Gender Dysphoria and Transgender Discussions

Discussions around gender dysphoria and transgenderism have become more prevalent in the past several months. In our local community, there have been messages shared and statistics provided arguing the dangers of gender dysphoria or transitioning. The ability to navigate all the data, facts and opinions leads to a lot of confusion and difficulty. The judgment disguised as love results in an increase in fear, isolation, and self-harm. 

What does all of this mean to us as human beings and what does it look like to navigate the information presented from both sides?

Would your opinion change if you were close to someone who is transgender or if that someone was you?

I write this from personal experience. I don’t pretend to know all the facts, but I know what it means to live with gender dysphoria and to be nonbinary. I know what it means to face the fear of rejection and having family members refuse to accept you. I know what it means to hide your identity because sharing your story could mean being fired from a job, kicked out of school or even thrown out of your house. 

This is a part of my story and I want to share it with you. 

When I was very young, around age 3/4, I recognized that I didn’t feel like a part of my body. I was biologically female but I did not feel like that was really me. I was allowed some freedoms until right about the time I started school. I was told I had to wear a shirt outside(why the other boys didn’t have to), made to wear dresses for special occasions, and the expectations of how I should behave became more pronounced. There were many instances of “girls don’t do that.” 

In first grade, I got my babysitter to cut my hair so I could spike it up and loved to play with Transformers and GI Joe, but I was bought Barbie and Care Bears. Growing up, I would play tackle football with my cousins and wrestlemania until I got told that was not appropriate games for a girl. The term used then was tomboy and I fully embraced that label because it felt closer to who I was. I remember teachers referring to me as he in class and my classmates laughing because they perceived that I was misgendered. I would then accept the label of she because the teasing and comments from fellow students were harsh and hurt a lot. I wanted to blend in and not be seen.

When I hit puberty there was a huge shift in my mental health with an increase in anxiety, depression, and feeling my body was betraying who I was. I feared every new physical development and the start of menstruation was extremely dysphoric. Every month there was a reminder that my body didn’t fit me. I didn’t know how to describe it, but it was the feeling of being foreign in my skin. I would try to fit expectations but the result was more anxiety and depression. There were days I wished that I would just not wake up or that I would be invisible. I hated the looks people gave me, the whispered conversations, kids asking if I was a boy or a girl. 

I was scared to tell anyone how I felt, so I shoved myself into the box of expectations for how females are to behave. I got married. I had kids. I met societal expectations because the pressure to conform was intense. I would try to express my masculinity in various ways and not be accepted. I would attempt to fit feminine stereotypes and would hate myself even more. It has been a long journey of decades of self-discovery, self-acceptance, and authenticity to get to where I am today. I didn’t have a support system when I was younger, I mean I didn’t have the support system until just recently to be my authentic self. 

I grew up going to church, and have a Master of Divinity. I had heard from a young age how there are males and females, how a man marries a woman, and how anything that goes against that is wrong. I suppressed myself because how is it possible that a loving God would give me the wrong body? Why would God make me in a way that didn’t follow what was right? 

This past year has been one of intense internal introspection and understanding that I am me. I am the way God made me, He didn’t make a mistake. I may have a physical body that is female, but my true self does not have a set gender. I am me, and I have learned over the last year that it is amazing to be me. I am raising some fantastic children as a single parent and have met the most accepting of partners. I am happier now than when I was fitting a mold. The ability to be real and remove the mask has helped me to accept myself fully. 

From Self-Reflection to Understanding

Every single person has their own journey in life and it is that path, that journey, that helps to shape who they are and who they become. I don’t wish my past on anyone else, but I don’t regret things from my past or the journey I have taken because it has helped me discover my authentic self and as such I am able to help others. 

Exploring gender dysphoria requires understanding the distinction between biological sex, sexual orientation, and gender identity. For the sake of this discussion, the focus will be biological sex and gender identity. Biological sex is the presence of male and/or female sex organs. Gender is the masculine or feminine attributes that a person displays, and what is defined as masculine and feminine can be different within cultures around the world. The term gender dysphoria comes from the recognition that gender may not always align with biological sex. The diagnosis of gender dysphoria was added to the DSM in 2013 to replace gender identity disorder and switched the focus from fixing a disorder to helping with resolving the distress that is present (American Psychiatric Association, 2013).

