Negotiating Gender in Everyday Life: Toward a Conceptual Model of Gender Dysphoria in Adolescents

Abstract

A growing number of adolescents are seeking medical care to alleviate gender dysphoria (GD). This qualitative study explored the subjective experiences of GD among help-seeking transgender and gender nonconforming (TGNC) youth in order to develop a more nuanced conceptualization of the phenomenon. Fifteen life-mode interviews were conducted with newly referred youth between the ages of 13 and 19. All participants were assigned female at birth. The data were analyzed using thematic analysis. The participants targeted five major themes that characterize GD: (1) Bodily sensations were constant reminders of GD throughout the day, (2) emotional memories from the past of being different and outside triggered GD, (3) the process of coming out was a transformative experience that changed how the participants understood themselves, (4) GD both increased and decreased in relation to others, (5) everyday life required careful negotiation to feel whole without developing new forms of GD. Based on the results, we suggest a more conceptually nuanced model of GD, one which accounts for how bodily sensations and emotional memories from the past were sources that elicited GD. The sources were mediated through the process of coming out and relating to others, and this resulted in the negotiation of GD today. The conceptual model suggested in the present study could ideally shed light on preexisting knowledge on TGNC youth struggling with GD. In addition, an improved understanding of GD could ideally help clinicians when addressing individual treatment needs.

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

“…Hetero-cis-normativity negates the complexity of gender, sexual orientation, and sexuality and disregards diversity and fluidity. This is all the more important since sexual identities, orientations, and practices of transgender and gender diverse (TGD) people are characterized by an enormous diversity (Galupo et al., 2016 ; Jessen et al., 2021 ; Thurston & Allan, 2018 ; T'Sjoen et al., 2020). Likewise, a strong cross-cultural tendency toward allonormativity—the assumption that all people experience sexual attraction or interest in sexual activity—negates the diverse experiences of TGD people, especially those who locate themselves on the asexual spectrum (McInroy et al., 2021 ; Mollet, 2021 ; Rothblum et al., 2020 ).…”

Life experiences leading to the choice of surgery—A qualitative study exploring reasons behind the choice of undergoing gender affirmative surgery

“…Because of how society devalues difference and the stigma attached to it, human difference can be experienced not only as small miseries but also represent a barrier to lifetime functioning (Kittay, 2006 ). In the study by Jessen et al ( 2021 ) on subjective GD experiences among help-seeking transgender and gender non-confirming youth, participants described emotional recollections of feeling different and left out among peers as a child. Some linked their sentiments to their incongruent gender, while others linked them to a general sense of not belonging and that these emotional experiences still tormented them.…”

“…In the study by Jessen et al ( 2021 ), most of the participants stated that their subjective experiences with gender dysphoria were impacted by their interactions with others. They had also experienced that forming bonds and relationships with people could help relate to their bodies in new ways, decreasing their subjective symptoms of gender dysphoria.…”

“…Some experienced that they no longer felt the need to conceal or act, and with the right support and acceptance from others, the symptoms of gender dysphoria could modify, but also sometimes persist. One of the findings of the study by Jessen et al ( 2021 ) was that living as the identified gender had been a transforming experience that had affected how participants saw their history. The participants expressed relief, stating that they now could understand their former sentiments and emotional recollections of being different in a another perspective.…”

“…There are some new studies concentrating on transgender people's subjective experiences of living as their assigned gender before treatment and surgery. Jessen et al ( 2021 ) investigated the subjective experiences of GD among help-seeking transgender people assigned female at birth. They found that a variety of physical signs in the body throughout the day triggered GD, as well as emotional recollections of being different.…”