While the term “transgender” has been making headlines for the past few years, there’s little to no talk about the word “gender dysphoria.” This form of psychological distress affects almost every self-identified transgender. More than a mental illness, it’s the burden they often pay from the incongruence between their sex assigned at birth and their gender identity.
What is Gender Dysphoria?
Gender dysphoria appears in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and it also appears in the manual by the American Psychiatric Association to diagnose mental conditions.
Previously known as gender identity disorder, it presents a feeling of discomfort or distress in people whose gender identity differs from their sex assigned at birth. The new term, gender dysphoria, focuses more on the discomfort as the problem rather than someone’s identity. To better understand this, it’s essential to know the difference between gender identity and sex:
- Gender identity: is the personal conception of oneself as male or female (or both, or neither). This is based on the gender role, defined as the manifestations of personality that reflect our gender identity.
- Sex: is a label people are given at birth based on medical factors such as hormones, chromosomes, and genitals.
Since gender dysmorphia can manifest in children before puberty or adolescence and adulthood, the DSM-5 has different diagnostic criteria.
The manual recognizes an incongruence between a child’s experienced and expressed gender and the assigned gender for children. These symptoms must prevail for at least six months and must include at least six of the following:
- A strong desire to be of the other gender or an insistence that the child is the other gender (or some alternative gender different from their assigned one)
- In boys (assigned gender), strong preference for cross-dressing or simulating female attire; on girls (assigned gender), a strong desire to wearing only typical masculine attire or resistance to wear ordinary feminine clothes
- A noticeable preference for cross-gender roles in fantasy play
- A preference for the toys, games, and activities stereotypically used by the other gender
- Preference for playmates of the other gender
- In boys (assigned gender), a rejection of typically masculine toys, games, and activities with a strong avoidance of rough-and-tumble play; in girls (assigned gender), a rejection of typically feminine toys, games, and activities
- Strong dislike for their sexual anatomy
- A desire for the physical characteristics that match their experienced gender
Clinically significant distress or impairment in social, occupational, and other vital functioning areas must be present.
In Adolescents and Adults
Similarly to children, adolescents, and adults who also experience an incongruence between their experienced gender and assigned gender must exhibit symptoms for at least six months and include two of the following:
- A noticeable incongruence between their experienced gender and primary/secondary sex characteristics
- Desire to be rid of their primary and secondary sex characteristics (in adolescents, a desire to prevent the development of the anticipated secondary sex characteristics)
- A desire for the primary and secondary sex characteristics of the other gender
- A strong desire to be of the other gender (or alternative gender)
- A strong desire to be treated as the other gender
- A firm conviction that they have the typical feelings and reactions of the other gender
Like in children, these symptoms need to be associated with clinically significant distress and impairment in social, occupational, and other functioning areas to meet the diagnostic criteria.
Common Misconceptions About Gender Dysphoria
Overall, the notion of gender dysphoria is confusing. Terms like transgender, transsexual, nonbinary, and so on make things a bit more confusing. Each of these terms means entirely different things and relate to various aspects of our exploration of gender, sexual orientation, and sex. Here are some things to keep in mind:
- NOT all transgender people suffer from gender dysphoria
- NOT all individuals with gender dysphoria seek gender-affirming treatments
- All travesties DO NOT have a psychiatric disorder
Treatment for Gender Dysphoria
Unlike other mental illnesses like depression and anxiety, most people are looking to embrace their gender dysphoria rather than suppress it. Support for people with gender dysphoria includes open-ended exploration with a therapist. Some psychological attempts to force a transgender person to be cisgender, also known as “gender identity conversion therapy,” are unethical.
The key here is to offer affirmations throughout their journey. For example, medical affirmations can include pubertal suppression for adolescents, gender-affirming hormone therapy for adults. Eventually, some adults might seek surgical affirmation, including sex reassignment surgery.
Next is behavioral health treatment to improve their psychological well-being. Again, the goal of behavioral therapy isn’t to alter their gender identity. Instead, therapy helps patients explore gender concerns and find ways to lessen gender dysphoria by embracing their true selves. The goal of treatment is to help them become comfortable with their gender identity expression, to enable success in relationships, work, and life. Therapy can also help address any other mental health concerns like anxiety, depression, and others.
Challenges People with Gender Dysphoria Face
First of all, family and social rejection are some of the strongest predictors of mental health challenges for people who experience gender dysphoria. Transgender and gender-nonconforming individuals suffer from all levels of stigmatization, discrimination, and victimization. This constant attack on their image increases the rates of other mental health disorders. They are at higher risk of victimization and hate crimes than the general public.
Suicide rates are also astonishingly higher than the rest of the population. Overall, the suicide rate among transgender people is nearly 10 times higher than the national rate. Transgender adolescents are often victims of bullying and discrimination at school, which can cause them to become socially withdrawn.
Also, transgender individuals may face challenges in accessing appropriate health care and insurance coverage of related services. They even struggle with legal challenges as they attempt to change their names and documentation.
Rates of addiction among transgender people are disproportionately higher than rates of substance use disorders in the general community. Indeed, as many as 30 percent of LGBTQ+ people report the abuse of drugs and alcohol, the general rate is only 9 percent. The higher rates are seen all around:
- 30% LGBTQ+ vs. 9% General Public report abusing drugs and alcohol
- 25% LGBTQ+ vs. 10% General Public report drinking dangerously
- 40% LGBTQ+ teens have attempted suicide or have seriously thought of suicide
- 78% of Transgender Students have reported suicide attempts as a consequence of gender identity bullying
If you or someone you know is struggling with gender dysphoria, please seek help. Support, professional guidance, and the right medical assistance can help. At Lighthouse Recovery Institute, our LGBTQ+ programs are designed to address all the challenges those in this group face. With support from our specialized therapists, they find the strength to practice self-love, manage underlying mental illness, and leave substance abuse behind. Your recovery starts today.