriage. Relationships, not our genitalia, are what make us human people.


The author asks, should intersex people adopt male or female sex, or opt for “eunuch”? Humans were created male or female, and there is no third sex, she insists; intersex is a deviation from male or female. But we don’t have to choose one or the other to be whole, as grace does not require this. Only in the context of marrying would intersex people be required to adopt one or the other sex/gender. Pragmatically, it is helpful to live as one or other sex, but surgery is not necessary to do this. Transitioning is fine, provided it is not within marriage. Christians should not exclude people on the basis of their biology.


There’s a convoluted discussion about how Jesus didn’t need to be intersex to understand how intersex people feel. I found this the most patronizing part of the book. Through Jesus’ negative experiences of stigma, rejection, persecution, etc., he can relate to us. This is followed by a rejection of the idea that the virgin birth somehow rendered Jesus intersex. I’m sure many of us have contemplated such things – but as I am not a literalist, I have always found it problematic trying to speculate about “what could have beens” that rely upon literal readings of scripture, given we have no idea what actually happened. Trying to engage with and square the mystery of the incarnation with human biology is pointless. We simply don’t have the information to reason about such matters, especially when we have no understanding of what the actual circumstances of Jesus’ birth were, beyond a mystical narrative about the virgin birth. So, I’d agree that the conversation is irrelevant, albeit for slightly different reasons.


There is discussion about disability as a result of sin, where sin is part of the human condition and not because of the affected individual or their parents. This still means we need to seek forgiveness to receive healing. However, we are told that healing does not mean being healed of that which afflicts us, not in this world anyway. It means forgiveness, which is more important than physical healing, apparently. Jesus accepted outcasts like tax collectors and adulterous women — and intersex people. Jesus loves intersex people because we are outcasts, and there’s no good reason why we should be (presumably, unlike those who are outcast for good reason?).

In relation to Genesis 1:26-27 – being created in the image of God – some might try to condemn intersex people who are confused about their gender, because we don’t conform to that divine image, but Christians are not to be like Pharisees, and should not use the Bible to control or condemn people. The role of the church is to help heal intersex people, through acceptance and inclusion. I agree with the author on these last two sentiments.

Personally, I’m not confused about my gender, I’m sick of gender, and I don’t really relate to either male or female. I’m not confused about that. I have good reason to be because of my experience in life, and because I know that gender is a social construct. I also note it is a social construct that privileges one sex over another – as well as intersex people.

Jesus’ experience of betrayal as a model

Jesus’ own experience of betrayal and persecution leading to his death is of particular significance for intersex people, according to Cox. Just as he has forgiven them/us, we are called to forgive those who have hurt us. Just as he experienced persecution, he can empathize with the persecution and rejection of intersex people. Intersex people can feel betrayed by parents as well as doctors, and Jesus was betrayed by someone close to him too.

The death of Jesus frees us all from guilt and shame, and shame is a particular problem for many intersex people from an early age. Of shame, Cox writes, “Possibly it is the intersex issue,” and I have to agree with her. However, I would want to add that trauma giving rise to feelings not unlike in those who have been abused can also apply. These have often been internalized, led to depression and self-harm.

Then Cox introduces the sales-pitch: through Jesus’ shame and exposure on the cross, he took on and understands all this. What follows is an exposition of how Jesus took on all the shame and humiliation intersex people endure upon the cross. To do this, the author lists vivid descriptions of just about every “trigger” an intersex person can have, presumably to try and reawaken trauma in a way that can create an emotional bond between the intersex reader and the one who was crucified, where the shame of being intersex is converted into something not shameful.

But here’s the problem for me: being intersex is nothing to be ashamed of; yet for the author, it is something we are (or should be?) ashamed of, and it is only through the crucifixion that this can become no longer shameful. I disagree: we can come to terms with the trauma, and overcome the sense of stigma and shame through understanding and accepting ourselves.

