Gender Dysphoria (alternatively known as gender identity disorder) is the name given to the feeling of discomfort or distress that a person may associate with living as the gender that the person was assigned at birth. If a person feels that they do not fully identify with their “assigned” gender, they may experience a wide range of psychological symptoms. If Gender Dysphoria is left untreated, there could be an increased suicide risk amongst sufferers.
Signs and Symptoms of Gender Dysphoria
Those who are suffering from Gender Dysphoria may experience the feeling that they are trapped in the wrong body. People may be disgusted by their own genitals or feel ashamed during sexual intercourse. Activities like standing up or sitting down to urinate may cause distress to children who feel that they wish to urinate in an alternative fashion.
Young children may perceive themselves as being the opposite sex or associate more with ideas which are commonly considered to be of the opposite gender. Children may insist that their body will change as they grow. The changes that teenagers undergo during puberty may be particularly distressing. These teenagers may take steps to try to hide these changes, such as binding their breasts to make themselves appear more flat-chested. Sufferers may experience feelings of anxiety, depression and isolation. Stress and depression may manifest themselves as self-harm or the desire to self-harm.
Treatment for Under 18s
Gender Dysphoria treatment for under 18s is still a relatively new field of medicine. Doctors recognise that it is easier to for patients to adapt to their bodies if they are able to prevent the natural changes which occur during puberty. However, doctors also realise that diagnosis and treatment of gender disorders in prepubescent children can have its own moral and ethical issues.
Many children will experiment with gender ideas which may fall outside of those which are expected of them. Male children can enjoy dressing up and playing with dolls, whilst girls may experience a “tomboy” phase. These expressions alone are not clear signs that a child is experiencing Gender Dysphoria and most children will grow out of these phases. Gender Dysphoric children can show signs of stress or anxiety if they are expected to match their assigned gender norms.
Children and teenagers should be referred to a specialist Gender Identity Clinic (GIC). Although families may have to travel quite far to reach their nearest clinic, it is worth undergoing a proper assessment to get a diagnosis and create a treatment plan.
During an assessment, GIC professionals will assess the child to decide whether they are suffering from gender dysphoria. They will also create a case management plan to decide on the best course of action for the child. The plan may involve individual or group support sessions to help the child to deal with their experiences. A treatment plan may also recommend counselling and support for the parents, to enable them to support their child going forwards. A multidisciplinary team will be involved to help to support and review the child throughout their treatment plan.
In some cases, hormone therapy will be prescribed to the child to help to halt or delay puberty. Hormone therapy is normally only administered to children as a final option, once a diagnosis of Gender Dysphoria has been confirmed. A child must have presented signs of severe distress about their present assigned gender. The hormones that are prescribed are designed to delay puberty, so that children do not experience any physical changes which could be counter to their gender identity. The hormone treatments which are given to children and teenagers are fully reversible and can be stopped at any time if the medical team or the patient decides that chemical treatment is not the right course of action.
Gender Dysphoria treatment for Adults
People in the United Kingdom can move to an Adult Gender Identity Clinic once they are 17 years old. At 17, patients are able to give informed consent for their own treatment and they are no longer required to get parental consent for treatment options.
After an initial consultation, adult patients will work with their doctors to create an agreed upon action plan. The initial stages of action plans will normally revolve around counselling and Individual/group therapy sessions. Support group sessions allow adults to meet with other people who are also experiencing Gender Dysphoria issues. These sessions normally include people who are at various different stages of the transition process, so they are very useful for people who have been newly diagnosed.
In addition to psychological treatments, physical therapy options are also available for some patients. These patients may be given speech and language therapy to help them to adopt speech and language patterns which are more typical of their gender identity. Other available physical therapies include hair removal treatments to remove body hair. In some cases, support referrals may also be available for family members. Familial support can be very important for helping patients to deal with the anxiety, stress and depression which are commonly associated with Gender Dysphoria.
Hormone treatments for adults tend to be semi-permanent and designed to change the physical appearance of the body. Most patients will be required to continue taking their personal hormone treatments for the rest of their lives if they wish to maintain the physical changes that they have experienced. A hormone plan is unique to each individual, so a patient should not take anyone else’s medication.
A trans man (person transitioning from female to male) will be given testosterone to help to make their body more masculine. A trans woman (person transitioning from male to female) will normally be given oestrogen to help to make their body more feminine.
In some circumstances, a trans person may decide that they want surgery to change aspects of their body. These people will still need to continue taking hormones even if they have genital reconstruction surgery. Surgery is a big step and not all trans people feel the need to fully alter their sex organs.