Let’s Talk: Dysphoria

So, before I begin, I need to make a confession: This is going to be a very emotionally charged post. I wanted to post this days ago, but I’ve been so depressed and feeling awful that I’ve been having trouble getting these words on the page through the tears. But I digress…

Today, I want to talk about gender dysphoria. What it is, and why it’s a serious problem. Now, I need to preface this by saying that dysphoria is an incredibly painful and personal experience. It differs from person to person, in varying degrees of severity. The experiences listed herein are mine and mine alone. It is also important to note that not every trans person experiences dysphoria, nor is the feeling of dysphoria required for being trans.

So let’s start with what dysphoria is. Gender dysphoria is the feeling of discomfort or distress caused by one’s gender identity being misaligned with one’s biological sex. In layman’s terms, “I’m a girl and should have a vagina, but I have a penis and it really upsets me.” Gender dysphoria is NOT a mental illness or disorder. It has been medically recognized as a real condition and the definition has been changed in the Diagnostic Standards Manual (version V). Gender dysphoria should never be confused with Body Dysmorphia, which “is an anxiety disorder that causes sufferers to spend a lot of time worrying about their appearance and to have a distorted view of how they look.”

Gender dysphoria can have many different triggers, and those triggers can change over time. Certain things can be more triggering than others. Allow me to explain my point by using myself.

I am a trans woman. I was assigned male at birth, meaning I was born with a penis. Before recently, I never had much issue with my penis. It was there, but it wasn’t bothersome. But recently, I’ve started disliking it more and more, and I’d like to see it go, I think. But the dysphoria triggered by my genital situation is nothing compared to some of my other triggers. For instance, my breasts (or lack thereof). When I look at myself in the mirror, I expect to see breasts. Well proportioned and shapely I would hope. Due to my height and weight, something close to a C or D cup would be a proper size. But as of this blog post, they are currently only an A cup. Barely noticeable. It causes an extreme amount of distress.

Another couple of triggers for me are facial hair shadow and my voice. Seeing beard shadow makes me incredibly uncomfortable. And putting on makeup is a torturous ordeal, because I have to stare at my face for upwards of 30-45 minutes every day as I try to conceal what it is I’m forced to stare at. And listening to my voice causes extreme distress as well. So much so, that I frequently don’t speak if I don’t have to, or I’ll just whisper. I can’t bear to sing in front of people (and rather hate it when I’m alone as well). Which is awful, because I love singing, but I can’t bear to hear myself do it.

Even the act of feeling dysphoria can be it’s own trigger, as odd as that sounds. Because all I want in life is to be a normal girl. But normal girls don’t have dysphoria attacks.

And there are many more triggers for myself as well. My shoulders are too broad, my face too angular, my hair isn’t long enough, my arms are too muscley, my feet are too big, I’m not skinny enough. All these things are things I think every time I pass a mirror. Some days, I’m able to ignore these thoughts. Some days, however…. Some days I can’t stop crying. I admit, yesterday and today have been two of those days.

“But these are all things that can be fixed, right?” I suppose they are. Most of those things will be taken care of over time alone, due to my hormone therapy. My hair will get longer, my feet have actually started shrinking. My muscle mass will atrophy and shrink, resulting in smaller arms and shoulders. But some things take more than just time. Beard shadow requires laser hair removal at best (a $3000-$5000 process over 18 months), and electrolysis ($10,000-$20,000 process over years) at worst. My breasts may require breast augmentation, which can be an expensive and scary process as well. And in the meantime, I am suffering.

Most times, dysphoria is accompanied with depression, which is a real and serious condition. For some people, that depression can become so unbearable, suicide becomes an enticing “solution”.

And while these may be my particular triggers and experiences, many trans people across the world suffer from the same distress. And the ramifications of this distress can be severe. Trans people from the ages of 18-44 have a 45% suicide rate. And the number increases to between 50 and 60 percent for the ages of 14-18 depending on the study. Let that sink in for one moment. Approximately half of all transgender children and young adults are killing themselves.

And yet many people in today’s society treat us like outcasts or jokes. Or worse, perverts and freaks. And it can hurt. It can undo years of therapy and self-management.

I’d like to share a story with you, to illustrate this point. This past Saturday night, two co-workers and a friend came into where I work, very drunk and proceeded to be loud and boisterous. At 3AM, I asked them to leave, as we were closing. One of them (the friend, not a coworker) made a joke about my genitals (my penis). 3 times. Now, my genitals are already a source of discomfort, and being out in public as a female already causes a certain amount of anxiety. But this was a blatant act of misgendering and harassment. In that one moment, my self-confidence was torn asunder. My already fragile self-esteem, shattered. I felt violated and unvalidated. This one person has nearly undone 2 years of therapy and self-management that I have worked so very hard to accomplish.

“That’s awful!” Yes, dear reader, it is. I’m glad you agree. But there are ways to manage gender dysphoria. The first and foremost thing that can be done is to accept it. If you experience dysphoria, it’s important to know that there is nothing wrong with you! And if someone with dysphoria comes to you, it is important to validate them and recognize their struggle. Use a new name or pronouns if they ask you to.

Second, there are ways to manage your discomfort. Find out what your triggers are and experiment with ways to keep them under control. Breastforms and wigs are helpful tools. I use both every single day to help manage my dysphoria while I transition. New names and pronouns can offer a lot of relief as well.

Third, when it becomes unbearable, it’s okay to cry. Cry a lot. Let it out. Do something that makes you happy. Read a book, listen to music. Have a glass of wine (though, don’t over do it.) For me, I cry a lot and drown my sorrows in coffee and wine, like a true Seattleite.

Fourth, if you begin feeling suicidal, take a moment to breathe and call Trans Lifeline. They are a suicide hotline for trans people, by trans people. There are real trans folks on the other end to help, so they understand what you’re feeling. Don’t hesitate; just call. And for any cisgender allies, donate to Trans Lifeline on their website to keep it active. If a friend comes to you with suicidal feelings, point them that way and make sure they know they are loved. Do whatever, just to stay alive.

And last, but not least, remember that it does get better. It definitely won’t feel like it at the time, but it will. Because there is a truth, and it’s on our side: Dawn is coming. You just need to open your eyes and look into the sun, at the new day’s rise.

“Stay Alive” – José González

1 thought on “Let’s Talk: Dysphoria”

  1. I love you so much. And, I truly think your voice is magical. You’re amazing, wonder girl, and made my rocky salt encrusted bitter little soul feel warm and human again, thanks for making me cry. *forehead smooch*

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