Gender Dysphoria
Gender dysphoria refers to the distress or discomfort associated with one’s gender not aligning with their sex assigned at birth. This conflict can affect people in different ways, potentially influencing behavior, dress and self-image.
A cisgender person is someone whose gender assigned at birth matches the one with which they identify. A trans individual’s assigned gender at birth is different from the one they identify with—in this way, trans serves as an umbrella term for people who are not cis and identify as non-binary, a trans man or trans woman.
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 isolate these individuals due to estrangement from family or rejection from peers. Transphobic discrimination can negatively affect one’s wellbeing, resulting in mental health challenges.
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% reported suicidal thoughts in the past 12 months.
Transphobic discrimination and stigmatization can increase an 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 include:
Victimization because of social stigma, discrimination, transphobia, sexual abuse, or gender abuse
Mismatch of gender identity and assigned gender
Difficulties accessing health care and social services
If individuals choose to pursue gender affirming therapies, it is within their 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 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 treats gender.
Gender dysphoria is not the same as gender nonconformity. Gender nonconformity is characterized by behaviours 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 Health care
Trans and gender non-conforming individuals have unique health care issues that are often not recognized, resulting in barriers accessing health care. These include:
Reluctance to disclose gender identity due to 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 stemming from historical and traumatic associations of gender
Resources:
Albertatrans.org – document that outlines the process of the medical transitioning process in Alberta
http://albertatrans.org/transition.htmlTrans 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/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
