Gender Dysphoria ?
Gender dysphoria is used as a diagnosis for being transgender, but what exactly is gender dysphoria, and what are the underlying reason for having gender dysphoria?
Someone once asked me to explain to them what gender dysphoria was. I started to answer, but stopped, as it dawned on me that I could not answer the question. It appears to have different meanings to different people. I personally see “gender dysphoria” as a concept used by medical staff as a symptom of being transgender. More generally dysphoria describes a high level of distress caused by being in a situation with apparently no escape - but what - if anything - is special for gender dysphoria?
“Gender dysphoria” was coined when I was 11, as the distress caused by a conflict between a persons gender identification and assigned gender. By then I had been expressing gender diversity for nearly a decade. I had already gone through several stages (such as declaring myself the opposite of my assigned gender at the age of six), and had - after external pressure - decided to follow the path of least resistance - trying to conform to the gender I had been assigned at birth.
I felt the distress caused by not being allowed to express myself in public - I just wanted to be able to dress and act the way that felt natural to me. The problem was that the surrounding society wanting me to be someone I was not. I did not have a problem with my body - I got that later when my body decided to complicate the issue further. I did not have a direct problem with my gender - I see gender as being irrelevant for how you are allowed to present - in the same way that the colour of your eyes should have no influence on what you are allowed to do. Different spaces have different rules, and as long as the rules and people in those spaces are respected, there should be no problems. My problem is that the society is setting rules for what I am allowed to do given how my body looks. I did have dysphoria - defined as feeling distress from being placed in an impossible situation - but I see the gender part as being forced upon me by society.
The underlying problem for most transgender people is that the different biological methods for determining gender does not add up. You DNA may identify you as one gender, while you genitalia may identify you as the opposite gender. Your genitalia may identify you as one gender while you brain structure and chemistry identify you as the opposite gender. Etc. I did try to “reprogram” my brain to fit my gender assigned at birth - but it failed spectacularly. Trying only worsened the distress. My gender identity was hardwired into my brain and all programming could do was to create a false persona or avatar to present to the world.
The individual transgender person may identify the cause of their dysphoria in different ways. I identified it as caused by an unsupportive society (I did write an essay about it while in high school). Others may identify it as caused by body and mind not being aligned (born in the wrong body) or caused by their body having both male and female attributes (intersex/DSD). Some start by assuming (or being convinced) they have a mental problem, and try to suppress it (mentally or medically), resulting in further problems. I was subjected to attempts to “correct” me, which resulted in me suppressing and creating temporary, secret, safe releases for half a century.
The only one that can determine which identity is the right for a specific person is that person themselves - there is no simple rule that fits all. It is very stressful to be denied your own identity, and preventing the alignment of this instability of internal and external gender identifications will in most cases result in mental of physical harm.
I cannot see my dysphoria any different than the distress felt by women not being able to make decisions about their own body, the distress felt by a homosexual person that is forced into a marriage with a person they do not feel any attraction to, or the distress felt by being placed in any situation where there does not appear to be an escape. There are two obvious methods to survive such stress: comply or revolt. Unfortunately some cannot accept any of those, so they choose to end their life.
Complying requires you to give up on yourself - typically filling up your life with something else so you do not have time to think about you predicament, such as work, special interests, volunteer work, etc. You create an external persona, create rules for yourself to ensure that no glimpse of your real self leaks to the outside world. The purpose is to fill your life with so many activities that you forget who you really are. My worst nightmare was to not be able to fill out time, such as when I could not fall asleep, allowing the negative thoughts to surface. My personal solution was to create stories about fictional worlds where I was free to be myself. Alternatively some tries to intoxicate themselves in different ways to simply forget their impossible situation.
Many of those that choose to comply ends up in a situation where they develop mental problems or they can no longer maintain the false persona and have to choose again. Having already built a world with a false persona and letting your real self out later in life can result in the life you have built to fall apart, giving further stress. For some this ultimately results in the choice to simply just end it all - in one way or another. This is true no matter the reason for the “dysphoria”.
I see “dysphoria” as society induced stress, and that the only way to prevent dysphoria is for society to accept people’s right to make decisions about their own body, presentation, sex life, etc. Society should only step in when someone is trying to hurt others, such as when someone is threatened or hurt or is prevented in expressing themselves. Unfortunately many religions and ideologies are based on the power to determine the “correct” way to live your life, which in some cases result in believers policing others. If the way of life the religion/ideology matches you, all is good, but if it tries to prevent you from being yourself, you should probably find a better place to be. There is no reason for you too not have spiritual, political or material beliefs without subscribing to a specific religion or ideology - but please do not try to force your beliefs onto others.
The best way to “treat” dysphoria is to remove the obstacles.
Transgender people need the right to present themselves as who they are. For some is is simply to be allowed to dress and act as who they identify as - and be accepted and respected as they present (which typically involves using the preferred name and pronouns). For some that in itself is enough, while others feel the need to make medical and/or surgical changes to their body and/or changing their legal name and/or gender. Many people that are not transgender feel a similar need to enhance their body or change their name, so I can see no real difference here.
All women need the right to present themselves as who they feel they are, but also have the added right to determine if they want to be pregnant - to be able to prevent being forced to bear a child - especially when it can result in harming the mother, child or others. The only ones that should be allowed to determine to start or continue a pregnancy is the woman involved or in some cases the medical staff - not politicians, religious leaders or even the odd male involved.
In some cases society also expects people to present and act in specific ways depending on their assigned gender, skin colour or similar attributes resulting in harassment and hatred if you step outside the accepted norm. When rules are set up to harass transgender people, these tend to spill over on especially women in general, disabled people and other minorities.
Men have similar problems, especially when their sexual identity is not purely straight, or when their body does not evolve to be “masculine” enough. Not presenting as a “macho” male, not being sufficiently aggressive, not having large enough attributes, etc. can make a man appear weak, which again results in harassment, violence and other forms of others taking advantage of you and subjecting you to their will and wishes. Of some reason the expectancy of the role of males does not appear to have changed that much since we were living in caves. This can make just being gay dangerous in some countries, resulting in “dysphoria”.
My dysphoria came more from me not accepting the role of a man than from having a (somewhat) male body - yes I was called a sissy in elementary school, I had no stamina, I failed completely at sports, etc. I ended up transitioning as this appears to be the only way to get society to accept the real me.
To sum up: Dysphoria as I understand it is just severe distress from being placed in an impossible situation. Dysphoria is not specific for transgender people. Gender dysphoria typically have a biological cause. Dysphoria can in most cases be treated - but only if the person being treated is the one deciding. External pressure only results in further problems and/or harm.