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TRAs typically argue that transpeople have dysphoria which gives them painful mental discomfort from being misgendered or seeing themselves in the mirror as the "wrong" gender (this doesn't account for all TRAs but that's a different topic). In order to reduce supposed mental pain, we must avoid misgendering trans people.

What are your thoughts on this? Is gender dysphoria real? Does it justify making people use preferred pronouns? Is cosmetic surgery necessary for some to cure dysphoria (and thus considered healthcare)?

TRAs typically argue that transpeople have dysphoria which gives them painful mental discomfort from being misgendered or seeing themselves in the mirror as the "wrong" gender (this doesn't account for all TRAs but that's a different topic). In order to reduce supposed mental pain, we must avoid misgendering trans people. What are your thoughts on this? Is gender dysphoria real? Does it justify making people use preferred pronouns? Is cosmetic surgery necessary for some to cure dysphoria (and thus considered healthcare)?

41 comments

[–] edieandthea 52 points (+52|-0)

I mean there are many psychological disorders related to hatred of the body: self harm, eating disorders, etc so I believe that a disorder involving aversion to the genitals and secondary sex characteristics can exist. It seems obvious that we should treat it the same way we treat the other body dysmorphia: psychotherapy to identify underlying causes and encourage self acceptance. Promoting hormones and surgery as first line treatment seems like promoting diet pills and liposuction for anorexia patients.

[–] briababieee 9 points (+9|-0)

I’ve made similar comparisons between eating disorders and gender dysphoria around people who are TRAs and they always tell me ‘it’s not the same!’ Of course they can never explain why it’s not the same.

[–] edieandthea 1 points (+1|-0) Edited

I wonder if there is some misogyny in the reluctance to be categorized with eating disorders, which are stereotyped as "rich White women's bid for attention" (when in fact it is an illness with high comorbidity with OCD). Maybe the TRA logic is "How dare you compare brave transpeople to those silly illogical privileged women choosing to have eating disorders."

[–] jelliknight 0 points (+0|-0)

I know an anorexic woman with a TIF daughter. She says it's so damn frustrating to hear the daughter say "You don't know what it's like to hate your body so much!" According to her, the daughter says the exact same things as the mother and other anorexics in regard to their bodies but refuses to accept that they're the same or even similar. She even tried just talking to the kid about the fact that there's a family history of body dysphoria and you probably should take that into account before acting on your feelings. Nope, mum's just a bigot.

[–] briababieee 1 points (+1|-0)

I believe it. I've been in recovery from anorexic binge purge subtype for nearly 5 years now and I am very well aware of how body dysphoria feels, so I’m not a fan of being told that I ‘don’t understand’ how it feels to hate your body. It's absolutely gutting but the solution is to heal your mind, not mutilate a healthy body. I cannot even imagine what would have happened if a doctor had told my 21-year-old, anorexic self that I could have (unnecessary and dangerous) weight loss surgery.

[–] [Deleted] 27 points (+27|-0)

I think gender dysphoria should be reclassified as a subtype of body dysmorphic disorder. I think the only two subtypes currently are muscle dysmorphia and BDD by proxy. To me gender dysphoria would be more justifiable as a subtype than the latter, or as a third additional one. To that extent I think it's real mental illness.

I don't think it requires using preferred pronouns because there isn't another psychiatric diagnosis I can think of that demands people other than the sufferer to behave differently for symptoms to be alleviated. The cosmetic surgery shouldn't be considered healthcare, but any psychiatric help should be.

But I'm also of the belief that transsexualism / transgenderism doesn't have any "real" forms. Whether or not people regard someone as real always seems based in how stereotypically they behave and personally I can't agree with it.

[–] bio-woman 17 points (+17|-0)

Yes exactly, even with someone with a significant mental illness like schizophrenia, we would never reinforce their symptoms by agreeing that their delusions or hallucinations are real. It is extraordinary then that the medical profession has decided that they should unquestioningly accept the word of someone claiming to have gender dysphoria and treat them as they request, without any investigation at all, and the rest of the world is to go along with this too.