I remember struggling with my own shame and guilt about the discovery of my own intersex history alongside trying to deal with the legacy of trauma and the gender issues that have afflicted me my whole life. I sought confession, because I felt awful about the break-up of my marriage with somebody I still loved and cared for deeply, and had been friends with for far longer than we were married. The confessor listened to my story, and it was probably the first time I had been able to coherently explain all that had happened. He was less concerned with hearing confession and providing absolution than in reassuring me that in the things I was describing, I was very much the one sinned against, and it was more important for me to come to forgive those who had done these things rather than me needing forgiveness. I needed to forgive others, and myself.

It can take a lifetime to reach a point of forgiveness for what has happened to us, and some never do. In my view, it is the grace to forgive for all that has happened that is most important. Not so much for those we forgive, but for ourselves.

I can entirely relate to the author’s statement “Many intersex people have been sinned against a great deal.” The wounds we bear in our bodies not only relate to how we were born and the attempts to fix things, but also the secrecy, the broken relationships with parents, siblings and eventually partners. It can take a lifetime to reach a point of forgiveness for what has happened to us, and some never do. In my view, it is the grace to forgive for all that has happened that is most important. Not so much for those we forgive, but for ourselves. Holding on to the pain, bitterness and disappointment is not healthy, and possibly as serious a health issue as the conditions we endure and the treatments we have had.


Question of identity

The question of our identity as intersex people gets swept under the carpet in Cox’s book, because we are supposed to gain a new identity through Jesus as sons of God, regardless of gender or sexual ambiguity. Through worship, biology has no relevance when it comes to access to God. Just as Jesus welcomed the blind and lame, so too (as Isaiah made clear about eunuchs) those who are intersex have access to God through worship.

This point is associated with the idea that human sexuality was also healed through the death and resurrection of Jesus, and at the resurrection of the dead, human sexuality will be transformed, and intersex people will be physically healed. Intersex people will become the males and females they were meant to be. I had problems as the discussion delved into the sexuality of glorified bodies, and speculation about whether intersex bodies would still be intersex when resurrected. I tend to agree with the author that we cannot understand how this will all be – yet despite this, the author goes to some lengths to talk about it. I was unable to come to grips with the discussion about post-resurrection bodies and sexuality. Like Susannah Cornwall (who the author engages with but then dismisses), I tend to see theological significance in establishing God’s justice here and now, rather than living life now in order to secure some future hope. At least there were references to de Franza, Gross, and to Cornwall who, like me, have written on this issue.

Sex is only moral within marriage, and marriage can only be between a man and a woman. So, intersex people should either get married or remain celibate.

This discussion about sexuality and bodily integrity after the resurrection eventually gave way to the implications for sexual life in this world. And from a certain style of theology, the answer given is simple. The same sexual ethics that apply to everybody else also apply to intersex people, because intersex people can’t be given special treatment. Sex is only moral within marriage, and marriage can only be between a man and a woman. So, intersex people should either get married or remain celibate. If an intersex person is to be married, then they need to either accept the gender assigned to them, or “decide on a gender and live out of that gender.”

In the case of intersex people, rejecting their gender assignment and transitioning is not in itself a sin. However, homosexuality is, so once married within a heterosexual marriage, transition would render a heterosexual relationship homosexual and unworkable. Intersex people can transition before marriage, or to marry, but not after. Others who can’t decide can remain that way, but must stay single and celibate, because sex outside marriage is wrong.

There should be full disclosure to the potential spouse before marriage, we are told, because of the possible difficulties in having a sexual relationship and infertility. What to do about marriage is ultimately the choice of the intersex person, and needs to be decided in the light of God’s word, love, honesty, and guidance of the Holy Spirit.

On the one hand, the author wants to portray intersex people as sexually broken and disordered in the same way that sexual deviants and prostitutes are, because of “the fall,” and on the other that despite this, this is not our fault, and we can be mightily used by God because we are in some way special. God often chooses disordered people over normal people to fulfill his will. We are weak, according to the author, but that is OK, because God chooses the weak to fulfill his purposes, and it is in our weakness that we are raised up.

