Environmental And Social Considerations
Environmental and social stressors greatly impact mental health. Transgender people are more likely to live in poverty, be discriminated against in employment, and be victims of violence than non-transgender people. Transgender people also face higher rates of family loss, and homelessness. Transgender people with intersecting identities such as race, ethnicity, or socioeconomic status face increased likelihood of adverse life events. Transgender women of color face extraordinarily high rates of social and health disparities. Routine primary care visits should always assess for housing, food, financial, and safety concerns in living and/or work environments. Case management services should be provided within the primary care setting if available. Due to environmental stressors, transgender people may have secondary adjustment difficulties including depression, anxiety, and trauma reactions. Offering referrals for individual and group therapy and support can bolster protective factors in lieu of the extreme hardships many endure.
Primary Mental Health Needs Of Transgender People
Transgender and gender nonconforming people, in general, have three types of need for mental health.
Transgender people may seek services from mental health providers when they come to realize that their gender identity does not match the sex they were assigned at birth, or when the distress of this incongruence becomes intolerable. The age at which this realization occurs, and the age at which treatment is initially sought, may vary greatly from one person to the next. It should not be assumed that arrival at this realization or seeking treatment late in life indicates that an individual is any “less” transgender.
Treating The Mental Illness
One of the ten tasks of the mental health specialist is to identify and treat mental illness where it is seen alongside gender identity disorders. Patients may be reluctant to reveal symptoms of mental illness, for fear that this may jeopardise their treatment of the gender disorder or because of other negative expectations of healthcare. Therefore, it is essential that the clinician develops a non-judgemental approach to dealing with these patients.
Although comorbid mental illness is not an explicit contraindication to commencement of treatment for gender dysphoria, there is some evidence that individuals with additional mental health problems experience more difficulties during the gender reassignment progression and that those with greater resilience to adversity fare better throughout life . Methods employed to improve patients mental well-being will include those adopted in general mental health practice as well as interventions that are more transgender-specific, if the distress is gender-related. Reference Bockting, Knudson and GoldbergBockting et al highly recommend that clinicians, alongside patients, develop individual healthcare plans to address patients mental health issues in a stepwise fashion and clearly described how gender-related issues that affect mental health may be tackled through psychotherapy.
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What Does It Mean To Feel Dysphoric
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Feeling that your body does not reflect your true gender can cause severe distress, anxiety, and depression. “Dysphoria” is a feeling of dissatisfaction, anxiety, and restlessness.
what is a dysphoric experience? Dysphoria , -, difficult, and , to bear) is a profound state of unease or dissatisfaction. In a psychiatric context, dysphoria may accompany depression, anxiety, or agitation. Common reactions to dysphoria include emotional distress; in some cases, even physical distress.
Just so, why do I feel dysphoric?
Dysphoria is a psychological state that is often caused by or accompanies a mental health condition. Stress, grief, relationship difficulties, and other environmental problems can also cause dysphoria. Most often, dysphoria is a mood, which means someone can have fleeting moments of dysphoria.
How is dysphoria treated?
Medical treatment of gender dysphoria might include: Hormone therapy, such as feminizing hormone therapy or masculinizing hormone therapy. Surgery, such as feminizing surgery or masculinizing surgery to change the breasts or chest, external genitalia, internal genitalia, facial features, and body contouring.
What Is An Example Of Pansexual Behavior
Pansexual definition Pansexual people may describe their attraction as focusing on personality rather than gender. For example, people with a pansexual orientation may feel an attraction to the personality of someone who is agender. They might equally find a female, male, or gender-fluid person attractive.
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What Is Extended Self Example
A mans Self is the sum total of all that he CAN call his, not only his body and his psychic powers, but his clothes and his house, his wife and children, his ancestors and friends, his reputation and works, his lands, and yacht and bank-account. … All these things give him the same emotions./span>
Making A Diagnosis Of Gender Dysphoria
There is no current tool or objective method of making a definitive diagnosis of gender dysphoria. As with most of psychiatry, the patient is physically, endocrinologically and genetically normal , therefore the diagnosis is based on the information given to the clinician by the patient and on the clinicians judgement during assessment and/or psychotherapy. Problems occur when patients alter their life story or their gender feelings to impress the clinician to attain their goal of hormonal or surgical treatment .
The World Health Organization gives three criteria for diagnosis:
1 there must be a desire to live and be accepted as a member of the opposite sex, normally with the additional desire to make their body as congruent as possible with that of the opposite sex;
2 the gender identity issues must have been present for at least 2 years; and
3 the gender identity issues must not be a symptom of another disorder .
It has been argued that these criteria are somewhat vague and do not emphasise strongly enough the patients overwhelming desire to acquire the anatomical characteristics of their preferred gender .
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What Is A Dysphoric Manic Episode
Dysphoric mania is when you have symptoms of depression and mania at the same time. It’s sometimes called a “mixed state,” “mixed mania,” “mixed episode,” or “mixed features.” While experts used to think it was rare, they now realize it’s common. About 40% of people with bipolar disorder have dysphoric mania at times./span>
What Is Bipolar Disorder
Bipolar disorder;is characterized by an extreme change in an individual`s mood, making them feel elated and depressed. The majority of people with bipolar disorder experience dysphoric mood, which is a symptom of bipolar disorder. It is helpful to educate yourself about dysphoric mania symptoms so that bipolar patients can understand when they should seek advanced guidance for their dysphoric mood.
