Gender dysphoria: one woman’s understanding of a complex and not yet fully understood state

Artist: Dan Page theispot

Gender dysphoria (GD) – typically characterised by clinically significant distress concerning mismatch between one’s biological sex and their perception of their own gender – is often overlooked in both LGBTQI+ and mainstream cultures. This is most likely due to great confusion surrounding what it is – confusion that persists even within gender specialists’ circles; after all, it is hard to be clued up on something that’s not fully understood by the experts.

Though GD is currently a diagnosable condition in itself, some researchers and transgender people support its declassification as a condition, due to their belief that its classification pathologises gender variance, and reinforces the gender binary model.

However, regardless of whether or not gender dysphoria should be treated as its own condition, 8,000 people in England alone in 2018/19 were referred to adult gender dysphoria services. This is a case rates number that has been steadily increasing over the last decade. And, though it may be a small number in comparison to the national population, it’s imperative that we learn more about any such experience that can so negatively influence members of our community’s day-to-day sense of self.

Most people can relate to feeling misunderstood and alone at times, and it’s a wonderful thing to see those feelings alleviated in others through just a little graft and self-enrichment.

Amongst GD’s internal ways of presenting can include: significant discomfort with your body; disgust towards and the desire to remove physical signs of your biological sex; being comfortable only in the gender role of your preferred gender identity; and, feeling significant distress associated with biological sex and gender identity mismatch. All this can influence your behaviour significantly in terms of your choice of dress, self-expression, and your mannerisms.

Yet, dressing or expressing in a way indicative of a gender separate from your biological sex could suggest gender nonconfirmity, not gender dysphoria – the critical difference being the sense of “clinically significant distress” stemming from conflict between biological sex and gender.

While we have a decent understanding of GD in terms of its symptoms and how it presents, its causes are still somewhat unclear. However, there is plenty of neurological evidence to support that causes are indeed biological as opposed to sociological.

Studies – which esteemed neuroendocrinologist Robert Sapolsky speaks on – indicate that there are parts of the male brain (the Stria Terminalis, for example), which are twice as large in male as they are in female brains. What’s interesting is that, when examined, trans male brains replicate these results: the Stria Terminalis appears twice the size of their cisgender female counterparts. Hereby, this proves that to be transgender is a naturally occurring phenomenon with core biological realities, thus making it highly inappropriate to ever refer to one’s transgender identity as a mental disorder.

This all ties into the validity of a gender dysphoric person’s experience, as GD is intrinsically linked to many (but not every) individuals’ transgender identity: both experiences encompass that very defining feeling of one’s biological sex and self-perceived gender being at odds.

Confusion between these two separate states is common because they’re defined so very similarly; the key difference to remember is that it is only during gender dysphoria that individuals will experience significant distress associated with their biological sex and gender mismatch. In other words, while all gender dysphoric people fall under the trans bracket, not necessarily all trans people are gender dysphoric.

Granted, this is all a lot of information to take on on this little-known-of topic. However, when you pause to consider how staggeringly high trans and gender dysphoric persons’ suicide rates are (an estimated 35% of trans and gender dysphoric individuals attempt suicide at least once over the course of their lifetime), it becomes imperative that we accomplish two primary things.

First, we achieve the normalisation of so-called ‘alternative’ forms of gender expression and the shunning of the gender binary model, so that gender dysphoric persons might feel better accepted amongst society, and therefore feel more able to speak up when going through periods of self-hatred. 58% of those experiencing gender dysphoria – according to one 2017 study – also had a second psychiatric diagnosis; it’s often the case that depression and anxiety disorders specifically will arise in people who feel isolated in their situations. It’s when the culture of silence that stems from societal shame towards appearing ‘different’ is shed that society’s illusion of what is ‘normal’ begins to crumble: each individual becomes able to present in whichever way suits his/her/their true self without fear of rejection.

Second, we push for more research to be done into the science behind gender dysphoria, trans identity, and how each one arises. While societal acceptance is a more urgent goal, and no one should have to ‘prove’ the validity of their lifestyle, further scientific studies into what it means to be trans or gender dysphoric will undoubtedly lead to light being shed on many curious questions: what the cause and real-life impacts are of the theoretical link between being gender dysphoria and Autistic Spectrum Disorder, for example.

Many non-westernised societies exist globally in which those of the trans identity have been uplifted and celebrated (at least, prior to colonisation): Ankole in Uganda, Bugi of southern Sulawesi, and in Aboriginal Australia, to name a few. It’s also a notable trend that similar societies as these, untainted by the Western world, tend to enjoy a stronger sense of ‘togetherness’ and better overall quality of life.

Two Bugi individuals photographed on the Indonesian island of Sulawesi

When such societies refrain from implementing the incredibly limiting gender binary system and still maintain a high quality of life, it begs the question: Why should we in the West continually support this system that is so backwards for our psychological well-being?

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