[–] ALoudMeow 2 points (+2|-0)

Right, and any doctor who validated or encouraged psychotic thinking would be committing malpractice. It’s the exact same thing.

[–] mathlover 12 points (+12|-0)

Yes. There is no "true trans". And no ones delusion should be rewarded with pronoun make-believe just because they are "really making an effort". Trying to pass is only trying to perfect a diguise well enough to decieve others into thinking you are the opposite sex.

Ultimately, though, it doesn't matter whether someone passes or not, or even if they admit they are still their biological sex. When we parcel out "preferred pronouns" as a reward, it is still asking people to lie.

[–] dasehe 16 points (+17|-1)

Yes, I think gender dysphoria is real, though I am still forming my views about the extent to which I think it is conditioned by existing rigid frameworks of gender and culture. The appropriate comparison class would be culture-bound phenomena/syndromes like latah.

I am undecided about preferred pronouns. If you would prefer I use a set of pronouns, and I am inclined to meet your preference, that is one matter. Another matter is if you will be psychologically distressed (in a concrete way, since we very easily claim psychological distress for everything these days) if I do not use your pronouns, in which case yes, why not. I think crime reporting and health journalism, possibly reporting in general, shouldn't defer to preferred pronouns. Either use the original (in the case of Barbie Kardashian), or do not use them at all. I am of the view it is kind to use preferred pronouns, but that refusal to use preferred pronouns should not be itself legally penalised. Kindness is supererogatory, rather than required. We've been making the slip quite a bit from: 'it is good to use preferred pronouns' to 'it is bad to not use them' and that logic doesn't follow, and licenses a lot of the abuse against (especially) women perceived as being unkind. I think there will be a fuzzy line in cases of intentional disrespect, e.g. referring to transpeople as "it", and that may need some form of hate speech regulation.

I am willing to accept that based on our current state of play, transition and related surgery/treatment might be the best option for some individuals. I think we need to be clearer about informed consent. I am fine with it being classed healthcare under previous requirements, such as GID diagnosis, and two years' social transition. I also think the clinics need to drop the 'affirm uncritically' model. Under those conditions, yes, I do think there remain some who will best have quality of life improvement from transition and surgery, and I am not interested in denying them that. Alice who gets referred to Tavistock because she likes to play soccer though? No.

[–] PotatoParameter 13 points (+13|-0)

Honestly, I think gender dysphoria is realizing that society expects you to act a certain way and your natural resistance of conforming to that expectation. I think that everyone has experienced it in some way and it hits some people harder than others. Think about it - I'm sure we've all experienced the "girls can't play sports/do math/be smart" or "girls must be demure/like pretty things" and hated it. It's a ton of assumptions put on us and it's a huge mental burden. We think that all girls can't be like that but if we have those traits then we feel disconnected from what a girl should be. The solution is therapy, not surgery or affirmation of sexist stereotypes.

[–] sensusquaeram 12 points (+13|-1)

I believe the suffering and ideation of GD can be very real, but I have a few speculative predictions:

We'll find profound GD to be something more akin to Body Dysmorphic Disorder

A lot of what is currently being labeled (or claimed as) GD will be reconsidered as Borderline or another form of personality disorder and/or Bipolar

Social contagion and outright recruitment will be better understood as important factors, especially for adolescents and people on the Autism spectrum

Pronouns for profound GD patients who've put responsible and sustained effort into transitioning (including working with a mental health professional) because they're GD patients and the current state of mental healthcare has no better solution -- I personally have no issue with that.

For everyone else (self-IDers, AGPs, TRAs, rebels, narcissists) -- hard no. It's manipulative and feeds delusions.

