dysphoria

G is for Gender Dysphoria and Euphoria

Welcome to the A to Z of Sex. I’m Dr Lori Beth and I am your host.  We are working our way through the erotic alphabet one letter at a time.  Just a reminder this podcast deals with adult content, so if you don’t have total privacy, you might want to put on your headphones.

Today the letter is G and G is for Gender Dysphoria and Gender Euphoria.

Dysphoria is defined as ‘a state of unease or general dissatisfaction with life’.  When it is applied to gender it is literally unease or general dissatisfaction with your gender.    Gender is not the same as your biological sex though many of us identify as the gender that matches our biological sex.    There are two biological sexes: male and female.  Some people are also born intersex which is being born with anatomy that doesn’t fit the typical for male or female bodies.  Some people have both male and female anatomy for example.

Gender is socially constructed.  Gender is how we feel and see ourselves.

For many years, male and female were the only genders recognised.  Now, we know that gender falls on a spectrum and that even people who are happy with their assigned gender at birth matching their biological sex can move along the spectrum at different parts in their lives.  I am a biological woman and I see my gender as female and I have always identified as female.  However, at some points in my life I have felt very feminine and at others, I have felt much more masculine.   Gender can be fluid.  Some people identify as female sometimes and male at other times.  The do not see themselves as transgender necessarily because the way they identify moves along the spectrum between male and female.

Some people feel they are neither male nor female and others feel they are both male and female.  Some of these people use the label genderqueer to refer to themselves.  Within the medical and psychological communities, these people are often called gender non-conforming.  This term also includes people who are transgender and gender fluid.

People who identify as transgender are the people who are most likely to be identified as gender dysphoric.

They often feel they were born into the wrong body.  Some of them choose to go through the process to change biological sex fully.  Others take hormones and change some of their sexual and gender characteristics.  Others choose to stay in the body they were born into despite feeling that it isn’t the right sex.

People who have gender dysphoria feel very strongly that their gender does not match their biology.  This is not a mental illness.  When someone experiences this dysphoria, it causes stress, anxiety and depression.  In some cases people feel suicidal as a result of the mismatch between gender and biology.

People who identify as gender fluid or non-gendered also experience gender dysphoria.

They may find this harder to express, particularly to people who are CIS gendered and not fluid.  Gender fluid folk find that their gender feelings and expression move around the male through to female spectrum.  Some people identify as non-gendered and don’t identify with the spectrum at all.

Gender euphoria is defined as feeling happy and comfortable with their gender.

This has traditionally been applied to CIS gendered people (CIS gender = someone whose gender is the same as their assigned sex at birth).  However it can also be applied to transgendered people.  Gender euphoria for a CIS gendered person is a state of joy and happiness about being male or female and having the associated roles and body parts.  For a transgendered person, it can be a state of happiness or joy from living as their desired gender (or after transition to their desired gender it becomes the same as for a CIS gendered person).

Significant dysphoria is experienced when the wrong pronouns are used.  For some transgendered people, their first experience of gender euphoria comes when people around them consistently use the correct pronouns.  For people who identify as gender fluid, this is often a great relief as many people who are not part of the LGBTQIA++ community have difficulty understanding the idea of fluidity in gender and accepting fluidity in gender.

Gender euphoria often comes from things that validate the person’s identity and expression of identity.  When significant people in the person’s life use appropriate language to refer to them, take time to understand their experience and include them in social situations and activities as they are without expecting any change, they are validating the person’s gender identity.

The pronoun issue should not be downplayed.

When someone refers to a person with the wrong pronoun, it invalidates a core identity – that of gender.  Gender is often central to how we view ourselves and how we are viewed in the world.   I see many people rubbish this idea on the internet. When I have posted memes listing a wide variety of appropriate pronouns to educate others, I often receive comments that denigrate the idea that any genders exist apart from those assigned at birth.  These people suggest that being upset about being mis-gendered is whining and shouldn’t be an issue.  They are often men and I wonder how well they would take continuously being referred to as women.  If people in their world insisted on referring to them as ‘she’ and ‘her’, I suspect they would not manage this well.

