Sometimes, people come to counselling to talk about their gender identity and to talk about the gender dysphoria they live with each day. But what is gender dysphoria, how does it affect someone and what can help a person experiencing gender dysphoria? In this short article I hope to raise some awareness about gender dysphoria and provide some basic information.
What is gender dysphoria?
The Cambridge dictionary defines gender as; ‘the physical and/or social condition of being male or female’ and dysphoria as; ‘Severe unhappiness, especially a person’s feeling of being very uncomfortable in their body or being in the wrong body’.
Combining these two words to define what gender dysphoria is, NHS England states; ‘Gender dysphoria is a term that describes a sense of unease that a person may have because of a mismatch between their biological sex and their gender identity.’
So, for example, a person may have been assigned male at birth but feel they identify more as female.
Gender dysphoria can affect both children and adults. Many parents may know that children often have questions about their gender identity, which go away as they develop. It can be identfied as not wanting to wear clothes associated with the sex they were born with, wanting to be identfied with a name associated with the oppostite sex, or playing with toys and children not typical of their sex.
For some individuals, the dysphoria continues into adulthood and it can be really distressing and painful to live with, both emotionally and physically. At some point an individual may want to make a decision about how they are going to manage the dysphoria they have about their gender. That might involve talking to someone, wanting to live their life socially in the gender they are comfortable with, changing their name or medically transitioning.
Living with gender dysphoria does not inevitably lead to transitioning. However for many people, socially and medically transitioning can be an important step in allowing someone to live their life more comfortably.
Getting a diagnosis
To get a diagnosis of having gender dysphoria in England, people need to see a GP. As for many medical diagnoses, certain criteria have to be met for a diagnosis to be given. Beattie and Lenihan, in their book, ‘Counselling Skills for working with gender diversity and identity’ state that a diagnosis ‘ requires significant clinical distress or impact on social functioning’. This needs to have lasted for at least six months.
The waiting time to get appointments, to start hormones, to get surgery can be very long. This in itself creates a lot of stress, anxiety, humiliation and anger for people who want to transition. For some people the waiting, gives them time to reflect and assess which is the best course of action for them to take. For other people, the waiting creates extra pressure and barriers for their mental health to contend with. Each person’s experience will be different.
Mental health impact of gender dysphoria
Our identity is absolutely core to who we are as people. It’s important then to consider the impact of living with gender dysphoria on a person’s sense of self. It’s not a mental illness but people can develop mental health issues as a result of living with gender dysphoria. Issues such as depression, anxiety and suicidal ideation. Which can all develop as a result of internally working out who they are, managing shame, feeling that something is wrong with them.
Then there is the external social pressure from bullying, stigma, harassment and the pressure from society. With a lack of knowledge in society about gender dysphoria, people can lack validation for who they are, what they are experiencing and how they want to live their life. This in turn leads to mental health issues for the individual.
Talking about gender dysphoria
Many people learn to live their life with the dysphoria they feel about their gender. This acceptance is not an easy thing to achieve and it can be more difficult at different times. Talking to people about the dysphoria you are experiencing can help to unpack it. For all of us, sharing any mental distress and confusion that we are feeling is often good for our mental health. Pressure can build in the mind, when we are trying to work through something by ourselves, so opening up about an issue can help manage the pressure.
Talking about gender dysphoria can help develop self awareness, which leads to being able to define oneself more clearly. A person may reach out to other people from the transgender non-conforming community and join groups, forums, get literature, build important relationships that will offer support. This support can be vital, as our identity is one of the most fundamental aspects of who we are. Thinking about it can take up a lot of energy, stir up many feelings and impact a person’s ability to live life comfortably. We are social beings. The support people get and give one another is enormously powerful and has a big impact on a person’s mental health.
As we are social beings, we can often tell people what we think they should do. This can include influencing someone in terms of their gender identity. It’s important though that people are allowed to make their own decisions, taking into account what would be right for them, not for someone else. It’s important to remember, that there may not be any reason to rush and make a decision, so time can be taken to work out would be right for the person experiencing gender dysphoria.
Respect people with gender dysphoria
People can often say something isn’t real, when they don’t understand or relate to what someone else is going through. Most people never have to consider how the body they were born with and their gender could be different. Yet the reality is that there are many people who live their life feeling dysphoria about their gender. Living life with a deep internal unease with your body, is serious and people who live with gender dysphoria must be respected and supported.
For more info about and support for people who are transgender, people living with gender dysphoria or anyone interested, there are some resources and websites listed;
TransUnite - Find a transgender support group near you
Mermaids UK - Helping gender diverse kids, young people and their families since 1995
All About Trans Information, resources and support
Beaumont Society Help and support for the transgender community\
Young Minds Offering information and support to young people’s mental health