According to;WebMD,;dysphoric mania can feel like a manic episode, but with some symptoms of depression, like a negative mood and sadness. A dysphoric mood can manifest as depression but with extra energy, restlessness, and emotional discomfort. Your mind might be racing, and you could have trouble sleeping. On the other hand, you may also be feeling down on yourself and in a dysphoric mood.
According to the dictionary, dysphoria is described as the feeling of deep unease or dissatisfaction with ones life, dysphoric mood. Dysphoria is a psychiatric concept that describes a severe depressive episode followed by psychotic psychosis . Due to this, a dysphoric mood is not considered a rational reaction to an event or stimulus but rather a sign of a constantly changing mood cycle that can bring profound emotional instability.
Simply put, dysphoria is an emotional detachment that has little to no connection to what is actually happening.
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In Adolescents And Adults
In order to be diagnosed with gender dysphoria as an adolescent or adult, an individual must experience clinically significant distress or impairments in social, work, and other important life areas. These feelings must last for at least six months and be accompanied by at least two of the following:
- A significant incongruence between primary and secondary sex characteristics and the individual’s experienced gender
- A marked desire to be rid of primary or secondary sex characteristics
- A desire to have the primary or secondary sex characteristics of their experienced gender
- A desire to be their experienced gender
- A wish to be treated as their experienced gender
- A belief that they have the behaviors, feelings, and reactions that are characteristics of their experienced gender
Causes Signs And Symptoms
The exact cause of gender dysphoria is unclear. Recent research suggests the condition may be the result of abnormal development of the foetus while it is in the womb, which leads to the brain to develop a gender identity that is different to the babys sexual organs. This is possibly as a result of genetic or hormonal factors, but social and environmental factors may also be involved. Gender dysphoria is not the same as homosexuality or bisexuality as identity conflicts need to continue over time to be considered gender dysphoria. How the gender conflict occurs, may be different in each person. For example, some people may cross-dress while others desire sex reassignment. During the coming out process, it is common to feel a lot of conflicting emotions, including feeling scared, relieved, confused, proud, vulnerable, uncertain, empowered, brave, exhilarated, and affirmed. Symptoms can vary by age and be affected by the persons social environment.
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What Are The Symptoms Of Dysphoric Mania
Dysphoric manic episodes are intense periods of manic activity accompanied by on average two to four symptoms of dysphoric mood. DSM-IV defines them as part of the primary personality disorder spectrum.
One month is considered to be a minimum for a manic episode. During this period, manic episodes are characterized by irritability, excessive self-esteem, and dysphoric mood. In dysphoric mania, psychotic episodes may disguise their symptoms initially because it occurs during a depression episode of dysphoric mood.
The symptoms of;Bipolar I disorder, which is usually a severe form of bipolar disorder, typically include obsessive-compulsive behaviors and dysphoric moods. It can also happen if you suffer from bipolar II disorder;. Also, dysphoria, which is characterized by reduced periods of both mania and depression occurring in tandem, can result from the dysphoric mood.
A Depressed Period Is Characterized by the Following Symptoms, According to The Mayo Clinic:
Dysphoric Mania May be the Cause if you See a Lot of These Symptoms in Others.
Other Factors that Can Induce a Manic Episode Identical to Those of Dysphoric Mood Include:
Other Possible Risk Factors of Mixed States in Bipolar Disorder Include:
- Changes in light intensity affect the sleep pattern and other aspects of a persons psychological well-being.
- Mood change caused by certain medications, such as tricyclic antidepressants
- Less sleep
The Following Might Contribute to The Development of;Bipolar Disorder:
Gender Dysphoria Vs Gender Nonconformity
It is important to note that gender dysphoria and gender nonconformity are not the same. Gender nonconformity involves behaviors and gender expressions that do not correspond to the stereotypical norms associated with a person’s birth-assigned gender. Gender nonconformity is not considered a mental disorder.
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The Role Of The Gender Specialist
Gender specialists traditionally come from a psychiatric background, probably for two reasons. First, it used to be assumed that transgender people had some form of psychosis , and second, before the development of gender reassignment treatments, the therapists only option was to help patients cope with their gender dilemma . Currently, the majority of gender specialists are psychiatrists. However, clinical specialist training may be available within other credentialing disciplines, for example psychology, social work counselling or nursing . The role of the gender specialist as listed in the sixth version of the Standards of Care and expanded on in the seventh version appear in Box 2.
