The Framework We Forgot: When Disease Looks Healthy

Man Confusion (1939) painting high

The first article in this series ended with questions that matter more than we realize: What are human beings designed to be and do? What does flourishing actually look like?

We can’t answer. Not because the questions are too complex, but because we’ve lost the framework that could orient us. Without that framework, we can’t tell construction from destruction. We call disease “health,” confusion “authenticity,” and think we’re building people up when we’re confirming them in their corruption.

The problem runs deeper than how we talk. We’ve lost the ability to recognize what flourishing looks like, and when you can’t recognize health, even your kindest words become cruel.

The Disorientation

Confusion has become a virtue.

What previous generations recognized as disorientation—the inability to reconcile mind and body—our culture now calls enlightenment. We don’t just tolerate the confusion; we celebrate it. We build institutions to protect it. When someone experiences a mismatch between psychology and biology, the body becomes negotiable. The mind decides the truth. Feelings become definitive. We create new language—cisgender, deadnaming, gender-affirming care, authentic self—to sanctify it.

Philosopher Nancy Pearcey calls this personhood theory: the authentic person exists somewhere inside, independent of the physical body. Anyone who suggests otherwise becomes the problem. As Frank Turek asks: “When biology and psychology are mismatched, why do we think changing the body instead of changing the mind is the way to fix the problem?” We don’t approach other forms of psychological distress this way.

It’s not science driving this distinction. It’s philosophy—specifically, a philosophy of identity. We’ve confused feelings not just for facts, but for personhood itself.

Imagine a man begging his doctor to amputate his healthy arm. He’s certain—absolutely certain—it’s rotting with gangrene that only he can see. The doctor examines pink flesh, strong pulse, full function. The patient is delusional. The right prescription is to treat the mind, not the body. No medical board would permit cutting off a healthy arm just to affirm the patient’s feelings. Yet with gender dysphoria, we reverse the script entirely.

Why? It’s not science driving this distinction. It’s philosophy—specifically, a philosophy of identity. We’ve confused feelings not just for facts, but for personhood itself. Gender, as we now use the term, locates identity in self-perception rather than biological reality. This is what Carl Trueman calls the triumph of the modern psychological self: a worldview where internal experience defines what’s real. In that world, affirming feelings becomes the only compassionate response.

This sounds progressive. Enlightened, even. But there’s a fatal problem: you can’t guide someone toward health if you’ve forgotten what health looks like. The affirmation feels compassionate, but it’s like congratulating the doctor for sawing off the healthy arm. You’re validating the feeling while enabling the destruction. And when pressed, we can’t rationally explain why this particular form of body-mind discord deserves celebration while others demand treatment.

For most of human history, people recognized that being human had a design. Our bodies weren’t obstacles to overcome but essential dimensions of who we are. Our feelings weren’t final arbiters of reality—they were experiences to be interpreted according to something outside ourselves. We had a framework. We’ve abandoned it. Now we celebrate the confusion, declare disease to be health, and call anyone who questions it the problem.

This is why the tyranny of niceness has such power. It’s built on the rubble of something we used to know—something that could have told us the difference between comfort and flourishing, between affirming someone and abandoning them to their confusion. So, what was that framework?

The Design

Scripture gives us the framework we’ve lost. Genesis 1:27: “So God created mankind in his own image, in the image of God [imago dei] he created them; male and female he created them.” This isn’t decorative theology. It’s the blueprint for human identity and purpose. The imago dei tells us what we are, where we come from, and what we’re for.

This image has two dimensions. The first is individual and formational—who we are as persons. We have moral capacity to know right from wrong and a will to choose. We possess natural capacities for reason, creativity, and emotion. And we are relational beings designed to flourish in community, capable of love, cooperation, and fellowship. These reflect attributes of God Himself. We bear His image in our very constitution.

The second dimension is corporate and vocational—what we’re designed to do together. God gave humanity a cultural mandate: to fill the earth and exercise stewardship over it. This means biological reproduction and cultural creation—language, arts, productivity, organization, civilization. We are co-regents with God, exercising delegated authority under His kingship. Our vocation is to spread His glory across the earth and live in harmonious fellowship with Him and one another. When these dimensions function according to design, the result is shalom—everything working as God intended. Universal flourishing. For humanity, this means right relationship with God, with one another, and with creation itself.

But we don’t live in shalom. We live in its corruption.

When we make something other than God our ultimate reference point, we become less than what we were designed to be.

The chief problem isn’t that we make wrong moral choices or that our emotions mislead us. The root of corruption—what Scripture calls sin—is failed worship. It’s our refusal to recognize and surrender to God as king and source of truth. Augustine named this cor incurvatus in se—the heart curved in on itself. When we refuse to worship God, we don’t stop worshiping. We redirect worship toward the self, and this redirection disorders everything. Think of it this way: if God is the sun that gives life and order to the solar system, sin is what happens when a planet declares itself the center and demands everything else orbit around it. The result isn’t freedom. It’s chaos. We were designed to orbit God, but when we make ourselves the center, we actively work against our own design.

