What is Gender Dysphoria?

I talked last time about how sexual identities – male and female – arise out of a complex interplay between sexual biology and cultural ideas about gender, and I promised to talk about how that relates to transgender identities and to gender dysphoria.

Gender dysphoria may be a new term for some reader so I’ll start by defining it. Simply put, gender dysphoria is a feeling of alienation from, discomfort with, or lack of identification with one’s reproductive or apparent sex. That can take a variety of forms. For some people the problem is quite literally with gender: they don’t have a problem with their reproductive biology, and may be quite happy to father/mother children, but they find it unbearable to try to conform to the gender expectations associated with their sex. I’m not talking here about women who feel a little tomboyish, or guys who don’t fit the “macho man” mould, I’m talking about people who feel out of place or artificial when they’re performing really basic gendered behaviours – like putting on “men’s” or “women’s” clothes, or presenting themselves in public as a woman or as a man.

Others experience a condition often called “sex dysphoria” where they feel that the sexual characteristics of their body are wrong. This can be really incredibly painful. For example, one trans woman that I know describes feeling like she is supposed to have a womb when in fact she doesn’t: “I found myself curled up in fetal position on my bed, sobbing hysterically and clutching my abdomen as if it were on fire and also a black hole, like there was a space there, a void. The death of all possibility and the death of all potential in me for life. Feeling like where there should be something positive there’s a negation.” Trans men may describe something almost like phantom limb syndrome – a feeling that a penis is part of their internal body-map, but not a part of their actual physical body. For others it’s simply a persistent feeling that the existing characteristics of the body (breasts, penis, facial hair, etc.) don’t belong, as if they’re not supposed to be there.

Now, if you’ve never experienced any of these things, probably they sound a little crazy. And that is the reaction that a lot of cis people (cis is short for cisgender and it just means “people who are not trans and/or genderqueer.”) Some will try to sympathize by saying “Well, sometimes I feel uncomfortable with gender expectations, and I find them restrictive,” or “I have parts of my body that I don’t like.” That is a good first step – it’s a move towards sympathy and compassion – but if you stop there it’s kine of like someone saying to a cancer patient “Oh, yes, I think I can understand your pain because one time I had my wisdom teeth out.”

So if you’re a woman, and you’ve had the experience of feeling really fake and restricted, say, when wearing women’s formal clothing, you might take that experience and imagine what it would be like if that’s how you felt all the time whenever anyone interacted with you as a woman. Or if you’re a guy and you’ve felt weird, isolated and alienated from your peers at sporting events, imagine feeling that way every you time you talk to other men or go to use a public toilet. If you’re someone who has never had the feeling of being uncomfortable with your gender… then this is probably just going to be hard to relate to.

The easy out is to say “All right, so trans people are crazy.” The problem is that the word “crazy” is being used here as a weapon. Most of the time, when I see people charging trans women with mental illness, they don’t really mean “We should have the same compassion and love for these people that we have for those who are suffering with severe depression or Stockholm Syndrome.” They mean, “We should just dismiss these people. Bunch of whackos.” People don’t generally get upset when folks raise awareness of bipolar syndrome, or help kids who are dealing PTSD understand what they’re feeling. If someone feels disgusted by a person who is mentally ill, they generally know this feeling is problematic – that it’s something they need to work on. Yet when trans people are accused of being mentally ill, the intent is very often to invoke the stigma associated with mental illness in order to belittle their experience.

It is possible that gender dysphoria can be a psychological response to some kind of gender or sexual trauma – or at least it’s possible that this is sometimes the case. I’ve encountered detransitioning women (that is, women who identified as trans men, began taking testosterone, and then realized that their fundamental sexual identity is female) who ascribe their gender dysphoria very specifically to gender-based trauma within patriarchal systems, or to direct experiences of male violence or rape. Those women are probably correct about their own experience – though I don’t think that their experience can be applied with broad brush to trans people, or even trans men, generally. In any case, the proper response to people who are mentally ill as a result of trauma is not to publicly denounce them, bully them, blame them, exclude them or otherwise dehumanize them. Psychological conditions are not voluntary: they’re not ideological errors, bad choices, or sins. People who are coping with trauma did not choose to be traumatized, and loudly condemning or deriding their coping mechanisms will only make the trauma worse. If trans conditions are psychological in origin, then we really ought to be redoubling our efforts to provide trans people with the social, emotional and spiritual support that they need in order to heal.

I do not think, however, that psychological explanations are sufficient to account for all experiences of gender dysphoria. Nor is there a good reason why Christians should reject the possibility that biological or neurological factors play a significant role. Next time, we’ll talk about gender and the body, and why I think trans experience may have its roots in the biology of sex.

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