Following on from April’s stress awareness month, Megan discusses stress in the context of gender dysphoria, and provides information on how to help those that may be suffering.
Gender dysphoria, also known as gender identity disorder (GID), is defined by the NHS as “a condition where a person experiences discomfort or distress because there’s a mismatch between their biological sex and gender identity”. The exact number of people in the UK with gender dysphoric feelings is unknown, but with society growing to be more accepting of individuals who do not fit the typical Western “norms” (i.e. man or woman), there has been a sudden and encouraging increase in public discussions, allowing individuals to be more transparent and open about their feelings towards their gender. However, being seen as different may still bring huge emotional distress and exclusion.
Imagine you are sitting in your local pub with a group of friends. It’s Friday evening, there is good music, good company, and perhaps a good flow of alcoholic drinks. Your only worries are who is going to buy the next round, and where the bathroom is – simple and ubiquitous thoughts and behaviours for most. For those with gender identity issues these concerns are not minor. Buying a round is fraught with difficulty as the bar staff may react to the fact that your voice doesn’t match your face. Going to the bathroom requires making a decision where neither outcome seems the right one for you. For some individuals, the stress caused in these situations by feeling a mismatch between their biological sex and gender identity results in gender dysphoria.
“Going to the bathroom requires making a decision where neither outcome seems the right one for you.”
Not all individuals who consider themselves to be transgender experience gender dysphoria. However, being seen as “different” can carry large amounts of stress in a wide variety of situations. Whilst data on the experiences of individuals diagnosed with gender dysphoria specifically is rare, the 2015 U.S Transgender Survey provides useful statistics from over 28,000 transgender respondents. In this group, 10% reported an immediate family member being violent towards them, 15% ran away and/or were kicked out of home, 27% had a relationship breakdown (1). Of those who had a job, 23% reported mistreatment in the workplace, and 77% reported taking steps to avoid mistreatment (1). Forty percent of respondents reported that they had attempted suicide in their lifetime, nearly 9 times the rate seen in the general population (4.6%). Further research is needed to determine and/or understand this increased suicide risk.
“being seen as “different” can carry large amounts of stress in a wide variety of situations”
Further statistics from the 2015 U.S Transgender Survey indicate that the stressors experienced by individuals in this population relate primarily to personal relationships (divorce, marital separation, sex difficulties, change in the number of arguments with a spouse), and work/finances (getting fired, change to a different line of work, change in financial state, trouble with your boss, and a change in work conditions) (1). Although it is unclear at present whether these life events influence gender dysphoria, life events such as these are known to be associated with increased rates of anxiety and depression. Of note, despite the high level of stressors experienced by transgender individuals, gender dysphoria appears to be an isolated diagnosis, meaning it has no common comorbidities (2, 3, 4).
Overall, although there has been a sudden and encouraging increase in public discussions of previously taboo topics, the need for further research and evidenced based support systems are still apparent – to target the high levels of stress reported by individuals who do not conform to the gender binary. Such research could examine potential associations between anxiety, depression and gender dysphoria, with an aim to develop more rounded treatment methods and support.
How can I help?
There are several online communities and resources which have been working relentlessly to provide information for not only those with gender dysphoria and/or those who identify as transgender, but their parents, friends, and anyone who wishes to learn more about supporting this community. Below is a list of a few examples of these online support networks:
Mermaids is a charity which aims to support children and young people who are gender non-conforming. It also has an online support group for parents with children who are experiencing a mismatch between their biological sex and gender, and also those with gender dysphoric feelings.
GLAAD is a group of media campaigners who have been spreading awareness of the LGBTQ+ community since 1985. Their main focus is ensuring media coverage of the LGBTQ+ community is positive. It has a page in which you can report any negative media coverage.
UK Trans Info is a charity designed to specifically support people who identify as transgender in the UK. The website provides information about your legal rights, waiting times for gender services and how to legally change your name.
My best friend Izzy was born Simon. In 2015 she came out as transgender, bringing the topic of this blog into my life and my personal experiences. She has faced discrimination at work, at school, within her family, and at the pub on a Friday evening, causing her a lot of stress and anxiety. I asked her how we can help the transgender community to feel more accepted and included, and the most effective ways of relieving the stress she feels:
“The most effective way to help would firstly be 100% acceptance. I would accept anyone for who they are and would expect the same back. Secondly, encouragement would really help – encouragement to dress the way I’d like without judgement, encouragement to act like me and only me. The times where I feel the most comfortable is when I am around friends that support and encourage me. If everyone treated me in this way it would give me a constant confidence boost”.
- James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). The Report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality.
- Cole, C., O’Boyle, M., Emory, L., & Meyer III, W. (1997). Archives Of Sexual Behavior, 26(1), 13-26.
- de Vries, A., Doreleijers, T., Steensma, T., & Cohen-Kettenis, P. (2011). Psychiatric comorbidity in gender dysphoric adolescents. Journal Of Child Psychology And Psychiatry, 52(11), 1195-1202.
- Hoshiai, M., Matsumoto, Y., Sato, T., Ohnishi, M., Okabe, N., & Kishimoto, Y. et al. (2010). Psychiatric comorbidity among patients with gender identity disorder. Psychiatry And Clinical Neurosciences, 64(5), 514-519