Understanding Gender Dysphoria and Gender Affirmation

The leading global LGBT+ charity Stonewall defines Gender Dysphoria by the following “when a person experiences discomfort or distress because there is a mismatch between their sex assigned at birth and their gender identity. This is also the clinical diagnosis for someone who doesn’t feel comfortable with the sex they were assigned at birth.”

Gender incongruence can lead to distress, anxiety, and depression. It can have devasting effects on the quality of life of those who live with it. Gender dysphoria often affects members of the trans community (including non-binary and agender individuals). It cannot be described as a desire to transition; it’s a lot more complex than that.

Research involving people experiencing gender dysphoria helps us to develop an understanding of gender incongruence. We then have a stronger basis for informed, compassionate, and effective support. Issues which interact with our identities are often those which society finds hardest to approach. Cutting-edge MDPI research has the power to make life a great deal more live-able for those affected.

Psychological Impacts of Gender Dysmorpia

The first step in helping those struggling with gender dysmorphia is to understand the incongruence. The lived experiences of those with gender dysmorphia, with particular importance on those identifying as trans, are vital to understanding the impacts of it.

Researchers in Rome undertook qualitative research with participants before hormone therapy to gain insight into their lived experiences.

Their study involved 36 AFAB and AMAB (Assigned Female/Male At Birth) individuals. It revealed that gender dysphoria can cause feelings of shame and repulsion toward the body. It highlights the mental and physical distress stemming from gender dysphoria. This is often combined with the pressures already imposed by the onset of puberty.

It is noted in the manuscript that people with body dysmorphia are also more likely to suffer from other mental conditions, such as anxiety, eating disorders, and depression. These feelings often led to physical harm, as the authors describe how some participants reported “self-harming behaviors, suicidal thoughts, and suicide related to their body dissatisfaction”. It can be difficult for people who have not experienced gender dysphoria to put themselves in the shoes of those suffering from it, as the ‘sense of unease’ by which it is characterised is very unrelatable for cis-gendered individuals.

The study also details how participants considered childhood to represent a “safe space”, “since it meant inhabiting a body in which gender differences were not yet evident, but that with that and the development of secondary sexual characteristics their feelings of uneasiness significantly increased”. The researchers conclude that “clinicians should enhance supportive interventions focused on encouraging resilience, strength and self-esteem to help these individuals dealing with their body discomfort and gender incongruence”.

MRI Analysis Could Shed Light on Gender Dysphoria

A group of scientists in Canada conducted research into how gender dysphoria manifests within the brains of patients. ‘A Multi-Modal MRI Analysis of Cortical Structure in Relation to Gender Dysphoria, Sexual Orientation, and Age in Adolescents’, a paper published in the Journal of Clinical Medicine, uses MRI analysis to determine the similarities and differences in brains between cisgender individuals (cis-male and cis-female) without gender dysphoria and AFAB individuals with gender dysphoria.

The studies showed that the brain surface area of AFAB participants with gender dysphoria had more in common with cisgender males than cisgender females. This understanding could lead to further research into the physiological characteristics of gender dysphoria, and so leads to a better understanding of gender incongruence.

Supporting Gender Diversity

The above articles have looked at the background and impact of gender dysphoria. Yet, it is also important to look at how to support those struggling with it. A paper, published in IJERPH, developed a scale to measure gender affirmation among transgender women. The team from the University of California developed a psychological gender affirmation scale with high reliability. This will aid research on psychological gender affirmation. This can thus help inform clinicians with gender-affirming clinical and social practices to promote the health and well-being of trans and gender-diverse people.

Gender affirmation, whether it be psycholocial, clinical, or social, has been demonstrated to reduce gender dysphoria and mitigate some of the knock-on negative health effects such as depression and anxiety. So what are the differences between these?

  • Social gender affirmation is the recognition and respect of one’s gender identity by friends, colleagues and family members.
  • Clinical gender affirmation usually utilisises gender-affirming medical treatments, such as hormone therapy or surgery.
  • Psychological gender affirmation is “an internal sense of valuing neself as a transgender or gender diverse person, being comfortable with one’s gender identity, and feeling satisfied with one’s body and gender expression”.

A combination of all three types of gender affirmation has been shown to help most with gender dysphoria, yet not all transgender individuals have access to clinical gender affirmation, as there are clear healthcare disparities with LGBTQ+ individuals.

Understanding gender incongruence is the first step in providing real, accessible support for trans and gender-diverse individuals. MDPI research is enabling clinicians to further help those struggling with gender dysphoria.