For those who argue that this is not so, I invite them to think back to being a young adolescent and how they felt when people either mis-gendered them or referred to them as a child because their gender identifying characteristics were not strongly visible yet.

Gender is one of the central features of self-image, self-understanding and impacts intensely on how we relate to others.    Feeling as though your body is wrong is an awful feeling, distressing on so many levels.  When others mislabel a person’s gender, it is jarring and the person feels invisible and not understood.  It impacts on every aspect of life.  People who have gender dysphoria have higher rates of substance abuse, depression, suicide attempts, eating disorders and anxiety.    Research suggests that 71% of people who have gender dysphoria have some form of mental health diagnosis during their lifetime.

People often are aware that their body doesn’t correspond to the gender they feel when they are quite young.

Children who have gender dysphoria will consistently tell people that they really are the opposite biological sex.  They will tell people that when they grow up they will become the other sex.  Many talk about removing the genitalia that doesn’t match their internal gender.  They will reject clothing, toys and activities associated with their biological sex.  They will often have friends of the gender they see themselves as.  They will often insist on urinating as the opposite gender so girls who identify as boys will pee standing up.

Tweens and teenagers will become very distressed by the biological changes that come when they hit puberty.  This is often a time that suicide risk increases.  They often express disgust at their genitals and secondary sex characteristics.  So biological girls who are developing breasts but identify as boys will do anything to flatten their breasts and become very distressed at the development.  Some will seek surgery.    They will often dress as the gender they identify as rather than according to biological sex.

As gender fluidity exists, it is important to support children and adolescents where they are at any given time and not assume where they will end up when they reach adulthood.  The goal of any talking therapy or counselling is to support the person, not to try to change their gender identification.  There is nothing wrong with their gender identification.  The dysphoria diagnosis is a description of the distress this mismatch causes not a description of a mental illness.  Many people choose to do things to get their bodies to conform more to their identified gender.  This may include taking hormones, or medication to block certain hormones, or having surgery.

Some trans people do not experience their bodies as wrong but rather that some modifications would make them feel more at home.

Since everyone’s experience of dysphoria is different, only using the ‘born into the wrong body’ analogy causes significant distress as people again feel outside of the norm.  It also dismisses the complexity of the issue.

Some trans people do not experience dysphoria around their bodies but rather around being mis-gendered.  There are people who experience body dysphoria around only one part of their bodies.

Gender fluid, non-binary and non-gendered people can also experience body dysphoria.

If you love someone who is gender fluid or transgendered how can you help?  First and foremost by accepting their own experience and their definition of gender.  Acceptance is the what leads to gender euphoria most quickly.   Don’t try to contradict a person’s view of themselves.  Use the gender pronouns that they choose and if you make a mistake, apologise and correct it.  Don’t insist that they confirm to your view of gender.   Give them space to teach you what works for them.

Allow for change over time.  People are not static, they evolve.  This is why referring to this as a journey is so common.  If someone changes the pronouns they prefer it does not invalidate all earlier expressions of themselves.  It may be more difficult to know how to address them, but it doesn’t mean that they were being deceptive or that they ‘aren’t really trans’ or ‘aren’t really serious’.  People change as they learn more about themselves.  People change as they move through life.    Support through their changes is what they need from friends, family and loved ones.

Ask questions but be respectful and if you feel you cannot be, or cannot act without judgement, take your questions and your feelings to someone else until you can be respectful.

CIS gendered people also experience both gender dysphoria and gender euphoria as their bodies change over time.    When CIS women make the transition to menopause, they can find that gender shifts as well.  Women who have hysterectomies (before or after menopause) often experience gender dysphoria.  Strong feelings of loss of womanhood cause significant depression for some.

CIS gendered women may experience gender euphoria during pregnancy, birth and breast feeding as they relish these expressions of gender.

Most importantly, don’t assume gender for anyone.  Ask respectful questions.

Thanks for joining me for the A to Z of Sex this week. Write to me with suggestions for the show, questions you want answered at drloribeth@atozofsex.com , follow me on twitter, Instagram and Facebook.

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