N.T. Wright explains that idolatry—misdirected worship—doesn’t just dishonor God; it dehumanizes us. When we make something other than God our ultimate reference point, we become less than what we were designed to be. The thing we worship shapes us. If we worship the self, we become trapped in our own limitations, reduced rather than expanded.

This is exactly what we see in the celebration of confusion. We’ve made the self—specifically, the feeling self—the object of worship. The internal experience becomes sovereign. Biology, design, purpose—all must bow to how I feel about myself. We create elaborate systems to protect this new deity of the self: therapeutic language that sanctifies subjective experience, institutional coercion that punishes dissent, the relentless demand for affirmation. We call confusion “authenticity” because we’ve lost the external reference point that could reveal it as confusion.

We still retain the image and still exercise the cultural mandate, but now in constant conflict with ourselves and each other. We use our formational capacities and vocational authority not to reflect God’s glory but to pursue our own. Self-worship produces self-destruction.

History reveals the pattern. At Babel, humanity united to fill the earth with their own glory rather than God’s. God’s response was to confuse their language. Why language? Because speech is central to how the cultural mandate functions: organizing society, creating culture, exercising co-regent authority. Control the language and you control the destiny, whether toward shalom or corruption.

The Power of Naming

Without this framework—without knowing our origin and direction—speech becomes directionless. We can affirm current states but cannot guide toward flourishing. This is why the tyranny of niceness persists: we’ve lost the vision that could orient our words toward what humans are actually designed for.

But this raises a deeper question: Why does speech occupy this central position in the first place? Consider what we’ve already observed. At Babel, when God judged humanity’s corrupted cultural mandate, He targeted their language. Not their technology. Not their organizational capacity. Their ability to communicate. Or notice how the celebration of confusion happens primarily through words. We don’t just experience confusion privately. We speak it into social reality through redefining terms, through the language of affirmation, through declaring dysfunction “good” and design “oppressive.” The confusion becomes institutional, enforceable, precisely because we’ve encoded it in our speech.

Madeleine L’Engle understood this. She wrote about the difference between naming rightly and the Namer being displaced. To name rightly is an act of humble, loving participation in creation. It’s recognizing what something truly is and calling it by its proper name. But when we displace the Namer, when we seize the authority to redefine reality according to our own feelings, we don’t create new truth. We distort true identity. We speak lies that deform rather than form.

when we refuse to use language that denies biological reality, we’re not being obstinate or unloving. We’re naming rightly. We’re refusing to participate in the displacement of the Namer.

This is what’s happened with our celebration of confusion. We’ve displaced the Namer. We declare “woman” means whatever someone feels it means. We call rejection of the body “authenticity.” We name disease “health.” And because words carry formative power, this corruption of language produces corruption of reality—institutional policies, surgical interventions, lives built on foundations of sand.

This is why Christians must push back against the distortion of language: the pronoun demands, the redefinitions, the new terminology that encodes confusion. It’s not “the culture war.” It’s about human flourishing. When we insist on calling men “men” and women “women,” when we refuse to use language that denies biological reality, we’re not being obstinate or unloving. We’re naming rightly. We’re refusing to participate in the displacement of the Namer. We’re speaking words that invoke God’s design rather than human confusion. This is pastoral care, not political posturing.

But here we need to be careful. This might sound like postmodern deconstructionism—the claim that language is malleable, that we can reshape words to suit our goals, that there’s no objective reality to describe. The biblical understanding of speech is profoundly different.

G.K. Chesterton observed that words are sacramental. Words don’t just describe reality, they make it present. When we speak, we’re not merely exchanging information. We’re invoking realities, shaping relationships, declaring what is and isn’t true. But in the biblical worldview, there is an objective reality: God’s design, His created order, the way things actually are. Our words don’t generate that reality from nothing. They make it present. They invoke it. They call it forth into our particular moment. The postmodernist believes we create reality through language. The Christian knows we invoke reality that already exists in God’s design. That’s the difference between naming rightly and displacing the Namer.

This points to something more profound. Speech isn’t merely one tool among many that image-bearers happen to use. It may be intrinsic to what image-bearing itself is—woven into the very fabric of personhood in ways that reflect something essential about God’s own nature. After all, God spoke the world into existence. He named the light “day” and the darkness “night.” He brought Adam the animals “to see what he would name them.” The first act of human co-regency was an act of naming. Words aren’t peripheral to the cultural mandate. They’re how it operates.

What is speech, really? How does it connect to the image we bear? Why does it carry the power to shape reality, to build up or tear down, to guide toward shalom or confirm in corruption? Until we understand what speech actually is—not just as a useful mechanism but as something fundamental to personhood—we’ll keep missing why the battle over language matters so much. We’ll keep underestimating both its power to destroy and its potential to give life.

Part 1 | Part 2

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