I no longer find the concept of “dysphoria” to be useful in reference to myself, and no longer refer to myself as dysphoric. Dysphoria is a big, somewhat amorphous word that obfuscates nuance. I sometimes find that putting that label onto my feelings prevents me from exploring them further; it is a “just-because” answer.
I have been reading some detransition blogs, and this has been one of my key takeaways. One criticism detransitioners have of how transition currently functions is that the moment a person has “dysphoria”, transition is often the only solution offered by medical professionals, and the nature of the dysphoria is not discussed.
I am speaking personally, of course. Lots of people find dysphoria a useful framework within which to understand their experience of the world, which is fine. However, I also find that medically, the concept is mainly used to 1. Gatekeep transition related procedures, and 2. Medicalise transness by making it a diagnosable condition.
I have several issues with the medicalisation of transness. I am deeply uncomfortable with the idea of discussing my gender with doctors. Anxiety, cancer, the flu, are medical issues. My gender is not. My gender is a personal thing I have no desire to have examined or treated or even talked about under fluorescent clinical lights. Gross!! My gender does NOT need treatment. I resent having to broadcast my gender in order to access physical transition.
I disagree that “do you or do you not have dysphoria?” is the right question to ask before “allowing” somebody access to medically gatekept transition related procedures. A better question† would be, “would you or would you not benefit from this procedure?”. The former values cis bodies above trans bodies‡. It implies that without diagnosable, “clinically significant” dysphoria, no assumed-cis person would transition or be trans.
I think that the psychological treatment of gender dysphoria should be separated from physical transition. For some people, physical transition is all that is needed to deal with dysphoria. That is fine. I am instead concerned with folks who may also benefit from therapy (i.e. most people, including cis people). Treating physical transition as the ONE answer to dysphoria does a disservice to people for whom physical transition may only be part of the answer, for any amount of reasons.
Clearly, if a person is in “clinically significant” gender-related distress, which is how dysphoria is defined, they should get professional help. But mental health professionals are simultaneously supposed to help people cope with gender dysphoria while gatekeeping access to transition. This is a conflict of interest, and for many trans people, therapy requirements become hoops to jump through rather than any opportunity for actual meaningful therapeutic relationship. I think that these functions need to be separated by demedicalising and providing free and easy access to physical transition.
‡ The idea that cis bodies and lives are valued above trans ones is elaborated on here in Julia Serano’s piece on detransition and desistance. An example she provides is that if an assigned female at birth cisgender girl started producing testosterone (possibly due to an intersex variation), she would find it much easier to access hormonal treatment than a transgender girl, despite comparable safety of the treatment, and age/maturity of the girls. A transgender girl is much more likely to be told to live with her “natural” body until she is “old enough” to decide, while we are much more likely to accept that of course the cisgender girl is correct in her assessment that she does not want the excess testosterone. Thinking that everyone should obviously try as hard as they can to be as cisgender as possible is the same condescending position as “queer people deserve rights because queerness is not a choice… because who would choose THAT?”.
† Transness as a choice, rather than an objective discoverable Truth, is elaborated on in Ozymandias’ blog here. They write that an identify-based framework in which you try to figure out if you are REALLY trans, and whether what you feel is REALLY dysphoria is often recursive and unhelpful. If transition would improve your life, you can just do that.
These are of course unorthodox views not in line with WPATH standards. The medical establishment, after all, is always between two and five steps behind trans people. This does throw quite a wrench into my hopes to qualify for transition…