BOX 2 The ten tasks of the mental health professional
1 To accurately diagnose the individuals gender disorder
2 To accurately diagnose any comorbid psychiatric conditions and see to their appropriate treatment
3 To counsel the individual about the range of treatment options and their implications
4 To engage in psychotherapy
5 To ascertain eligibility and readiness for hormone and surgical therapy
6 To make formal recommendations to medical and surgical colleagues
7 To document their patients medical history in a letter of recommendation
8 To be a colleague on a team of professionals with an interest in gender identity disorders
9 To educate family members, employers and institutions about gender identity disorders
10 To be available for follow-up of previously seen patients
Gender Dysphoria Fuels Depression And Low Self
I know that its sad to say that I feel like a freak, but I really do. Every time I look at the mirror, I find myself wondering why I cant be normal. I wish I could be content with my feminine face and my breasts. My short hair is growing longer and all I want is to cut it shorter. I wish I could look more masculine. I feel so uncomfortable in my body. I know that Im supposed to love myself and I try to accept myself as much as possible, but I dont see how thats going to happen with my gender identity struggles .
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Gender Identity Disorder And Schizophrenia: Neurodevelopmental Disorders With Common Causal Mechanisms
Ravi Philip Rajkumar
1Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research , Dhanvantari Nagar, Pondicherry 605 006, India
Gender identity disorder , recently renamed gender dysphoria , is a rare condition characterized by an incongruity between gender identity and biological sex. Clinical evidence suggests that schizophrenia occurs in patients with GID at rates higher than in the general population and that patients with GID may have schizophrenia-like personality traits. Conversely, patients with schizophrenia may experience alterations in gender identity and gender role perception. Neurobiological research, including brain imaging and studies of finger length ratio and handedness, suggests that both these disorders are associated with altered cerebral sexual dimorphism and changes in cerebral lateralization. Various mechanisms, such as Toxoplasma infection, reduced levels of brain-derived neurotrophic factor , early childhood adversity, and links with autism spectrum disorders, may account for some of this overlap. The implications of this association for further research are discussed.
2. Clinical and Phenomenological Overlap between Schizophrenia and GID/GD
2.1. Comorbidity between the Two Disorders
2.2. Beliefs Related to Gender Change in Schizophrenia
2.3. Gender Identity in Schizophrenia
2.4. Schizophrenia-Like Traits in Patients with GID/GD
3.2. Cerebral Laterality and Handedness
Is Crossdressing A Gender Dysphoria
Also, most of them do not have an inner sense of belonging to the opposite sex as people with gender dysphoria do. However, men who cross-dress may have feelings of gender dysphoria when they are under stress or experience a loss. The term cross-dressers is usually used to refer to people with transvestism.
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How Much Does It Cost To Transition From Male To Female
Its simply a lot easier to be singled out and targeted when the aggressor can identify you as being trans. But again, theres a price to pay for the procedure. Board certified surgeons that are qualified to do these procedures will charge anywhere from $25,000 to $60,000 depending on the amount of work you get.
How Do You Deal With Non Binary Dysphoria
1. Express your feelings – share your feelings in a notebook or blog, or express how you feel through an art, craft or music project. 2. Talk to someone who understands – talk to a supportive friend, find an online trans community you feel connection with, or speak to QLife (qlife.org.au to webchat or .
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Gender Identity Vs Sexual Orientation
It is also important to recognize the distinction between gender identity and sexual identity. Gender identity refers to a person’s internal sense of gender, whether that is male, female, or outside of the gender binary. Sexual orientation refers to a person’s physical, emotional, or romantic attraction to other people.
Where gender involves who you are, sexuality is about who you are attracted to. Some people with gender dysphoria are part of the LGBTQ+ community, but experiencing gender dysphoria does not mean that a person is gay, lesbian, or bisexual.;
Reaching Out To Others Helps To Lessen Gender Dysphoria
Talking to others like me is helping me see that I am not a freak. Even though I may feel like a complete weirdo, its reassuring to know that there are others like me who are struggling with similar issues. Gender is still a very sensitive and taboo subject, but I hope that by speaking out on my personal issues, I can add to the conversation and raise awareness about gender dysphoria and its effects on depression for LGBTQ people.
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Transition In Gender Dysphoria May Improve Comorbid Psychosis
Gender-affirmative treatment may be safe and effective in patients who have gender dysphoria with comorbid psychotic disorders, early research suggests.
A case series of two transgender women and two transgender men who had been diagnosed with GD and a comorbid schizophrenia-related disorder were successfully treated with GA treatment. The minimum follow-up period was 3 years.
Although the GA treatment was initially complicated by the ongoing presence of mild psychotic symptoms, patients ultimately experienced stabilization of these symptoms and a satisfactory adjustment to their new gender.
“There has been much controversy about offering a transgender trajectory to individuals with a psychotic condition because, traditionally, gender dysphoria has been regarded as a gender delusional state in those with psychosis,” Dr Meijer told Medscape Medical News.
“These cases show that gender-affirmative treatment is viable when handled appropriately and that it does not cause psychotic decompensation if anything, the psychotic complaints improve,” she said.
The study was April 1 in LGBT Health.
Ethical Right Withheld
Although GA treatment “should be an ethical right of all individuals with GD,” it has been withheld from many patients with psychosis because psychiatric illness has been considered a negative prognostic feature of GA treatment, the authors write.
No Increase in Psychotic Symptoms
Few Contraindications to Gender Transition