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DJ was recently diagnosed with something the therapist called "gender dysphoria." DJ has very little idea what this means. The therapist talked about how someone like DJ with gender dysphoria typically feels extremely upset inside about the gender they were assigned at birth. They might not feel like they identify with their assigned gender, and this causes pain inside.
Gender is not the same as sex. Gender usually describes how a person acts and identifies and does not refer to their biological sex. However, the facets of gender – masculine or feminine –typically apply to the male or female sex. Masculinity is associated with being male and femininity with being female. Problems with gender and sex arise when the two don’t align properly.
Gender dysphoria is a psychological condition defined by the distress produced by a person’s belief that their biological sex does not correspond to their psychological sex (gender identity).
Gender dysphoria was formerly known as gender identity disorder (GID), which was changed after the DSM was updated to be more inclusive in terminology.
Gender Dysphoria, Flaticon
Like all disorders, gender dysphoria has specific characteristics by which professionals can tell if a person has it. The symptoms of gender dysphoria are:
There are biological and psychological explanations for Gender Dysphoria, or Gender Identity Disorder (GID). First, we will look at biological explanations.
Brain gender theory states that differences in brain structures and incompatibility with biological sex cause gender dysphoria. This is usually found in sexually dimorphic brain regions.
Dimorphic brain regions are structures of the brain that serve to identify an individual's birth sex.
Zhou et al. (1995) studied the bed nucleus of the stria terminalis (BSTc), a brain area that plays a role in sexual function. This area is typically 40% larger in males than females. In the post-mortem study, six male-to-female transgender participants were found to have a BSTc size equivalent to typical females. They concluded that this may be due to the interaction between the brain and sex hormones during the developmental period.
Kruizjer et al. (2000) also found similar neurons in the BSTc of male-to-female transsexuals as in females. This finding suggests there is a neurobiological basis for gender identity issues.Hare et al. (2009) examined the genetic components of transsexualism and suggested a particular gene is associated with lower levels of masculinity and the resulting feminisation. They identified an androgen receptor gene (AR) and found that allele repeats of AR were longer in male/female transsexuals than in non-transsexual males.
Males and females have different brain structures, Flaticon
Psychological research on atypical gender development has shown genetic factors influence gender dysphoria. Coolidge et al. (2002) examined 157 twin pairs (96 MZ and 61 DZ) for signs of GID using the DSM-4 clinical diagnostic criteria. GID was detected in 2.3% of the pairs, and 62% of these cases were associated with genetic variance GID. This finding suggests a strong genetic component to GID.Heylens et al. (2012) compared 23 MZ and 21 DZ twins in which one of the pairs was diagnosed with GID. They found 39% (9) of the MZ twins had genetic concordance for GID compared to the DZ twins who did not. These data suggest a genetic component to GID.
Concordance in twins indicates the likelihood that twins will develop a particular trait or illness.
People with congenital adrenal hyperplasia (CAH) are more likely to suffer from gender dysphoria. CAH is when someone produces too many male hormones. A mutated gene inherited from the parents has been found to cause the condition. The mutated gene affects an enzyme responsible for 21-hydroxylase. A deficiency in this enzyme is the cause of people with CAH producing too many male hormones.
Girls with CAH may be born with genitals that look similar to those of men. Boys with CAH are likely to reach puberty earlier, and girls may experience the puberty that boys experience. This can lead to gender confusion and the appearance of GID.
Another genetic disorder that may cause the onset of GID is androgen insensitivity syndrome (AIS). This syndrome is inherited from the mother. In AIS, a child is born genetically male (with the X-Y chromosome) but resistant to androgens (male hormones). The individual may have female-like features such as breasts.
Although the person looks like a woman, they still have the genetic makeup of a man. This can lead to confusing feelings about their gender and cause the onset of GID.
Since gender is mainly based on how a person acts and identifies, it is only logical that their social environment influences their gender identity. Psychological components are something we need to consider.
One psychological explanation for atypical gender development comes from psychoanalytic theory. Ovesey and Person (1973) argued that extreme separation anxiety in childhood before gender identity is established, causes gender dysphoria. They argued that the child fantasises about symbolically fusing with their mother to alleviate this separation anxiety.
According to their theory, the male child ‘becomes the mother’ and adopts the female gender identity. When interviewed, Stoller (1973) found that men diagnosed with gender dysphoria reported a close mother-son relationship. This likely leads to a stronger female identification and confuses gender identity.
Closeness to the parent of the same sex may influence gender dysphoria, Yzabelle Bostyn - StudySmarter Originals
Dual-path theory – another psychological explanation for the atypical development of the sexes – comes from the cognitive theory. Liben and Bigler (2002) proposed expanding sex schema theory to emphasise individual differences in gender identity. They suggest gender can take two paths:
Although the theory uses the terminology ‘normal’, we recognise this term can be considered offensive. By ‘normal’ the theory refers to what is most common.
Closeness to the parent of the same sex influences GID, Yzabelle Bostyn - StudySmarter Originals
Considering that explanations revolve around the results of studies, it is important to understand what the results mean and to evaluate their reliability and validity.
Evaluating the biological explanation of gender dysphoria:
When an approach is reductionist, it tends to oversimplify complex processes by ignoring factors contributing to behaviour.
Evaluation of the social-psychological explanations of gender dysphoria:
Androcentric research– Ovesey and Person’s explanation of gender dysphoria only considers male transgender individuals. The research does not consider females, so the theory does not provide a complete explanation of gender dysphoria.
Psychoanalytic explanations are difficult to measure and test scientifically because they state gender dysphoria occurs unconsciously.
Descriptive versus explanatory – Liben and Bigler’s cognitive theory of gender dysphoria is descriptive. The theory describes what causes gender dysphoria. However, it does not explain the underlying processes that cause the development of gender dysphoria.
The most common treatments for people with gender dysphoria are therapy and hormone therapy. Because gender dysphoria can also occur in children, gender reassignment is usually done later. This is the typical medical standard when gender behaviours or feelings change with age.
Gender non-conforming behaviour is when an individual’s behaviour or ascribed gender role does not conform to societal masculine or feminine gender norms.
Hormone replacement therapy can impact a person’s physical appearance and physiological processes.
For example, people with high testosterone levels may have increased hair growth.
There are two common types of hormone replacement therapy:
Puberty blockers
Cross-sex hormones
One gender dysphoria symptom is negative feelings toward one’s biological sex. People with gender dysphoria usually try to avoid experiences with their biological sex. Therefore, hormone replacement therapy may be a treatment option for them. It is used to prevent the individual from reaching puberty. They are typically used as a treatment for young adolescents.
Hormone therapy essentially involves increasing the hormone levels of the gender with which the affected person identifies. Testosterone is the hormone associated with the male gender.
Hormones associated with females are estrogen and progesterone.
Therapy is the most common treatment used for patients with gender dysphoria. Therapy can serve to:
Uncover the causes of gender dysphoria (psychotherapy).
Learn how to cope with gender dysphoria (cognitive behavioural therapy).
Understand how others can help and understand gender dysphoria (couples or family therapy).
The onset of gender dysphoria can happen at any age. But, it usually starts at a young age.
Gender dysphoria is diagnosed by a trained clinical psychologist. Gender dysphoria is diagnosed after the clinician establishes that the symptoms match a sufficient amount of the DSM-5 criteria.
Gender dysphoria was formerly known as gender identity disorder (GID), which was changed after the DSM was updated to be more inclusive in terminology.
The symptoms of gender dysphoria are:
Gender dysphoria is a psychological condition defined by the distress produced by a person’s belief that their biological sex does not correspond to their psychological sex (gender identity).
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