Clarifying the Facts

Another point recently spoken on was regarding a report that mentions that 80% of transgender youth detransition later in life (Brooks, 2018). The truth is the methodology of the study was flawed and the researchers could not locate over half of the original population and assumed they had detransitioned for their study.  In 2022 a study found that 3% of transgender people experienced some regret but that did not mean they detransitioned; meaning that 97% of the people who have transitioned are happy. The study goes on to further discuss that 5% of the 3%(so 0.4% of transgender individuals) who had some regrets felt that transitioning was not right for them(Hildebrand-Chupp, 2020). The struggle with identifying individuals who have detransitioned or otherwise is that the specifics of what that means differs depending on who is doing the study (Exposito-Campos, 2021).  

Another recent discussion has stemmed from the idea that some believe gender dysphoria is similar to anorexia. The argument is that performing gender-affirming medical care is equivalent to performing liposuction on someone with anorexia. First off I will agree with psychiatrists that anorexia is considered to be one of the most dangerous and lethal of mental health diagnoses (Compton & Han, 2022). In the United States, one person dies every hour as a result of an eating disorder. If a surgery existed that was helping people with anorexia the way that gender-affirming care works for people with gender dysphoria, then everyone would be on board with it. 

Addressing Mental Health

Individuals who have gender dysphoria or who are transgender are at risk for higher rates of suicide than the general population. The prevalence of suicidal ideation among adolescents with gender dysphoria or who are transgender is close to double that of cisgender adolescents. The prevalence of having attempted suicide in the same population is three times that of cisgender adolescents (Trevor Project, 2023). The ability to provide gender-affirming care, in the most recent studies, is demonstrating a reduction in suicidality among those who have started to receive care (Jackson, 2023).

It is imperative that as human beings we meet people where they are and see them. The idea that there is this rapid onset of gender dysphoria among adolescents is not true which argues against it being a social contagion (Yurcaba, 2022). The identification of gender dysphoria did not increase the prevalence of it, but the acceptance of people for who they are has allowed them to remove their masks and be authentic. 

Understanding the Risks

It is important to understand that every major medical and mental health organization has condemned the use of conversion therapy, or a therapy that is designed to change an individual’s sexual orientation or gender identity. Conversion therapy has been outlawed in 22 states for use with minors. Individuals who have undergone any type of conversion therapy, including talk, shock, aversion, etc., are twice as likely to attempt suicide and reported being 2.5 times as likely to have had multiple suicide attempts in the past year (Trevor Project, 2022). 

This discussion is about recognizing people as who they are and loving them where they are at. It is about being able to walk alongside someone and not judge them for who they are but rather accept them and show them that they matter. This is not something to be cured, this is acceptance of amazing differences and supporting people with love because all people deserve to be authentic.

If you or your adolescents are navigating gender dysphoria or transgenderism and considering seeking out mental health services, please consider checking out our providers here.

If you are ready to become a client of The Mental Wellness Center, Inc. please take your first steps here:

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Brooks, J. (2018) The controversial research on desistance in transgender youth. KQED. https://www.kqed.org/futureofyou/441784/the-controversial-research-on-desistance-in-transgender-youth

Compton, W. M., & Han, B. (2022). Substance Use Disorders Are Deadly. American Journal of Psychiatry, 179(1), 11–13. https://doi.org/10.1176/appi.ajp.2021.21101069

Expósito-Campos, P. (2021). A Typology of Gender Detransition and Its Implications for Healthcare Providers. Journal of Sex & Marital Therapy, 47(3), 270–280. https://doi.org/10.1080/0092623X.2020.1869126

Hildebrand-Chupp, R. (2020). More than ‘canaries in the gender coal mine’: A transfeminist approach to research on detransition. The Sociological Review, 68(4), 800-816. https://doi.org/10.1177/0038026120934694

Jackson D. (2023). Suicide-Related Outcomes Following Gender-Affirming Treatment: A Review. Cureus, 15(3), e36425. https://doi.org/10.7759/cureus.36425

Trevor Project. (2023). 2023 U.S. national survey on the mental health of LGBTQ young people. https://www.thetrevorproject.org/survey-2023/#support-transgender-and-nonbinary-young-people

Trevor Project. (2022). New study finds conversion therapy, and its associated harms, cost the US an estimated $9.23 billion annually. https://www.thetrevorproject.org/blog/new-study-finds-conversion-therapy-and-its-associated-harms-cost-the-u-s-an-estimated-9-23-billion-annually/

Wright J., Chen L., Suzuki Y., Matsuo K., Hershman D. (2023) National estimates of gender-affirming surgery in the US. JAMA Netw Open.6(8). doi:10.1001/jamanetworkopen.2023.30348

Yurcaba, J. (2022). ‘Social contagion’ isn’t causing more youths to be transgender, study finds. https://www.nbcnews.com/nbc-out/out-health-and-wellness/social-contagion-isnt-causing-youths-transgender-study-finds-rcna41392