I tend to see my experience and my being intersex as what has made me strong. But strong with humility – a word strikingly absent throughout this book.

According to the author’s interpretation of scripture, it is in the separation of two distinct gender roles that our humanity consists, which implies that those who reject gender roles are in some way less than human, and anti-Christian.

Standard Evangelical mischaracterizations are employed here to avoid dealing with contrary perspectives: There are people who seek to use intersex as part of their “gender agenda.” Intersex people who have questioned the gender construct (such as myself), are mostly ignored and seen as duped by those others. Their agenda is somehow pagan in origin. According to the author’s interpretation of scripture, it is in the separation of two distinct gender roles that our humanity consists, which implies that those who reject gender roles are in some way less than human, and anti-Christian. Humanity consists in relationships, particularly marriage, as these are in the image of God. Unlike reason, because reason has nothing to do with the image of God. This is probably why so much the author has to say seems more rhetorical and polemical, while being unreasonable and inconsistent. She condemns those who would use intersex for their agenda, yet has no qualms about trying to subsume and explain away a phenomenon that undermines her theology as if it is all consistent, but has to develop convoluted explanations that simply make no sense in order to do so.

Our humanity lies in far more than just one thing. I agree it is in our communality, in relationships, in marriage, and in our genders, but not exclusively, not necessarily, nor entirely, nor exhaustively. It is also in our power of reason, in love, in compassion, and in humility.


My concern about the book and its conclusions are more about the use of authority to direct intersex people’s behavior and choices. In this case, it is a theological interpretation of scripture that seeks to coerce people, rather than medical expertise, or activism arising out of the LGBTI community. Nevertheless, it is still about somebody who isn’t intersex trying to explain to intersex people, their families and peers, who intersex people are, what we are, and how we should be and behave, rather than intersex people working this out for themselves, and then informing and teaching others about themselves.

However, having laid out my view of the substance of the book, I would also like to recognize the author’s intention here. I know from personal experience that it can take a lifetime to come to terms with some of the issues she highlights, and to make sense of one’s situation, grapple with the question of who one is, where God is in it all, and deal with an overwhelming sense of shame that persists from earliest memories. Somehow, we all have to overcome and survive, and we do so in the context of how we are raised. For many intersex people, this context will be completely immersed in this brand of Christian theology. I may not subsume my own humanity to that type of interpretation of the Bible, but the reality is that many parents – particularly in the USA – do. Some of those parents will have children who are intersex, and many will (maybe unknowingly) come across such children. Whatever I might think about this type of religion, if this volume gives those parents, and their children, some hope and understanding, and helps diminish their shame, stigma, isolation and bullying, then that has to be celebrated.

There are some important messages in Cox’s book for intersex people and the church communities people may find themselves in. The most important being that we should not be rejected simply for being who we are, and that the Church has a duty to include us as part of the body of Christ. I certainly applaud the aim of communicating that. I recognize that this book is written for a particular church audience, a brand that I have had little to do with for decades. Within those communities there will be individuals with experiences who need love and support. This is not the way I would want to be included and supported, but for those in that situation, this approach may be a blessing.

For some intersex people, an LGBT+I approach may make no sense, where this might. At the end of the day, we all have to work out our own salvation with fear and trembling. As intersex people, we all (most) have to struggle with self-acceptance, stigma, trauma, and come to terms with our condition as best we can. Some do come to celebrate this, some mourn. But, I do object to the patronizing attempt at proselytizing vulnerable people. It shows a lack of understanding of the existential pain and legacy of trauma that many of us carry throughout our lives. Some of the content will be “triggering,” and I got the impression that this was a ploy to elicit an emotional response in intersex readers.


Editor’s note: Since Jennifer Cox’s book is not recommended, here is one that is more helpful. This book was recently recommended in the “Intersex Christians” Facebook group.
Sex Difference in Christian Theology: Male, Female, and Intersex in the Image of God
By: Megan K. DeFranza
Publisher: Eerdmans (May 16, 2015
Paperback: 240 pages

Avialable on Amazon.