Dysphoria...Is This The Hallpass To Being Trans?

First off, yes, there are literally TONS of opinions on gender dysphoria out there. You can google and all kinds of things pop up. Some articles explain, some decry, some welcome, and many others just inspect the various aspects and applications that the term is used for. But something no one can seem to agree upon is whether or not dysphoria is an actual requirement for being trans, as if it was a hallpass into the community. So...is it?

The short answer for me is no, it isn't a requirement. And if you disagree, that's fine, too. Everyone has their reasons. But let me show you my logic here. The term gender dysphoria is relatively new as far as medical terms go. It has been called other things in the past (and present for that matter), such as gender identity disorder. But I believe my problem with the term is due to the WHY of its creation. The definition used for gender dysphoria, loosely, is for one to have a marked incongruence between one's sex assigned at birth and the gender they identify with. And there is an emphasis on the word "markedly," meaning there must be some form of distress or discomfort being experienced by the individual in order for them to qualify for this to apply to them. And for years now, in order to be "diagnosed" as transgender and begin receiving any kind of transitional assistance, a person had to be labeled as such. This is where I have a problem with it.

Gender dysphoria exists, oh my God it does. And for some, it can be debilitating to the point that their lives are essentially ruined by it, as the high rate of suicide among the trans community attests. It can also be mild, though. And intermittent. And gone altogether at times. Waxing and waning throughout one's life. And then there are some who identify as trans but say they have never felt this "marked" discomfort, instead saying they simply know they weren't labeled the correct gender at birth. So why does everyone need this label then?

A lot of it has to do with healthcare. Right now, when I see a patient who is trans and seeking hormone therapy, I have to put down SOMETHING as their diagnosis, as the reason why I am prescribing them medicine. This then attaches a stigma to the term. As if you are seeking treatment for something wrong with you, like you have a disease that needs fixing. It is especially grating on the nerves since the term's origins came up in the medical community through the field of mental health. Folks feel labeled with a negative tag because of this. And it doesn't matter much (although it is appreciated) that the term is now being rethought and removed from being a mental health diagnosis because there is always going to be a certain stigma attached to it. I mean, how about if I told you that from now on I was going to call you "asshole" instead of "dude" when we are out together, such as, "Hey asshole, over here!" or maybe, "Whatcha eating, asshole?" If I say it's fine to do this because Merriam Webster's dictionary has redefined the term "asshole" to be indicative of strong affection, would you then be okay with it? Probably not... And I can't blame you. The same for me applies here.

So what to do? Come up with another word that hasn't been associated with anything bad yet? Just keep plugging along? How about this: instead of using some term to say that someone fits the criteria for being transgender, why not just say they are transgender? I mean, really, why not? We don't diagnose gay folks with a term meaning a marked incongruence between heterosexuality and what they feel inside. What would that be? Sexuality Dysphoria? Come on. Be real. This stuff is so easily fixed and dumb, but as usual the medical community is going to screw it up for a couple more decades.

But back to the requirements for being trans. So, obviously there has to be some sense of things not being right, correct? Otherwise, no one would ever identify differently. So is there something there? Sure. Can it sometimes be actual dysphoria? Sure. But could it also just be something that you simply know deep inside? Definitely.

I know I've used my hand dominance example a lot, but it really is handy. Let me apply it to how I believe people without dysphoria operate:

I'm right handed. When getting dressed, I generally put my right foot in my pants first, and my right arm in my shirt. Now let's say I was told I can no longer dress this way. I have to use my left hand first, or both hands at the same time. Will it cause a lot of upheaval for me to do this? No. But will it feel weird? Yeah. It would feel not quite right. Not enough to be upset over, but I would notice it...every time. I believe some trans folks are this way. They notice the sense of wrongness, but it is workable, and they keep pushing through it. It would be better if they didn't have to, but they do. Does this deserve a whole medical diagnosis? I don't think so. I believe if someone comes into my office, identifies as trans, and tells me they know this because they recognize something is wrong with their day to day interactions as their birth sex, then I think I should be able to assist them in whatever transition process they desire. Social, medical (hormones), and surgical transitioning are all valid options, whether alone or in combination. And choosing to not transition at all is also ok. It doesn't make you any less trans. Sometimes you just know something, and just the knowing of it makes it acceptable.

Warning: Divergence from original topic to follow...

Also, I've recently given a lot of thought to how society views male and female. It's pathetic. It's all so boxed in. And I may yet do another topic on how we are always trying to conform to society's views on beauty and health, but for now, just this.... I look forward to and predict that in the future, the dysphoria some experience will no longer happen. Why? Because we as a people will have figured out that female doesn't equal dresses and softness and hairless legs. And male doesn't equal facial hair and broad shouldered musculature and all hard lines. And genitals don't either. Because I mean, where do we get these ideas from anyway? You guessed it! Society and other people. Sigh. And have you met people? They're crazy! So why would we limit our views and self-worth according to what others say gender should be? I think this is the root of a very deep acceptance issue that trans folks run into. Because I mean, if Billy Porter wears makeup and a dress (and looks damn fantabulous doing it), and then let's suppose he comes out identifying as female, there are many who will say something rude like, "Oh, too bad he has such masculine features because he will never pass." Pass what? Society's standards for womanhood? Who the hell cares about that? And then other people will whisper and giggle, "Oh, I wonder if he's gonna have THAT surgery, you know, down THERE..." Honestly, what business is it of ours? And what does it matter what's in someone's pants if they're happy?

I was really thinking the other night about this. There's a lot of pressure on trans folks to transition at least medically. It seems social transitioning is taken for granted that it will be done, but the next expectation is hormones. And then surgery, especially bottom surgery...well, many see this as the final goal, but I think many more see this as optional. And they should! I foresee a day when we will stop thinking that a penis equals a man, and a vagina equals a woman. How limited are our imaginations if that is all we can come up with? There are animals out there who are possessed of one or both sets of gonads, or vice versa. There are even animals that manage to change their sex when certain environmental factors occur. But they started off as a particular gender, right? Hmmmm, maybe not. You know what I'm starting to think? I'm starting to think that genitals are just like hair color, height, eye color, and skin color. It's just a feature we have. Nothing more or less. Society placed value on it, just like they seem to like to place value on white skin (and look where that trash has gotten us). I think if you're a girl with a penis, then that's just what you are. You have brown hair, blue eyes, a penis, and olive skin. Maybe you have a big nose, too? Who cares? You're you. Live it. If you want to get bottom surgery because it fits how YOU feel, then do it. No one else should tell you how to feel or where you fit or what should be between your legs. It is my hope for the future that we will not feel forced to comply with society's definitions of male and female and will finally see what we all really are: human beings.

Stacie, NP

Spectrum: The Other Clinic

Transgender Hormone Therapy

Telemedicine Clinic in Mississippi

otherclinic@gmail.com

601-466-9495 Text Me!