[–] InvisibleWoman 5 points (+5|-0)

I agree with you re the pronouns, but how can we ever know? Transtrenders are lying about having dysphoria more and more and about receiving treatment (hormones), and it's entirely possible to get hormones without any specific measures in most countries nowadays. And they're redefining what dysphoria is to include themselves (wrong pronouns make me dysphoric but my body is perfect the way it is sort of people) as well.

[–] sensusquaeram 1 points (+1|-0)

There's the rub -- we can never really know. And Cluster Bs and human nature and quasi-anonymity on the web being what they are . . . where do we draw those lines? And how?

[–] AriadneOnNaxos 10 points (+10|-0)

Do you remember adolescence, and the deep, temporary distress at your changing body? I remember it well, and have seen kids of both sexes go through it. For girls, part of it is definitely the way men start creeping on you, but there’s also just the weirdness of breasts and changing hips in themselves.

I can see that gender dysphoria might be like that - partly internal, partly social, only of longer duration, something like the dysmorphia that leads to eating disorders. I would think it’s also to do with trauma disassociation.

That said, I don’t think that every person who talks about gender dysphoria is describing something like this. Some of the loudest of them seem to be talking about narcissistic injury instead.

[–] immersang 5 points (+5|-0)

For girls, part of it is definitely the way men start creeping on you, but there’s also just the weirdness of breasts and changing hips in themselves.

I still remember that day in fourth grade when a girl from my class told me the other girls were talking about me behind my back since I was already growing breasts, and the others weren't yet, and how bad I felt about that. On the other hand years later I was one of the last girls in my class to get my period and it was a big thing back then not to be the last one. At least it felt like it, you were looked at funny if you were "lacking" in that area. I was so relieved when I finally got it. Such a source of stress without any good reason, really, but that's how it is at that age.

[–] DetectiveMills 9 points (+9|-0)

You know, it always reminded me of Body Identity Integrity Disorder (BIID). People with BIID often describe how their arm or their leg felt 'alien' to them and they would stop at nothing to have it removed. I don't know about gender dysphoria, but the whole 'Trans' identity seems to be like an amalgamation of a whole type of things. Like issues around sex, identity, the intense need for and seeking of excessive validation, wanting to be the centre of attention- the word histrionic comes to mind. Trans Identified Males appear very misogynistic and this becomes apparent when they 'become' a woman. They don't become a woman, they become their *idea *of womanhood, which shows how misogynistic they are. As if being a woman is based solely on how much lipstick you wear, wearing skirts and having long hair.

[–] SkettiNoodle 4 points (+4|-0)

I think they are very similar issues. BIID is very persistent in the same way that being trans is. Some of the treatment we've seen for BIID includes providing medical equipment to the person as a substitute for actual amputation, which would be seen as validating their mental illness. There are cases where BIID patients have mutilated themselves and reported that they couldn't be happier! I don't know of any therapy that doesn't validate the person's feelings - that's not really publicised and I haven't looked at any papers about it. There seems to be no 'conversion therapy' to mentally reconnect the person's leg to their body. Can body dismorphia be cured through therapy? If so, maybe true gender dysphoria isn't as related to body dismorphia as we thought, and is instead a type of BIID?

There's also sometimes/more often than we know a sexual element to BIID, not unlike AGP. They are (often exclusively) sexually attracted to disability want to become disabled because of this.

An interesting thing is the public perception, in two ways. I think (not sure) that sometimes part of the allure of amputation is to be seen as a disabled person afterwards, so, like the trans mindset, it depends on changing how others view you (hence the intense thought and speech policing that goes on with trans people).

The other public perception thing is how people perceive BIID vs trans surgeries. Trans surgeries are supposedly necessary, normal, and even a right, but BIID surgeries (and even access to wheelchairs) are deeply wrong, disturbing, unnecessary practices. Why is a lower limb more important than a penis or boobs? I don't have the answer to this.

It would be nice to think that someone could talk some sense into both of these groups of people. However, they are mostly likely victims of quite severe, persistent mental illnesses/fetishes.

