I’ve been putting off this post for a long time. Six months ago I had a post title prepared: “Don’t forget the ‘T’ in LGBT” where I’d offer an introductory educational piece within the umbrella of “Transgender.”
I think the reason that post never happened is because as I thought about what goes within that umbrella, there was just way, WAY too much stuff to try to put in a blog post without writing a book. Fortunately, other people have already written fantastic books with more to come out soon (hehe, get it? “Come out” 😊). I will link to some favorites at the end of this post.
When I broach the topic of gender identity with individuals who have minimal exposure or education to language falling outside of traditional gender norms, I find myself fumbling around to communicate as we realize there is a whole glossary of terms to know within this umbrella. Without access to this vocabulary this entire subject is difficult to communicate clearly about.
If you’re not as familiar with transgender vocabulary or if you would like a refresher, here are two links to help you get acquainted:
If you find yourself scratching your head at any terms I use here on out, please refer to these links as an introduction.
For today’s post, let’s just focus on one topic: what is gender dysphoria?
Sex is “Assigned” at Birth
Though there is mounting controversy surrounding whether this practice should be maintained, currently every newborn baby is assigned a sex at birth. This assignment is done based on an inspection of an infant’s genitalia either prenatally or at birth. Most of the time, babies seem to unambiguously fit into “male” or “female” based on this inspection.
About 1 in 2,000 infants are born with ambiguous genitalia. The term used for this is intersex. For infants born intersex, they are still assigned a sex as “male” or “female,” usually within hours or days of birth. Medical professionals will attempt to make a best guess based on various tests and inspections. In some cases they may potentially perform surgery to make the genitals less ambiguous, and assign a sex accordingly.
It’s also possible that despite seemingly unambiguously “male” or “female” external genitalia presenting at birth, there can be ambiguous or inconsistent sex characteristics in an individual’s internal organs. It’s also possible for someone to present with sex characteristics of one sex at birth, but to develop secondary characteristics of the opposite sex during puberty, or ambiguous presentations of both sexes.
As you can see, we are already dealing with some complications in how our culture assigns sex before we’ve even touched on the subject of gender identity. It’s for these reasons that the terms “biologically male” or “biologically female” are inappropriate, because these terms assume a certain amount of clarity in a situation that is actually quite complex. Instead we use the phrasing “assigned female at birth” (AFAB) or “assigned male at birth” (AMAB).
What is Gender Dysphoria?
Simply put, gender dysphoria refers to when one’s experience of their gender is not consistent with their designated sex at birth. Typically this discrepancy includes a sense of internal distress or frustration for the individual. This discrepancy and distress can take many shapes and forms, reflecting unique experiences for each individual.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes diagnoses of gender dysphoria for adults, adolescents, and children. Click here to read the American Psychiatric Association’s complete criteria for the diagnosis of gender dysphoria.
Gender dysphoria isn’t limited to those born with ambiguous sex characteristics, but is an experience that can occur for anyone. Sometimes individuals with gender dysphoria can experience depersonalization, a phenomenon that reflects a sensation of disconnecting from reality or from one’s true self. Unfortunately, the pain of gender dysphoria as well as the stigma and lack of understanding from others can lead to self harming thoughts and behaviors.
This topic is incredibly serious and grave. Suicide rates are high for transgender and gender non-conforming individuals. I offer some resources at the end of this post if you or a loved one may be experiencing thoughts of suicide.
Is Gender Dysphoria a Disorder?
Until very recently, what’s currently known as gender dysphoria was previously referred to as gender identity disorder (GID) in the fourth edition of the DSM. The diagnostic criteria of GID was similar to gender dysphoria, but the primary named concern surrounding GID was that it classified gender-related discomfort as a disorder, as though there is an illness to be remedied, or possibly something wrong with the individual experiencing that discomfort.
The fifth edition of the DSM was published in 2013, shifting the framework and language from disorder to dysphoria when describing the experience of distress around one’s gender identity. This change in wording helps move away from stigmatizing language while offering a framework and vocabulary to describe this experience.
Some people argue that having gender dysphoria listed in the DSM-5, regardless of its new name, still creates stigma around the experience. Though I hear that tension, I personally advocate for keeping it as a term in our diagnostic manual. Doing so offers a diagnosis to point to when offering professional care for those seeking psychological or medical support around their gender, making it possible to access insurance coverage for such treatments when appropriate.
To sum up, gender dysphoria is not a disorder, but it is an experience that brings up significant distress for the individual and is worth naming as such.
If you or someone you know might be experiencing gender dysphoria, there is help available. If you are having thoughts of self harm or are in crisis, please seek the support you need:
The National Suicide Prevention Lifeline (24/7): 1-800-273-8255
The Trevor Project Lifeline (24/7): 866-488-7386
Trans Lifeline (18 hours/day): (877) 565-8860
For access to some of those books I was talking about as well as other gender-related resources, you’ll find those in my services and resources page here.
Austen Hartke’s book Transforming: The Bible and the Lives of Transgender Christians will be releasing next month. Find information about Austen’s upcoming book here.
As always, I’d like to be clear that this blog post isn’t intended as professional counseling or clinical advice. If you’re in need of support, please consider speaking to a professional to be evaluated.