Beyond diagnosis: “Gender dysphoria feels like a living hell, a nightmare one cannot ever wake up from”.

Abstract

Despite the central role of gender dysphoria in the lives of many transgender people, discussions of gender dysphoria remain scant in conversations about affirmative practice. As such, scholars have called for qualitative studies to explore gender dysphoria through the voices and perspectives of transgender people. The primary aim of this study is to use grounded theory methodology to gain a more in depth and comprehensive understanding of gender dysphoria from the perspectives of transgender adults. Data for this study is associated with the online, written responses of 362 transgender adults (nonbinary ϭ 118, trans woman ϭ 49, trans man ϭ 133, genderqueer/genderfluid ϭ 49, and 2-spirit ϭ 8). Data deepen understanding through the following 7 themes: (a) being impossible to explain, (b) never being seen as me, (c) living in an imposter's body, (d) shapeshifting nature of gender dysphoria, (e) being tortured by one's own body, (f) emotional suffering, and (g) disrupting impact. Findings shed light on the multifaceted impact of gender dysphoria as well as the depth and severity of suffering associated with these experiences. Participants' first-person descriptions of their own experiences with gender dysphoria offer concrete as well as metaphorical examples that elucidate the nature, severity, and impact of distress on multiple dimensions of functioning. Findings underscore the importance of transgender affirmative medical and mental health care rooted in comprehensive knowledge of the scope and impact of gender dysphoria and the interventions (e.g., transition related care) that help to alleviate gender dysphoria. Public Significance StatementThis study provides rich description of experiences of gender dysphoria among transgender individuals. Study findings dispel the myth of the singular transgender experience while advancing understanding about the range, severity, and impact of gender dysphoria. Findings offer important insights to inform the development of affirmative practices and policies to advance access and availability of comprehensive transition related care.

Gender-related minority stress and gender dysphoria: Development and initial validation of the Gender Dysphoria Triggers Scale (GDTS).

“…Furthermore, researchers have recently conceptualized gender dysphoria as a proximal minority stressor, finding that gender dysphoria is associated with anticipated social stigma and suggesting that experiences of gender dysphoria can involve the internalization of social experiences (Lindley & Galupo, 2020). Austin and colleagues (2021) call for more comprehensive, multidimensional conceptualizations of the impact and scope of experiences of gender dysphoria, but gender dysphoria associated with social contexts has not been quantitatively evaluated in previous studies.…”

“…In other words, gender dysphoria is often defined as the distress that a transgender or nonbinary person may experience when their gender identity does not coincide with their sex or gender assigned at birth (American Psychological Association [APA], 2015). There is ample evidence that, for many, gender dysphoria is a powerful, internal experience that persists/exists even in affirming settings and after both social and medical transition have been achieved (Austin et al, 2021). However, prevailing, individual-focused conceptualizations of gender dysphoria as a personal disorder does not account for how factors outside of the individual (i.e., living in an oppressive and violent world) exacerbate experiences of gender dysphoria (Schulz, 2018).…”

“…Medicalization is an effective approach to treatment for many health issues, including gender dysphoria (Austin et al, 2021). In contrast to past conceptualizations of gender dysphoria as a unitary construct, scholars are beginning to provider broader, more diverse syntheses of gender dysphoria research that acknowledge the roles of internal dissonance, negative external interpersonal experiences, and the interface between both external and internal dynamics (Cooper et al, 2020).…”

Minority stress, pandemic stress, and mental health among gender diverse young adults: Gender dysphoria and emotion dysregulation as mediators.

“…Gender dysphoria is defined as emotional distress due to discrepancies between assigned sex and gender identity (Schneider et al, 2016). Gender dysphoria is a notable stressor for transgender folx (Austin et al, 2021; Galupo et al, 2019; Schneider et al, 2016), with links to suicidality, nonsuicidal self-injury, and body dissatisfaction (Peterson et al, 2017). This experience is particularly relevant for trans people, as few other identity groups must reconstruct their sense of self and, over time, internally manage misalignment between their assigned and true identities.…”

Exploring the influence of gender dysphoria in eating disorders among gender diverse individuals

“…Gender dysphoria has been described as a sense of incongruity between one's gender identity and that which was assigned at birth, and can occur on a social, emotional and/or personal level. 9,10 Gender dysphoria has been associated with extreme emotional distress for people and in a study by Austin et al, 11 one participant said that 'gender dysphoria feels like a living hell, a nightmare one cannot ever wake up from (p. 6). ' In regard to body dysmorphia, it has been reported that body dysmorphic disorder and some eating disorders share clinical traits and demonstrate high comorbidity.…”