Gender Dysphoria and my experience

Gender dysphoria is the feeling a person has that their assigned gender does not reflect the gender they are. From a diagnostic perspective, Gender dysphoria is listed in the DSM - V – Diagnostic Statistical Manual of Mental Disorders 5^th edition, and has the following diagnostic criteria:

A. marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months duration, as manifested by 2 or more of the following indicators: [2, 3, 4]

1. a marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or, in young adolescents, the anticipated secondary sex characteristics) [13, 16]

2. a strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or, in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics) [17]

3. a strong desire for the primary and/or secondary sex characteristics of the other gender

4. a strong desire to be of the other gender (or some alternative gender different from one’s assigned gender)

5. a strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender)

6. a strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender)

B. The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning, or with a significantly increased risk of suffering, such as distress or disability

This diagnosis replaces an older diagnosable disorder called Gender Identity Disorder, or GID. I needed a diagnosis of GID to be accepted for genital reassignment surgery and I passed it with flying rainbow colors :D (funny how it feels like a test rather than a confirmation of what you know is true).

A diagnosis of gender dysphoria is not a diagnosis of transsexualism of which there is none. You don’t have to be a transsexual to experience dysphoria and actually you don’t need to experience it to be a transsexual. For example, I pretty much have no symptoms of gender dysphoria because I have resolved them through my transition yet I still consider myself a transsexual. A whole host of other queer/trans/other types may experience it, or something similar. I love how this ‘diagnosis’ takes into account alternative gender identities and I think it is fantastic non-binary people are given recognition.  

Another thing to note with this diagnosis is that it does not require you to hate your body. Traditionally we are indoctrinated by various trans communities that you can only be transsexual if you have a strong hatred for your birth sex body and that you desire surgery. This is not a requirement for being diagnosed with gender dysphoria.

I’m starting to believe more and more that being a transsexual has become an identity that you can choose. I think this is the same in regard to gender and sexual identities. A woman can have sexual attractions solely to women but this does not require them to identify as a lesbian. A person might not feel they are male or female but this does not require them to identify as non-binary. As such I don’t think you can diagnose someone else as transsexual. This is something only you can decide for yourself. But in a lot of ways this label is a red hearing anyway. I think many of us focus on whether we fit the label instead of focusing on your distress and how you can resolve it.  

It is a very hard thing to describe what it is like to experience gender dysphoria. When gender dysphoric folk talk about it, it seems to be a combination of a number of different things from social to physical. One thing that is often overlooked is that people experience dysphoria in different ways. Not only that but the strength of these feelings can fluctuate, particularly with age, life changes and other stresses. Puberty is a particularly distressing time for many trans people as this is where secondary sex characteristics start to emerge. It seems to be true for many of us that when unresolved it tends to get worse over time, or at least our tolerance of it weakens. I find it interestingly my dysphoria vanished for short periods of time when newly in love – I have heard many stories of tans people meeting someone and feeling like they are ‘cured’. I imagine huge euphoric moments like when someone ‘finds god’ can mask feelings of dysphoria for a bit. As far as I know it always comes back.

I started to feel aspects of gender dysphoria as a child. It was like a slippery eel I could not quite grasp right on the edge of my consciousness. Something was wrong. I remember wishing I could play elastics with the girls and I would watch them from around a corner at school. I thought I was a boy but I was a very uncomfortable boy. I felt very lost and at odds with many of the expectations of being a boy. I resisted being part of the culture of masculinity.

So how did it feel for me as an adult pre-transition? It was not a hatred of my body. I admired my own strength. I liked using my male equipment but I had a sense of wrongness. Dysphoria for me was that sense of wrongness that was often very undefined. Sometimes it was just a low murmur on the edge of my brain but it could also feel like a nightmare you can’t wake from. Dysphoria was sometimes a feeling of being filled with filth that I could vomit in a never ending stream but without actually feeling physically sick.  Sometimes it was like I was living inside an alien body and I was in there looking out. It was as if I was itchy wearing my own skin.

I would close my eyes and in my mind’s eye my body had curves. It was so real I felt like I could touch them and it was always a shock to open my eyes and not see them there. I often felt I had a phantom vulva and found comfort in pressing the place it should of been. I think that is an interesting aspect of dysphoria that it seems to be related to our internal image not matching our external reality. It is not body dysmorphia in the sense that we do see our bodies as they are. But just like anyone we can be body dysmorphic too, particularly around how masculine or feminine we perceive our features to actually be.  

Birthdays and Christmas were always times of depression for me and I often still respond to them that way. I would get ‘male’ gifts which would just make me weep inside. I would of given anything for a pair of earrings. I mean yes I liked the machete and Metallica t-shirt I got one year and I put them both to good use. But I was left feeling pretty hollow and more and more like nobody actually knew who I was.  

On the social side being considered male made me cringe and squirm – particularly when lumped in with the boys such as when segregated at school by gender or being the butt of gendered jokes. Often when I went shopping for clothes I would be overcome with depression and longing. Dysphoria for me involved a lot of longing – longing to shop in women’s clothing shops, to have been born a girl, to be called she, for a body I did not have.

I never really felt at odds with my penis until I had sorted out other things like starting hormones and dressing as a woman. Before then I always did have a kind of vagina envy but never felt actively distraught about having a penis despite it’s inconveniences. At some point it became the elephant in the room in my head, and not because I was well hung. Imagine you had a big purple pink growth out the side of your body that moved of it’s own accord that everyone said was normal. It felt kind of like that. I found it fun to play with and it was good for scaring the neighbors but it did not belong. It became such a foreign thing I just had to get rid of it – it was a bit like the feeling of having a deep splinter and just needing to get it out. I never realised how big that elephant was until after surgery. Shortly after I realised that I had this massive space in my mind that used to be consumed with the awareness of it.

One interesting aspect of my dysphoria was I would often look at women with duel perceptions. I would see a good looking woman and part of me would find her sexually attractive, but on the other I was full of envy. Often that envy could feel like attraction (though let’s face it, with my sex drive as it was then I was attracted to a lot of people). The envy sometimes left me feeling very bitter. I know some transwomen have reported that after transition what they thought was an attraction to women was actually their envy.

In short dysphoria made me miserable. It consumed me. It impacted on my relationships with everyone and everything and my mental health. I chose to resolve my gender dysphoria before it buried me.

Blog Mistress Nicole