Does Gender Dysphoria Exist?

If you think you're trans, you're halfway there, and if you wanna go for it, you've made it. Here's your necrotic skin tube.

Gender dysphoria is a category of patterns of clinically observable or self reportable preoccupations, and so it can exist even if there is no such thing as a biological mechanism called gender identity. Gender dysphoria is the label for the psychological illness characterized by a belief in gender identity conflicting with sex, among other things, and trans ideology is the reality claim the illness has caused many to make, such as their industry reps trying to sell million dollar diseased arm skin funnels to teenagers.

The actual DSM-V criteria for gender dysphoria does not explicitly reference the term gender identity. It refers to experienced or expressed gender (how you say you feel and how you look to others) and assigned gender (what's socially and biologically expected of your legal sex).

In addition to that, and coequal, having personal beliefs about whether you have gender dysphoria is one of the ways to have gender dysphoria. In other words, it really is just gender dysphoria all the way down. If you think you're trans, you're halfway to a diagnosis. If you also want to trans, here's your nipples in a doggie bag so we don't clog the shower drain. Dysphoria cured. That'll be $300,000 at Dr. Marano’s office.

Gender incongruence is one of SIX possible manifestations of gender dysphoria under the DSM-5. You need only TWO criteria to qualify. You don't actually need to feel gender incongruent to have gender dysphoria. Wanting to get rid of your sex traits, even if no one can tell - what drove my use of HRT - is its own criterion.

Another criterion is wanting to be the opposite sex (trans classic). Again independent of that, is the desire to not be your sex, even if you don't want to be the other sex (nonbinitarianism). The final two are a DESIRE to be treated as a different gender (regardless of personal identification) and a BELIEF you're more like another gender.

This is an illness often borne of an incomplete theory of the world, and young person motivators like group cohesion and sexual desirability. There may be an un unquestioned belief that atypical reaction patterns for an individual member of a sex category are pathological, or not mirrored in the diversity of individuals of the other sex. It can be worked through in therapy. But for some, it is a kind of transient psychotic symptom that may portend a deeper neurological deterioration or medically treatable dysfunction.

Prior to and during my time on hormonal suppression and binding, I definitely met the official diagnostic criteria for gender dysphoria even though I had no interest, after beginning hormones and altering my appearance, to further look specifically like a man or have more of the physical traits of a man. My dysphoria was cured by having fewer female sex traits without additional male ones. 

Of course, my dysphoria was only beginning, because the hormone suppression made me worse the longer I was on it. It interacted with my underlying syndrome by affecting tissue elasticity, muscle strength and size, and other factors. I still saw the hormone suppression as helpful, since the injections felt good.  I was afraid of how bad I would feel without it.  I should have considered how I might feel better.  I did not realize the hormones worked by suppressing the function of certain glands in the brain, and that this might worsen cognitive symptoms from syndrome-related vascular compression, on top of the effect of a lack of estrogen and testosterone on brain function. 

Before long, I went beyond a rubicon of clinical invalidity, while the con continued to reinforce that all compounding difficulties and diagnoses they were giving me were coincidental to the original intervention of hormone suppression, and intrinsic to me. By the end, they were using my rejection of their last slew of diagnoses to argue I was too ill to understand my condition. In fact, they did not understand Eagle syndrome. 

They should have recognized they did not have the competency to treat me, but instead I was affirmed and given a binder, injections and an implant. Then it was ignored as a factor by a ridiculous number of providers who treat other women taking these same hormones for other reasons. Maybe at a lower dose than me, and maybe without my syndrome, makes them not be as affected. But, they're still affected. There's no free lunch. 

So I walked away. I stopped calling myself nonbinary and began consuming Magdalen Berns, Kellie-Jay Keen and Heritage Foundation panels trying to understand why the last decade of my life looked the way it did. I wouldn't begin making content for another year and a half. I had a lot of private healing to do first. Some would argue I clearly needed to do more of that. But I never expected my content to pop off the way it did. I had barely downloaded the app and spent most of my time talking about Turkish Article 301 and linguistics. I was pushed into disclosing my detrans status by the commenters calling me cis. No, I explained, actually I'm a detransitioner if I'm anything. I was completely out of the loop on the detrans movement’s existence at the time. 

The DSM criterion based diagnosis is not ranked. You aren't more or less gender dysphoric depending on what transition interventions you wish to select. Transition is how you respond to the conclusion that you're experiencing what psychiatry has defined as gender dysphoria with reference to these 6 observable or reportable criteria. If you buy into the idea that matching a psychiatric category automatically means you're ill and need their help, good luck to you as you will need it.

But for some, the preoccupation may be organic. That doesn't make the content of the delusion true or real. It makes it neurological versus psychogenic or socially acquired. The distinction matters because interventions for one won't work on the others, but to be clear, penis inversion should not be for sale. I believe much of what I was labeling dysphoria was simply symptoms of my Eagle syndrome, which is a physical condition that causes neuropsychiatric symptoms, including dissociation and a negative feedback of pain from social communication.

To suggest gender dysphoria cannot describe a person's preoccupations if gender identity does not exist is not consistent with what the DSM says. Gender dysphoria, like psychiatric diagnoses generally, is not a pathogen that can be isolated. It is a pattern of psychological preoccupation some people have, for complex reasons that detrans people are often publicly and pains-takingly, while facing significant ostracism and denigration, picking ourselves apart to show you the clockwork of.  And do you know what really grinds my gears?

Based on a true story. 

It is also akin to saying Capgras delusion can't exist unless the family members are actually imposters, or Cotard syndrome can't exist since obviously the patient isn't dead, and so we shouldn't have a specific label for those specific neuropsych patterns of fixed false belief, that may be neurogenic. “So you're saying some men have women's brains!” No, not anymore than I'm saying some Cotard patients are really dead. A delusion can come from the brain without being true. That's what a sense of gender identity conflicting with sex is. A fixed false belief. No one “has” a gender identity.  That's what gender atheists say. 

Some people do have gender dysphoria just like some people do have OCD. But no one needs to transition to prevent suicide and no one needs to wash their hands 100 times an hour so the planes don't fall out of the sky. The clinical label documents the reason for the clinical services. It doesn't require the patients’ beliefs to be true, just qualitatively identifiable. 

My take on the problem with the diagnosis is that it's defined in the way it is to be accessible to members of a social fad and then insurance fundable. The dog is then wagged with the 41% statistic to convince a lot of otherwise healthy, normal, beautiful, traumatized, neurotic young people, mostly women, many autistic, to self harm to prevent self harm on the belief that they're at high risk of self harm. I was deeply confused when this made sense. 

Look at these categories.  You want this. You desire that. You feel like this. You are convinced you're like that.  It's worse than giving the people what they want because psychiatry has redefined the concept of want as need.What's medically necessary is not amputation of the confused healthy person's organs, but professional support in thinking through the underlying cause of this envious fixation on what you don't have and don't need, to develop the metacognitive strategies needed to grow past it or reveal other impairments over time, in the case of genuine underlying mental illness. 

For most people, gender dysphoria is a phase. For some, they are stunted and will not outgrow it. And some are manifesting the behavior because of a deeper and possibly degenerative issue. They may also not grow out of it no matter how much talk therapy you give them.  It is important to not forget that you can only help the people you can help, and there are more people you can help than you have time to help, so don't waste time trying to help the people you cannot help.