The Presbyterian Church USA (PCUSA) recently voted with overwhelming support to affirm transgender surgeries in children. Delegates of PCUSA, the US’s largest Presbyterian denomination, voted 441-30 in support of an overture entitled “On Access to Healthcare” during a plenary session of the denomination’s 227th General Assembly. “Gender-affirming care is age-appropriate care that is medically necessary and evidence based for the well-being of many transgender, nonbinary, and gender-expansive people who experience symptoms of gender dysphoria or distress that result from having one’s gender identity not match their sex assigned at birth,” the denomination wrote in its rationale. The Presbyterian church has had several splits over theology regarding gender and sexuality, with the Presbyterian denomination leaning more and more leftward since 1973, when the conservative Presbyterian Church in America (PCA) split off over “opposition to long-developing theological liberalism, which denied the deity of Jesus Christ and the inerrancy and authority of Scripture.” The PCUSA formed in 1983.

The PCUSA defended the decision to support transgender surgeries in children, calling it “safe.” “By preventing doctors from providing this care or threatening to take children away from parents who support their child in their transition, these bills prevent transgender, nonbinary, and gender-expansive youth from accessing medically necessary, safe health care backed by decades of research and supported by every major medical association representing over 1.3 million U.S. doctors.” It’s a hardline stance, given that President Trump’s administration has stated it will “rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures.”

Many conservative Christians responded to the news with mild surprise, noting the PCUSA’s leftward drift for decades. Virgil Walker, co-host of the “Just Thinking” podcast with Darrell Harrison, called on churches to remain steadfast in biblical truth. “When a denomination votes to bless what God calls sin, the vote itself is not the real story. The real story is a church that has decided the spirit of the age gets the final word instead of the Word that made the age. That decision was settled long before any ballot was counted,” Walker told Decision. “Scripture does not leave us guessing about who we are. Genesis tells us God made us male and female in His own image, and He called His handiwork very good (Genesis 1:27, 31). A church that can no longer say so has stopped listening to the One it claims to serve and begun echoing the culture it was sent to reach.”