Peer Review Reflection:

The peer reviews I received were very insightful. I managed to add things I didn’t consider, which was
nice. Before the edit, I had the section “Transgender” instead of “Transgender and Gender Dysphoria” on
top of forgetting to add a definition for transgender. It gave more context and understanding. For other
additions of organization, I moved the section of treatment to be after the discussion of gender dysphoria
and its impact on children so that it made sense.
One peer had also stated that they wanted to know more about the importance of informing others about
gender dysphoria. Originally, I also gave more of a subtle hint as to why understanding gender dysphoria
was important, but I provided a few more notes as to the struggles people who experience it have.
Someone also suggested I use the number citations instead of using the typical APA format, which did
help clean up my paper a bit.
Gender Dysphoria
By Tiffany Chan

Gender dysphoria is the psychological distress that

is experienced when a person feels a disconnect

between their assigned sex at birth and their gender

identity. It can be experienced at any point in a

person’s life, but it most commonly begins at

childhood. The factors that go into gender

dysphoria are complicated. It involves different

parts of a person’s life, like their physical body, to

the social interactions they share, all the way to the

society they reside in and how each part plays off

(6, Figure 1). A diagram used to help individuals understand
and fill in their own scales of gender and sexuality. each other. Most commonly, gender dysphoria

goes hand in hand with transgender experiences. It is currently classified as a mental disorder in

the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) although there are ongoing

fights against that label. It can create a harmful image that leads to a negative perception towards

transgender people.

Gender Dysphoria and Transgender

A transgender individual is a person who “transitions” from their assigned gender at birth

to their preferred gender. Someone is not required to experience gender dysphoria in order to be
transgender, but it is often associated with the transgender experience. The two things are

connected but even if someone does not experience gender dysphoria, their experience as a

transgender person is just as valid. By forcing the idea that dysphoria must be experienced in

order to be welcomed as a transgender person into the community, a painful subtext is created.

Between the lines it reads that suffering and shame is a fundamental aspect of the trans

experience, when it is truly something to be proud of (4).

Childhood and Adolescent Gender Dysphoria

A large portion of people suffering from gender dysphoria are children and adolescents.

As they begin to formulate their own identity, transgender and gender-nonconforming (TGNC)

kids start to notice a discrepancy. Who they think they are and who they physically are at odds

with each other. It can feel like a constant tug of war, with the child and their gender identity on

one end and societal gender norms on the other. Sometimes they may feel gender euphoria when

playing dress up or role playing as their

gender identity, but then feel gender

dysphoria when being forced to wear

certain clothes or being called gendered

terms. It is hard to find a balance, because

of how fluid humans are and how different

each person is with their experiences.

There is a complex interplay that is

(7, Figure 2). Illustration of the different aspects of dysphoria and
what an individual may experience.
at work between the body and the

individual’s social experiences when it comes to gender dysphoria, particularly during

adolescence as the child undergoes puberty (5). Sometimes they may feel dysphoria from just a

social interaction where they get misgendered due to their gender expression (what they present

to society). Other times it can be a bodily dysphoria from looking in the mirror or hearing their

voice and feeling dysphoric from that. Sometimes it can even come from a person’s expectations

or preestablished conceptions of what a certain gender should be in their mind and feeling like it

doesn’t match their gender identity (7, fig. 2).

Treatment

Treatment ranges depending on the individual patient’s needs and reasons behind their

gender affirmation. It could include multiple methods of treatment, or they could need just one

depending on the individual. Treatment for gender dysphoria can include therapy, hormonal

treatments, gender-affirming care and surgery. It can often include an open-ended journey of

gender identity in order to find what truly works for the person. There are different gender

affirmation domains to treat gender dysphoria.

 Social affirmation through pronouns, a preferred name, and gender expression.

 Legal affirmation, having their preferred name legalized and changing gender

markers.

 Medical affirmation, such as hormone treatment and puberty suppression.

 Surgical affirmation, such as breast augmentation, chest reconstruction, facial

surgery and more (1).

