1. What is Gender Identity and Gender Dysphoria?
In gender identity disorder the condition is such that there is a conflict between a person’s physical gender and the gender he or she identifies with. The individual may identify to the point of believing that they are, in fact, a member of the other sex, but is ‘trapped’ in the wrong body. Gender dysphoria, can be defined as a psychological state where someone is facing feelings of depression, anxiety and restlessness as a result of their gender issues, and can be categorized as a unpleasant psychological state of being. People with gender dysphoria may act as members of the opposite sex, for example one who is physically a boy may feel and act like a girl. This may lead to the person being very uncomfortable with the gender they were born as. Precise numbers of people who experience gender dysphoria are not easy to obtain because many people with the condition may never seek help. A study carried out in Scotland in 1999, found that around 1 in every 12,500 people may have the condition, although some people believe this is a significant underestimate. A survey of 10,000 people undertaken in 2012 by the Equality and Human Rights Commission found that 1% of the population surveyed was gender variant, to some extent. It was estimated in 2013 by the Royal College of Psychiatrists, that up to 40% of people with gender dysphoria may not be receiving appropriate help.
2. Causes, signs and symptoms
The exact cause of gender dysphoria is unclear. Recent research suggests the condition may be the result of abnormal development of the foetus while it is in the womb, which leads to the brain to develop a gender identity that is different to the baby’s sexual organs. This is possibly as a result of genetic or hormonal factors, but social and environmental factors (such as parenting) may also be involved. Gender dysphoria is not the same as homosexuality or bisexuality as identity conflicts need to continue over time to be considered gender dysphoria. How the gender conflict occurs, may be different in each person. For example, some people may cross-dress while others desire sex reassignment. During the ‘coming out’ process, it is common to feel a lot of conflicting emotions, including feeling scared, relieved, confused, proud, vulnerable, uncertain, empowered, brave, exhilarated, and affirmed. Symptoms can vary by age and be affected by the person’s social environment.
- Be disgusted by their own genitals
- Be rejected by their peers, feel alone or isolated
- Believe that they will grow up to become the opposite sex
- Say that they want to be the opposite sex
- Dress like the opposite sex
- Feel alone or isolated
- Want to live as a person of the opposite sex
- Wish to be rid of their own genitals/ have sex reassignment
Adults and children may:
- Cross-dress, show habits typical of the opposite sex
- Have depression or anxiety
- Withdraw from social interaction
Gender dysphoria is a psychological diagnosis recognized by the American Psychiatric Association (APA). This condition is marked by clinically significant distress caused by a marked incongruence between one’s experienced gender and assigned gender and the gender others would assign him or her, which is continual for at least six months. This condition causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. The feeling of being in the body of the “wrong” gender must last for at least 2 years for this diagnosis to be made. A historic review and psychiatric evaluation can confirm the person’s constant desire to be the opposite sex.
For some people, support and advice from a clinic or therapist are all they need to feel comfortable in their gender identity. Others will need more extensive treatment, such as a full transition to the opposite sex, cross-sex hormone treatment, speech and language therapy, hair removal treatments, and surgical sex reassignment. If you think you or your child may have gender dysphoria, see your GP for specialised medical advice. Many people with gender dysphoria report the benefit from psychological treatments. Psychological support is often provided in conjunction with sex transition work to help with the difficult emotions associated with the dysphoria. In recent years this treatment has usually taken the form of Cognitive Behavioural Therapy (CBT). Elements of this approach typically include stress reduction and mood management. It may help you to learn how to better deal with unhealthy negative emotions in order to feel differently and act practically on things that may be maintaining negative vicious cycles. Therapy can be offered in the form of individual or couples therapy. Living openly doesn’t mean that the sole or even primary, aspect of your identity is having gender dysphoria. It means making this part of your life a natural piece of you — just like your age, height, hair colour or personality. Many people refrain from talking about gender identity and expression because it feels taboo, or because they’re afraid of saying the wrong thing. Therapy will allow you to explore and express your thoughts around your own gender, as well as help you manage difficult emotions that might come from this process.