The World Health Organization only recently — in May 2019 — announced it no longer considers being transgender a mental health disorder. Earlier, transness — having a gender identity different from that associated with an individual’s sex assigned at birth — was considered deviant from the norm and categorized as Gender Identity Disorder (GID).
Now, WHO, along with several other international health organizations, have awakened to the reality of being transgender and have recategorized GID as gender dysphoria.
What is gender dysphoria?
It’s a feeling of distress from identifying with a gender different from that linked to the sex assigned one at birth. Gender dysphoria collects under one term the feelings associated with being transgender or gender non-conforming, whereas its earlier counterpart, GID, incorrectly pathologized being transgender as a disorder.
What are the signs of gender dysphoria?
According to the fifth edition of the Diagnostic and Statistical Manual (DSM) of Mental Disorders, published by the American Psychiatric Association, a child may be experiencing gender dysphoria if at least six of the following apply for a minimum of six months:
- a desire to be of another gender or insistence on being of another gender;
- a resistance to wearing feminine clothing (in girls) or a desire to cross-dress and wear feminine clothing (in boys);
- a desire to adopt gender roles incongruent with assigned sex at birth during fantasy play;
- a desire to play with toys and engage in activities linked to another gender;
- a preference for playmates of other genders;
- a dislike of sexual anatomy;
- and a desire to have primary and secondary sex characteristics linked to another gender.
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In adolescents and adults, the DSM-5 states, experiencing any two of the following for a minimum of six months would indicate gender dysphoria:
- an incongruence between gender and primary and secondary sex characteristics
- a dislike of primary sex characteristics and a desire to stop the progress of secondary sex characteristics;
- a desire to change one’s primary and secondary sex characteristics to that linked to another gender;
- a desire to be treated as another gender;
- strong identification with typical feelings and reactions associated with another gender.
According to the Mayo Clinic, these desires are also accompanied by anxiety, depression, a tendency to self-harm, eating disorders, and substance abuse — especially if the individual is in an environment that threatens their safety and dignity in expressing their gender dysphoria.
Bullying or any other kind of discrimination for wanting to be identified as a different gender can also cause severe stress, and put individuals experiencing gender dysphoria at risk for suicidal ideation and suicide.
What causes gender dysphoria?
While scientists have yet to determine what exactly causes the mismatch between one’s gender and their assigned sex at birth, they have explored some factors at play in a baby’s brain pre-birth.
According to the United Kingdom’s National Health Service (NHS), when hormones dedicated to determining a baby’s sex organs at birth work differently between the brain, reproductive system, and genitals (perhaps as a result of any medication the mother is on), it can cause a mismatch.
In addition, a myriad of syndromes occurring in a fetus can also contribute to a mismatch between sex organs and gender — for example, androgen insensitivity hormone, which reduces a fetus’s sensitivity to hormones, can cause gender dysphoria, according to the NHS. Other rare conditions that can cause gender dysphoria, according to the health service, include congenital adrenal hyperplasia, which causes higher than average production of male hormones in a female body, leading to the development of more male-looking genitals, and intersex conditions, that is, when babies are born with either both male and female, or ambiguous, genitalia.
How can individuals cope with gender dysphoria?
No matter the cause, however, gender dysphoria is a serious condition that throws individuals’ lives into disarray and must be treated according to the individual person’s needs. While all treatment should be geared toward reducing the individual’s distress and discomfort stemming from the mismatch between what they identify with and their bodies, the process of doing so can differ — a person living with gender dysphoria can decide to dress and live as their gender; they can also change their bodies either hormonally and/or surgically to better match their gender.