With gender dysphoria does come more complex issues. What is the proper and ethical

way to treat a child when they experience gender dysphoria? That can be a slippery slope, as
children often can not express themselves and their dysphoria clearly. Gender-affirming care,

which is a wide range of care from social, psychological, to medical designed to support an

individual’s gender identity, is currently the most common treatment as well as providing

medical and surgical options. However, not everyone who experiences gender dysphoria needs to

undergo massive, expensive, and difficult to reverse treatments. While it may seem like the best

one size fits all approach to dysphoria, gender-affirming care has received some backlash. Many

professionals fall into the trap of considering gender-affirming care as the only way to treat

someone with gender dysphoria. In some cases, it could even be traumatic or harmful for a child

by pushing them into a set of procedures that “should” work, when humans are too complex for

that (3). It’s important to take in consideration the child and all their contexts before devising a

unique care plan for them, instead of forcing a universal path for them. Otherwise, it is no better

than society forcing them to conform into the gender role they did not want to begin with.

Some treatments are more permanent than others. Knowing that, there must be significant

understanding of the individual and their unique experience with their gender identity and their

body. For example, if someone just had gender dysphoria with their voice but not so much their

physical body, they might not need to get surgery and just have hormone treatment. It can be

dangerous putting a universal treatment plan onto such a diverse and dynamic experience.

Gender dysphoria is often treated as a label onto transgender people, which is unhelpful for

people who have specific needs (2).

Inclusivity

Recognizing a person’s gender dysphoria and the reasons behind their discomfort can be

vital to providing an inclusive environment. In a world that is becoming more accepting and
progressive, more people are willing to express themselves in their own unique way. It can be

challenging for people who do not understand gender dysphoria to create that welcoming

environment. By eliminating the negative stigma around gender dysphoria and transgender

individuals in general, there can be a safer and happier environment for them.

There have been big steps to reconceptualizing transgender people and breaking down the

societal image placed upon them. Instead of viewing it as a disorder or as something negative,

advocates have pushed against the idea that gender dysphoria is a mental illness. It is a natural,

albeit distressing process of the human mind trying to make sense of being in a body that does

not feel like their own (2). The criteria behind diagnosing someone with gender dysphoria also

overlaps with the transgender experience far too much, which means that someone who identifies

as trans may be labeled as experiencing dysphoria. The issue there is, as mentioned before, not

every transgender person has to experience gender dysphoria. This can further perpetuate the

notion that there is something psychologically wrong with someone for being transgender.

Instead, through accepting gender dysphoria as part of the human experience we can

lessen the burden for people who experience it. Otherwise, they will continue to be discriminated

or denied medical services simply due to a lack of understanding. Many people who are

transgender must claim to have gender dysphoria so that their insurance will cover their surgery

treatments, but that locks them into a box of shame knowing that something may be

fundamentally wrong with them for wanting the surgery (2).

 References

1.) American Psychiatric Association. (2020). What Is Gender Dysphoria? What is gender

dysphoria? https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-

gender-dysphoria

2.) Ashley, F. (2019). The misuse of gender dysphoria: Toward greater conceptual clarity in

Transgender Health. Perspectives on Psychological Science, 16(6), 1159–1164.

https://doi.org/10.1177/1745691619872987

3.) D’Angelo, R. (2020). The complexity of childhood gender dysphoria. Australasian

Psychiatry, 28(5), 530–532. https://doi.org/10.1177/1039856220917076

4.) Earl, J. (2019). Do you need gender dysphoria to be trans? Advocate.

https://www.advocate.com/commentary/2019/1/18/do-you-need-gender-dysphoria-be-

trans

5.) Jessen, R. S., Wæhre, A., David, L., & Stänicke, E. (2021). Negotiating gender in everyday

life: Toward a conceptual model of gender dysphoria in adolescents. Archives of Sexual

Behavior, 50(8), 3489–3503. https://doi.org/10.1007/s10508-021-02024-6

6.) Killermann, S. (2017). The Genderbread Person Version 4 [Online Image].

https://www.itspronouncedmetrosexual.com/2018/10/the-genderbread-person-v4/.

7.) Types of Dysphoria [Online Image]. (2019) A Smack of Everything. Retrieved from

https://asmackofeverything.weebly.com/little-house/gender-dysphoria.