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Writer's pictureAnushka Mahashabde

Gender Dysphoria in Children and Adolescents

Gender dysphoria is the unease and discomfort a person may feel due to differences between their biological sex and their gender identity.


Introduction

Gender dysphoria is the unease and discomfort a person may feel due to differences between their biological sex and their gender identity. People with this condition feel uncomfortable in their bodies and feel distressed thinking about themselves with respect to their gender. There is a dissimilarity between their bodily characteristics and their sense of self. Transgender and non-binary people may feel gender dysphoria, but some people feel at ease with their bodies, with or without surgery.


Gender dysphoria and sexuality are not correlated. It is important to understand the difference between gender and sexuality. Gender is who a person is while sexuality is who they are attracted to. A person does not necessarily have to be gay, lesbian or bisexual in order to feel gender dysphoria.


The causes of gender dysphoria are not clear but it is suggested that exposure to certain chemicals while pregnancy can lead to disruption in the normal determination of sex. Chromosomal abnormalities can also cause gender dysphoria, according to some researchers.


Symptoms

According to the APA, the feeling of discomfort and uneasiness related to gender dysphoria should last for at least 6 months to be diagnosed.

  1. The strong desire to live or be treated as the other gender

  2. Desire to not have the physical characteristics of the assigned gender

  3. Insisting that their gender is different from their biological sex

  4. Desire to get rid of their genitals and other sex characteristics associated with their gender.

  5. The certainty that their typical feelings and desires are associated with the opposite gender.

Gender dysphoria in children is diagnosed by

  1. Strong desire and insistence on being the other gender

  2. Wanting to wear clothes, play with toys and be associated with the stereotypical traits of the other gender

  3. Disliking the physical and sexual characteristics of the body they are born with

  4. Having a liking towards cross-dressing. Dressing like girls and wearing stereotypical “girl” colours for boys. For girls, it is usually dressing in a more “boyish” or masculine way.

  5. Having a preference for friends who belong to the opposite gender.

  6. Insistence on playing the opposite gender in make-believe, fantasy games.

Gender dysphoria comes along with major psychological stress and significant discomfort.


Challenges

Stigmatisation

People experiencing gender dysphoria are subjected to incessant bullying and stigmatisation due to their mannerisms and characteristics that don’t match their gender. People may also have a bad experience with doctors and other healthcare systems due to confusion about their gender. Gender dysphoric individuals also stand at a higher risk of hate crimes and victimisation.


Economic disadvantages

Medical procedures like hormonal or surgical procedures are extremely expensive and have a big financial load. These procedures are sometimes not covered by insurance, making them difficult to access. Gender dysphoria and transgender people have also reported significantly low employment rates, due to discrimination in the workplace.


Psychological effects

Facing bullying and discrimination is bound to have major effects on mental health. Discomfort and unease with one’s gender also increase the risk of anxiety, depression and even suicidal ideation. Undiagnosed gender dysphoria can lead to substance abuse, eating disorders and even schizophrenia. Lack of social support from friends and family also adds to the major psychological stress of gender dysphoria.


Problems in daily life

The stress and unsettlement of gender dysphoria have effects on the life of an individual. Discrimination and bullying can cause a person to be lonely and isolated from the world. It also disrupts friendships and relationships. School or work-life also suffer due to all these reasons and can aggravate mental health issues.


All of these issues combined lead to major psychological stress and can have an extremely harmful effect on the quality of life.


Treatments

The goal of the treatment for gender dysphoria is not to change their gender identity or “cure” them. It focuses on relieving the person of their psychological stress and emotional harm by making them feel comfortable in their identity and gender expression.


Medical procedures

Some people may choose to change their physical appearance to align with their sense of self. Hormonal treatments include puberty blockers that suppress physical changes during puberty. People may also opt to take sex hormones like estrogen or testosterone for the development of physical characteristics of the gender they identify with. Gender affirming surgery is done after hormone treatments and only after 18 years of age.


Therapy

Therapy is essential in dealing with the stress and mental health issues that come with gender dysphoria. It helps them feel comfortable with their identity and cope with the distress. It can also help work through relationships with parents and loved ones to create a more accepting and positive environment. Therapy can also guide an individual towards deciding their gender identity and practising self-acceptance.


Coping strategies

Not everyone who experiences gender dysphoria wants to change their gender. Some people prefer to be unlabelled, non-binary or gender nonconforming. Practices like genital tucking or breast binding can help reduce the distress caused by gender dysphoria. Prioritising mental health and self-care can induce positive feelings about self. Meditation and breathing exercises can help with the anxiety caused by gender dysphoria. Being kind and taking one step at a time in order to not feel overwhelmed by feelings is essential and encouraged. Voice and communication therapy, wearing accessories and changing clothes and hairstyles may help with affirming gender identity.


Conclusion

Gender dysphoria is a mental disorder, which can have lifelong effects if left unresolved.

Gender dysphoric people may choose different ways to cope with their feelings. Some may choose to change their gender through hormonal treatments or surgery while some may choose to be unlabelled or non-binary. Some people may use they/them pronouns and it is important to use their preferred pronouns. Respect their wishes and respect their choices. The challenges and obstacles faced by the LGBTQ+ community are serious and we should stand by them against prejudice and hatred. Gender dysphoria is complex and confusing for an individual so being kind and gracious will go a long way in making this world more accepting and comfortable for them.


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