[8]: 27 In the past leaders taught that in the premortal life individuals chose whether to live as male or female during mortality, and that poor choices during their time on earth could demote them back to a genderless condition.
[18][20] Many conservative groups within Mormonism have disagreed with the Church's more accepting stance on transgender people who don't transition, viewing it (and LGBTQ rights in general) as a threat to the traditional family unit.
[22]: 32 Laurie Lee Hall stated that church policies are built on a false premise equating gender and sex at birth, and give no place for trans members like her.
[19] Author Charlotte Scholl Shurtz stated that the focus on God as a cisgender, heterosexual couple excludes transgender, nonbinary, and intersex members and enshrines cisnormativity.
[41][42] A key factor in determining mental health wellbeing is family acceptance and support, and feelings of isolation and rejection are correlated with suicidality.
Former stake president and church architect Laurie Lee Hall was excommunicated by her Utah local leaders in June 2017 for socially transitioning to express her gender identity as a transgender woman.
[30][44] Alison Kluzek reported that she was suicidal during a time after coming out to her LDS parents as a trans woman while they initially refused her request to begin transitioning by hormone therapy.
[58] Previously, author Duane Jeffery criticized LDS teachings around intersex individuals as falling short on including real-world biological complexity.
[57]: 286–287 LDS urologist Dr. David Hatch stated that if top church leaders say gender is permanent and eternal then they can't include intersex people which creates a conflict.
For instance, the apostle David A. Bednar has stated that gender defines much of who we are, why we're on earth, and what we do and become since god made male and female spirits different as part of a divine plan.
[60] Additionally, apostle Harold B. Lee taught that the "so-called 'transsexuality' doctrine" was hellish and false since God didn't place female spirits in male bodies and vice versa.
[61]: 232 [62] Church president Spencer W. Kimball addressed the BYU student body in 1974 and stated that sex reassignment surgeries were an appalling travesty.
[64] In contribution to a work on the Family Proclamation, Robert Millet wrote going against church-taught gender roles would cause unhappiness and a lack of fulfillment before and after death.
[65] Current church stances on gender identity and expression and sexual orientation are that they are different and that there is "unfinished business in teaching on [transgender situations]".