Gender dysphoria has historically been explained through both a clinical lens and the narrative of body dissatisfaction. Because clinicians serve in a gatekeeping role for gender affirming medical services, trans clients may feel the need to report symptoms consistent with diagnostic criteria. Clinicians’ accounts of dysphoria, then, may not be the most comprehensive descriptions of gender dysphoria. The present study aimed to understand how trans individuals describe their experience of dysphoria in relation to their body and appearance.
Using a non-clinical sample, qualitative data were collected online from 463 participants who identified as transgender, transsexual, non-binary, or having a transgender history, and ranged in age from 18 to 74 (M = 26.89 SD= 8.03). The sample was predominantly White (84.9%), with 15.1% identifying as a racial or ethnic minority. Participants answered an open-ended prompt describing their experience of body dysphoria.
Three overarching themes emerged via thematic analysis: 1) Disconnection from Body; 2) Manifestations of Distress; and 3) Changes in Dysphoria. Participants' responses clearly disaggregated the concept of gender dysphoria by independently describing their body (Disconnection from Body) and their distress (Manifestations of Distress). Our participants also specifically described how their dysphoria changed over time and fluctuated in other ways (Changes in Dysphoria).
The present findings suggest that trans individuals’ experience of dysphoria is heterogeneous and highlight the ways that lived experiences both support and extend current understandings of gender dysphoria.
Discussion focuses on the implications for current clinical practices regarding assessment and diagnosis of gender dysphoria.
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We use the word trans as a term inclusive of all individuals who do not identify with the sex/gender they were assigned at birth, and to also represent individuals who do not identify as transgender but describe their transgender experience as a status or medical history.
We use the singular they/theirs to acknowledge non-binary identities that are expected within our sample.
We use Gender Dysphoria (uppercase) to refer to the diagnosis, and gender dysphoria (lower case) to refer to the feeling, experience, or state of discomfort that is endorsed by some trans individuals.
AFAB = Assigned Female at Birth
AMAB = Assigned Male at Birth
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Pulice-Farrow, L., Cusack, C.E. & Galupo, M.P. “Certain Parts of My Body Don’t Belong to Me”: Trans Individuals’ Descriptions of Body-Specific Gender Dysphoria. Sex Res Soc Policy 17, 654–667 (2020). https://doi.org/10.1007/s13178-019-00423-y
- Gender dysphoria
- Gender identity