The two little letters carry a world of significance: he. Amid the wave of reaction to Caitlyn Jenner’s announcement that she is a transgender woman, and her upcoming cover story in Vanity Fair, pronoun use has become a symbol of deep cultural divisions: Calling Jenner “he” versus “she” has important implications for the speaker’s understanding of gender identity.

Sometimes, as Megan Garber wrote on Tuesday, pronoun awkwardness is a matter of confusion or lack of education; even well-meaning media outlets have made mistakes in covering Jenner’s debut as a woman. But some reactions, particularly from conservative Christians, have reflected skepticism about the deeper claims of transgender identity.

Matt Walsh, an often polemical conservative Christian blogger, wrote an article for The Blaze headlined, “Bruce Jenner Is Not a Woman. He Is a Sick and Delusional Man.” The charismatic Christian magazine Charisma News ran a story called “Celebrating Confusion: The Crisis of Bruce (Not Caitlyn) Jenner.” The pastor who ministers to the members of the ultra-conservative Duggar family, who star in the reality-television show 19 Kids and Counting and are currently experiencing their own share of media attention, said about Jenner, “What's remarkable about this is the world is applauding.” And speaking more broadly on transgender issues earlier this year, Republican presidential candidate Mike Huckabee said, “Now I wish that someone told me that when I was in high school that I could have felt like a woman when it came time to take showers in PE. I’m pretty sure that I would have found my feminine side and said, ‘Coach, I think I’d rather shower with the girls today.’”

Although many of these statements have come from conservative evangelical Christians, there’s evidence that those in other denominations are also inclined to reject transgender identity. On Wednesday, the archbishop of San Francisco, Salvatore Cordileone, responded to the news of Caitlyn Jenner’s Vanity Fair cover at a conference, saying, “The clear biological fact is that a human being is born either male or female.” According to David Gibson of Religion News Service, “Cordileone said a friend recently pointed out to him that a major university advertised housing ‘for a grand total of 14 different gender identities. … I’m sure even more will be invented as time goes on,’ he said, prompting laughter from the audience of about 200.”

Understandably, these kinds of responses have prompted anger and hurt and condemnation from the LGBT community and beyond. There’s a strong element of tone-deafness, even trolling, in calling someone who goes through this kind of vulnerable, public transition “sick and delusional.” But these negative reactions also suggest an important difference in understandings about what gender identity and sexuality actually mean—and indicate how difficult it will be to reconcile transgender identity with the beliefs of certain Christians, both culturally and politically.

After Jenner revealed her struggle with gender identity in an interview with Diane Sawyer, the head of the ethics organization of the Southern Baptist Convention, Russell Moore, wrote, “We do not see our transgendered neighbors as freaks to be despised. They feel alienated from their identities as men or women … In a fallen universe, all of us are alienated, in some way, from who we were designed to be.” But this empathy was accompanied by a statement of belief: Rejecting your gender, and particularly taking hormones or undergoing sex-change surgeries, does not fit with the Southern Baptist understanding of theology.

Moore framed his position with the rhetoric of the culture war. “The cultural narrative behind the transgender turn … is rooted in the ancient heresy of Gnosticism, with the idea that the ‘real’ self is separate from who one is as an embodied, material being,” he wrote. “Our transgender neighbors experience real suffering … the answers the culture and the Sexual Revolution-Industrial Complex offer can’t relieve that suffering.”

Setting the initial-capped “Sexual Revolution-Industrial Complex” aside, this is a straightforward claim about the nature of existence: Individuals can’t define the nature of their “self”; only God can. Feeling discomfort with yourself and alienated from the world is a normal part of being human, Moore is saying, but living as a Christian means accepting that Jesus, and not alterations of the body, is the salve to that feeling of alienation.

This is one person’s interpretation of theology and how Christians should respond to transgender identity. There are also many, many, examples of Christians welcoming members of the trans community. Jenner herself identifies as a Christian and has at times been a regular church attendee. But these reactions also point to the challenges ahead as transgender issues—and individuals—become a more prominent part of culture.

“Many evangelicals, and probably most Americans, [believe] that sex and gender are the very same thing,” said Sara Moslener, a professor at Central Michigan University who studies religion and sexuality. Outside of the LGBT community, many people haven’t had significant exposure to transgender issues. And for those who look to their church and faith for guidance on sexuality and gender, Biblical teachings don’t necessarily speak to the complexity of transgender identity. “When evangelical Christians look at the Bible, they go to the creation story and say this is the story of Adam and Eve, this is how God created it,” Moslener said.

These first-principle disagreements about the nature of gender and sexuality might stay contained within their respective spheres—some culturally conservative Christians will reject the choices of Caitlyn Jenner and her transgender peers, while many other Americans will choose to celebrate them. But from a legal perspective, the challenges are just beginning. In a panel discussion at a conference on religion and politics I attended this spring, John Inazu, a professor at Washington University in St. Louis, said transgender issues pose “conceptual challenges” to both liberals and conservatives: Equality for transgender people is a question of identity, not sexual practice. “This plays out in institutional policies that are down to how many and where the bathroom is going to be and who plays on the sports teams,” he added. “These are all binary decisions, and they’re zero sum, in some sense.”

In other words, refusing to call Caitlyn Jenner “she” isn’t just a question of etiquette or philosophy; it could have real implications for how policies are created in everyday communities. This is about being able to find a person at the DMV to change an “M” to an “F;” letting transgender girls join Girl Scout troops, creating protections against harassment and unequal treatment; and making sure people can get adequate medical care during a gender transition, if they so choose, and after.

And in some cases, it may be about preventing irreversible tragedy. Late last year, 17-year-old Leelah Alcorn, a transgender teen from Ohio, committed suicide. In a note she posted to Tumblr, she wrote about her conservative Christian mother’s reaction to her desire to start transitioning to a female identity: “God doesn’t make mistakes.”

“I’m not against anybody. I’d just like for somebody to bring their brain to work some day and not leave it on the bed stand when they show up to govern,” said Huckabee about recent ordinances concerning gender-neutral bathrooms. There is a difference between allowing people to hold their beliefs and allowing those beliefs to shape public policy; and there is a difference between holding beliefs and mocking those who believe differently. The adjustment period on this issue will be complicated. And as the response to Caitlyn Jenner has shown, it’s only just beginning.