Understanding dysphoria

Gender dysphoria was sometimes  succinctly summarized with the phrase "born I the wrong body" which is a disservice to something considerably more complex. When patients were pleading their case before medical gatekeepers they learned to use certain language to get them to their goal and you certainly never mention sexuality.

The more I would read the literature plus the narratives of others I began to realize that there wasn't a simple way to describe what was a yearning to express and sometimes embody gender outside of birth sex. However understanding how expression and identity worked as a tandem made nailing things down very challenging. Some people felt comfortable with sporadic or regularly timed expression and yet others could not live one more day in a body they had come to completely disown.

Anne Vitale coined the wonderful phrase "gender expression deprivation anxiety" which I felt came closest to describing what dysphoria felt like and yet it wasn't predictive of outcome in that for some this could mean indulging in expression more frequently. We used to make a distinction between tranvestism and transsexualism which I believe still has merit but there seemed to be blurring in some patients which is what likely prompted Harry Benjamin to develop his scale.

To make things even more complex, some people do not experience dysphoria and simply begin to express variance in adulthood almost as sport. I tended to leave those people out of the definition of transgender which I always understood to begin at the point of where core identity is questioned.

Today it appears that all gender variance is being lumped in under the term "trans" which may be inclusive language but contributes nothing towards our understanding of gender dysphoria. Some people are even transitioning without it and then regretting it down the road. 

Next week I have that session to discuss the presentation in Paris on the topic of detransition.