GENDER DYSPHORIA

A cisgender person is someone whose gender assigned at birth is the same as the one they identify as. A trans individuals assigned gender at birth is different than the one they identify with. It is an umbrella term for people who are not cis, including people who identify as non-binary, trans men and trans women.

Individuals who do not ‘fit’ into the gender binary as male or female are more likely to experience discrimination and victimization. Stigma-related prejudice can also isolate these individuals because of estrangement from their families or being rejected by their peers.  Transphobic discrimination can negatively affect one’s wellbeing, so individuals may be more likely to experience mental health issues. 60% of trans people report to have experienced depression, 36% have had suicidal thoughts in the past 12 months and 10% reported a suicide attempt. Among trans youth, up to 65% have reported suicidal thoughts in the past 12 months. Furthermore, transphobic discrimination and stigmatization can increase individual’s risk for mental health issues, such as substance misuse, social exclusion, relationship problems, homelessness, and poverty.

Risk factors for anxiety, depression and other mental health issues for trans individuals 

-        Victimization because of social stigma, discrimination, transphobia, sexual abuse, gender abuse

-        Mismatch of gender identity and assigned gender

-        Difficulties accessing health care and social services

Gender dysphoria refers to the distress or discomfort associated with your gender not aligning with the sex assigned at birth. The gender conflict can affect people in different ways and can influence behavior, dress and self-image. If individuals choose to pursue gender affirming therapies, it is within the family physician’s scope to prescribe and refer to appropriate interventions. Some individuals may socially transition (transitioning into the affirmed gender’s pronouns and bathrooms) and others may want to medically transition with surgery or hormone options. Gender dysphoria is a medical diagnosis, therefore it can be seen as pathologizing in the trans/gender expansive community due to the history of how the medical system has treated gender.

Gender dysphoria is not the same as gender nonconformity, which is behaviors that do not match the norms and stereotypes associated with their assigned gender. For example, women behaving and/or dressing in ways socially expected of boys or vice versa.

Barriers to Healthcare

Trans and gender non-conforming individuals have unique healthcare issues that are often not recognized and face many barriers for access to healthcare, which include:

-        Reluctance to disclose gender identity because of social stigma and cultural prejudices

-        Lack of provider support, knowledge, experience and resources

-        Structural barriers, such as using demographic information based on assigned gender, resulting in erasure of identity

-        Cost and affordability

-        Fear of being pathologized that stems from historical and trauma associations of gender

Resources:

1)     Albertatrans.org – document that outlines the process of the medical transitioning process in Alberta
http://albertatrans.org/transition.html

2)     Trans Equality Society of Alberta – non-profit advocacy group with links to information in the areas of the law, housing, police, transitioning, etc.  
http://www.tesaonline.org/

3)     Pride Centre of Edmonton – Can connect individuals with LGBTQ2+ friendly physicians and with health-care and non-medical resources.
https://pridecentreofedmonton.ca/resources/gender-transition/

References: 

American Psychiatric Association – What is Gender Dysphoria?
https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria 

Dhejne, C., Van Vlerken, R., Heylens, G., & Arcelus, J. (2016). Mental health and gender dysphoria: A review of the literature. International Review of Psychiatry, 28(1), 44–57.

Snow, A., Cerel, J., Loeffler, D. N., & Flaherty, C. (2019). Barriers to Mental Health Care for Transgender and Gender-Nonconforming Adults: A Systematic Literature Review. Health & Social Work, 44(3), 149–155.

Roberts, T. K., & Fantz, C, R., (2014). Barriers to quality health care for the transgender population. Clinical Biochemistry, 47(10-11), 983-987.

McCann, E. & Sharek, D. (2016). Mental health needs of people who identify as transgender: A review of the literature. Archives of Psychiatric Nursing, 30(2), 280-285.

Rainbow Health Ontario- Language and Terminology

https://www.rainbowhealthontario.ca/TransHealthGuide/intro-terms.html