What is Gender Dysphoria, and How Should It Be Treated?

What is Gender Dysphoria?

Simply, gender dysphoria is the formal diagnosis for people who experience distress over their assigned physical sex and/or societal gender. People who suffer from this are colloquially called trans men (female to male) and trans women (male to female) respectively. To better align their physical body with their mind, a trans person may elect to undergo medical transitioning. As one can expect, transitioning is an arduous process which can include a plethora of medical treatments, such as hormone replacement therapy, mastectomy / breast augmentation, masculinization / feminization facial surgeries, hysterectomy, etc. Trans people who physically transition are said to be transsexual, due to the change of their physical sex instead of simply the change of how they present themselves. Transitioning is often seen as the pentacle of a trans person’s life, and it is a significant, political issue in the LGBT community.

"Mommy's Little Girl" created by Sabishiidesu13 on DeviantArt
A picture depicting how a trans person perceives themself versus how others perceive them

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What Treatments are Advocated For?

The trans community asserts that transitioning is essential for those suffering with gender dysphoria to be happy and healthy (as shown here), for transitioning helps to better represent how a trans person feels that they truly are, thus lessening dysphoria significantly. On the other hand, the opposition largely classifies gender dysphoria as a disorder that needs to be cured, like any other severe delusion. They view transitioning as the irrational mutilation of a mentally ill person, and as such, they reject trans people’s identities. However, for the most part, the opposition is ill-founded, for transitioning is proven to greatly improve the lives of trans people. Still though, both sides overlook important issues and provable facts, thus neither is truly right. Instead, an alternate — though similar — path to transitioning needs to be implemented – one with an emphasis on therapy, a caution toward HRT, an allowance for SRS, and an overall acceptance of the trans identity.

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On both sides of the issues, therapy is seen as the first step toward getting better. For the opposition, therapy is the path to overcoming the “disorder” and living a normal life. For instance, Dr. Paul McHugh writes that the “treatment should not be directed at the body as with surgery and hormones any more than one treats obesity-fearing anorexic patients with liposuction” and further goes on to say that therapy is needed to correct the problematic mindset of a trans person. However, Dr. McHugh fails to mention that gender dysphoria is not classified as a disorder, like anorexia. Instead, gender dysphoria is often caused by genetics and biological processes, meaning that it is not detachable from a person’s being (X). So, therapy can not rid a person of gender dysphoria. While the opposition places too much emphasis on therapy, the trans community barely does at all. Therapy is usually seen as a means to an end, for an official diagnosis is often a prerequisite to HTR and surgeries. In fact, some people call for the complete removal of therapy as a prerequisite for medical treatment. However, since gender dysphoria tends to give rise to various mental issues, such as depression and anxiety, therapy is necessary in order to cope with and overcome these issues among others. Thus, therapy should continue to be a required part of transitioning, where the focus should be correctly diagnosing gender dysphoria and helping the person overcome any issues before and during transitioning.

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Hormone Replacement Therapy

After receiving a diagnosis, a trans person can start hormone replacement therapy. HRT does alleviate gender dysphoria and often can improve the mental health of a trans person (X); thus, it is often romanticized in the community as a golden cure for their problems, leading to the tendency of some people to pressure the medical community to increase doses. However, cross-sex hormones are linked to increased rates of medical issues, including an increased risk of cardiovascular disease (X). As the extensive study by Eva Moore and others found, it is necessary to keep HTR at reasonable levels in order to avoid extreme increases in the rates of morbidity and mortality. Though HTR can be greatly beneficial for the mental health of a trans person, thus leading to decrease rates of depression and anxiety, HRT must be regulated in order to balance out the psychological relief with the adverse effects that it may cause.

The various ways that one can receive hormones. By pills, injections, creme, patches, etc.