[–] crispycherrypie 8 points (+8|-0)

I believe it's a mental illness akin to anorexia or body dysmorphic disorder.

There are certainly people who claim they don't have dysphoria but are still trans, and I tend to classify them separately than the people who do have it.

As it's a mental illness, preferred pronouns, cosmetic surgery, etc, does not actually address the actual problem and is akin to treating symptoms over treating the actual illness.

If you look at the people who transition because they are ill (I'm not going to address the ones who are sexually motivated because that's something else entirely) it's clear that hormones, surgery, preferred pronouns, and name changes, do not actually improve their mental wellness.

They're just as miserable, just as unwell, and still chasing a fix and don't understand why they're still unhappy after "fixing" everything they don't like about themselves.

This is the medical industry taking advantage of the seriously unwell in order to make money, and I think it's completely monstrous.

[–] LobselVith 6 points (+6|-0)

What I'm inclined to think is very simple.

The feelings of discomfort can be real and might even be very intense for some. But they should be treated like the feelings of discomfort in other types of body dysmorphia, so not affirmed, not confirmed as "valid", but worked through in order to have the person overcome them.

Cross-sex hormones, pronouns and even surgery, while they might superficially help someone in a way that feels concrete to them, are not "cures" to dysmorphia, they're a "putting a patch on it", avoiding to actually treat the real issues.

At least, this is how I feel abotu this.

[–] blahblahgcer 6 points (+6|-0)

I had/have pretty bad gender dysphoria. I still wish I had no boobs and peopel seeing I have them makes me freak out. Same with my hips. I thought I was nonbinary for a long time because of this and the fact that I didn't want male genitals or facial hair or anything like that.

I'm autistic and pretty mentally ill. I also grew up in a very conservative environment and had a lot of trauma growing up. Getting therapy for these other issues without even mentioning the trans stuff really helped the dysphoria.

I still have some but I try to ignore it. I still wear baggy things but I've gone outside without a baggy sweatshirt and I feel better about being a woman. I still wish I could have a different body, but I realize that there's nothing I could do without like... Hormones lol (I almost asked to go on some hormone that makes you look more androgynous but I don't remember why).

Honestly I was more GC than people liked when I was trans lol. I didn't care about pronouns or anything at all. Actually, I get mistaken for a dude a lot and I don't care. Except the TRAs had me convinced that was a sign I was trans, the fact that I wasn't upset about it......

I think therapy should help it a lot. I think I heard especially with TiFs that dysphoria is pretty correlated with eating disorders and that seems like it could use very similar approaches.

In my opinion, transitioning should be a last resort sort of thing. Like "years and years of therapy but still miserable".

(oddly enough, writing this and describing what I was dysphoric about made me focus on it and has kinda triggered it lol)

[–] Lioness 6 points (+7|-1)

In my opinion, gender dysphoria is real the same way “hysteria” was - it’s a product of the time, and a big blank diagnosis that could mean a slew of things. I also think that in 100 years, it will be considered an archaic and offensive term. I feel like the term is used way too loosely to actually have a “treatment” that works. There are so many things that someone can experience that they could say is “gender dysphoria”, and the current way the medical world has if treating it (hormones, happy pills, or hopes and dreams) isn’t working because it isn’t actually targeting the problem.

I’m sure for some people, it’s true body dysmorphic disorder. A disconnect with their mind and a want to self harm. For some, maybe a subset of a personality disorder. Or further, a “generalized” way of describing a discomfort related to culture for neurodivergent people, such as those on the autism spectrum. And even for a few, maybe it’s just internal homophobia or a mental wrestling of a cultural expectation, but they learned everything from tumblr, so they just use the word everyone else is using.

For those suffering from it - it’s very real. It’s the name they have come to know associated with the pain they feel. You can’t just wish away a pain because someone in the internet doesn’t “believe in it” (like adhd). But I think in terms of medicine, it’s way too broad and needs a lot more research and clarification.

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