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Sex Reassignment Surgeries

Following HRT, some trans people choose to go a step further and undergo sex reassignment surgery. As with HTR, SRS often improves the mental health of a trans person (X). Furthermore, as far as the safety of it, SRS is no worse medically than any other type of cosmetic surgery. However, unlike other cosmetic surgeries, people who undergo SRS actually have a significantly lower rate of regret (X). This could be due to the fact that trans people often feel more at home within their own bodies and feel more integrated into society as their preferred sex after the surgery. The people who oppose SRS usually do so because it is unnatural, which is true for SRS and all other surgeries. And, just like many other surgeries, SRS is highly beneficial to those who choose to undergo it. Therefore, SRS should be made available for any trans person to undergo if they wish to since the negatives of this type of surgery are so few when compared to the benefits of it.

trans license Kenji-Baptiste OIKAWA
A trans woman activist with XY written on her hand.

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Does Transitioning Truly Help?

The opposition to transitioning often claims that HTR and SRS do not actually improve the lives of trans people, for transsexual people are still more likely to commit suicide than the general population (X). However, the vast majority of individuals who undergo HRT and SRS report these treatments as being significantly beneficial to their overall mental health (X). At the same time, as found by Jaime Grant and others in their extensive survey, 90% of trans individuals are likely to experience harassment at work, and 57% of trans people are rejected by their families after coming-out. In fact, in almost every social setting, trans people are likely to face some sort of discrimination, ridicule, or abuse. Therefore, transitioning is not the issue when it comes to trans suicides. Instead, the lack of acceptance and understanding of trans people is often the main cause of distress after undergoing HRT and SRS. Therefore, in order to decrease the suicide rate, the general population needs to better informed and needs to embrace trans people as people, who — like anybody else — should be treated with respect and should be generally accepted.

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To put it briefly, transitioning is an important part of a trans person’s life. Both HTR, in reasonable amounts, and SRS can greatly improve their mental health and their overall life. However, there needs to be a higher emphasis placed on therapy throughout transitioning, for it can help a trans person better cope with depression and anxiety before treatment is available, and it can provide an outlet for dealing with social discrimination after transitioning. These treatments are proven to help trans people overcome and effectively handle gender dysphoria along with any mental illnesses that it may also cause. However, society in general is still ignorant of what it means to transition and often causes the most unrest for a trans person. Therefore, education of the public and general acceptance must also be put in place so that the trans community can live as themselves happily and with good mental health.

Sources Used

Asscheman, Henk, Erik Giltay, Jos Mengens, and Luis Gooren. “A Long-term Follow-up Study of Mortality in Transsexuals Receiving Treatment with Cross-sex Hormones.” European Journal of Endocrinology (2011): n. pag. European Society of Endocrinology. Web. 15 Apr. 2016.

Benjamin, Dakota. “A Study on Transitioning.” Survey. Kwik Surveys. March 2016. Web. 22 April. 2016.

Dhejne, Cecilia, Paul Lichtenstein, Marcus Boman, Anna L. V. Johansson, Niklas Långström, and Mikael Landén. “Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden.” PLOS One 6.2 (2011). Web. 15 Mar. 2016.

Grant, Jaime M., Lisa A. Mottet, Justin Tanis, Jack Harrison, Jody L. Herman, and Mara Keisling. Injustice at Every Turn: A Report of the National Transgender Discrimination Survey. Washington: National Center for Transgender Equality and National Gay and Lesbian Task Force, 2011. Web. 30 Mar. 2016.

Heylens, Gunter, Griet De Cuypere, Kenneth Zucker, and Cleo Schelfaut. “Gender Identity Disorder in Twins: A Review of the Case Report Literature.” The Journal of Sexual Medicine 9.3 (2012): 751-57. ISSM. Web. 23 Apr. 2016.

McHugh, Paul. “Transgenderism: A Pathogenic Meme.” The Public Discourse. The Withering Institute, 10 June 2015. Web. 15 Mar. 2016.

Tannehill, Brynn. “Myths about Transition Regrets.” Huffington Post. TheHuffingtonPost.com, Inc, 18 Nov. 2014. Web. 11 Apr. 2016.

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