A closer look a the reality of Gender Dysphoria

During her childhood, JSC education-biology double major Blair Koonz didn’t have the words for how she felt. She shied away from mirrors, discomforted by how she felt about her body.

Conscious of her feminine preferences at home and school, Koonz said she knew early on that she was a girl, but her body didn’t match her identity.

The word Koonz would soon learn was ‘Gender Dysphoria.’ In 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) reclassified ‘Gender Identity Disorder (GID)’ to Gender Dysphoria, which is often just called dysphoria in conversation.

The American Psychological Association’s (APA) 2015 publication, “Guidelines for Practice with Transgender and Gender Nonconforming People,” defines Gender Dysphoria as: discomfort and distress related to the mismatch between one’s assigned sex and gender identity.

Koonz puts it in simpler terms: it’s a problem one has with their body, not their mind, though dysphoria can be interconnected with mental illnesses like depression.

For this installment, Basement Medicine will examine several of JSC’s students; experiences with dysphoria, including its effects on the mind and body, its triggers and its treatments.

The APA’s “Guidelines” states that 12-50 percent of children who experience Gender Dysphoria will continue with their identified gender — not their assigned sex — into late adolescence and adulthood.
Aware of this incongruence from a young age, Koonz says her dysphoria became bad enough to put her in a hospital in Waltham, Massachusetts. “I spent two months in the hospital and I initially went in because I was suicidal; I was not comfortable with my body and other personal things.

“Then I started hormones (Hormone Replacement Therapy) in the hospital, which immediately led to an improvement in my mood and alleviation of Gender Dysphoria,” said Koonz. “That was in a general psych unit for the first month, then I got laterally transferred to an eating disorder unit because — relating to Gender Dysphoria — I didn’t want to eat because I’d become more masculine, or at least that was my perception. If I ate I would become more masculine, so if I didn’t eat my body couldn’t develop that way.”

According to the Trevor Project, a national suicide prevention service for LGBTQ youth, 40 percent of transgender adults said they have attempted suicide in their lives, and 92 percent of those adults said they attempted suicide before they were 25 years-old.

Since beginning hormones to treat her dysphoria, Koonz’ appetite returned as she began seeing the changes she wanted in her body.

She soon found that growing her hair out and training her voice up were changes she could make to her appearance independently, but says certain societal norms still exacerbate her feelings of dysphoria.

“…finding clothing that fits, or is comfortable, isn’t as easy — and having to deal with other people and having to explain it or when random people misgender me — it’s not a fun time,” said Koonz. “I wouldn’t say it takes away from my identity, I would say it’s being isolated from society; it’s not what society expects or wants, so you’re isolated and you’re labeled as different.”

For JSC student Randy Raymond, the onset of puberty brought on stronger feelings of dysphoria. When he met his first trans person, Raymond says this dysphoria intensified.

“I realized that something was definitely wrong because before that it was just a small thing in the back of my mind saying, ‘hey, this isn’t right!’ It was something that you just shove back into a corner and would pop up every now and then.”

The day Raymond came out as trans, he wore a chest binder to help alleviate his symptoms of dysphoria, despite the physical pain. “[I wore] lots of baggy shirts and my posture suffered a lot from just bending forward and trying to hide my chest. Also, just from the binder itself because it hurts your spine; I think the effects of that are still present with how I sit and stand all the time,” he said.

Before English-secondary education major Shane Wyman began testosterone nine months ago, he also had days when dysphoria controlled his life. Wyman went from being a three-sport athlete to ceasing to work out entirely; he said he had trouble making regular conversation or even getting out of bed.

Wyman likens his dysphoria to an internal voice that is relentlessly negative and malicious.

“It’s like your brain devaluing your own self; it takes a lot to get through it and deal with it every day,” Wyman said. “It’s the internal process of trying to combat that and still have confidence and look in the mirror and see[ing] a boy and knowing the rest of the world’s going to see a boy.”

A 2013 study titled “Factors Associated with Desistence and Persistence of Childhood Gender


Dysphoria,” led by gender identity specialist Dr. Thomas Steensma, linked the intensification of Gender Dysphoria from childhood into adolescence to a greater likelihood that an individual will identify as transgender later as adults.

Some within the trans community also blame society for intensifying their symptoms of Gender Dysphoria through its recognition of gender identity and sex as a binary concept; or, male or female.
“Society’s pressure — on everybody, trans or not — to adhere to conventional gender norms, combined with a fixation on the gender one was assigned at birth and a failure to recognize trans identity, makes dysphoria harder than it has to be,” said one transgender woman who requests anonymity.

“…you’re not only dealing with the discomfort of your own body, with the disconnect between your identity and your physicality and physical appearance – which is hard enough on its own – you’re also dealing with society’s refusal to recognize you as the gender you know you are and always have been,” she continued. “That adds a whole other dimension to dysphoria, which, frankly, in a society which truly embraced all gender identities, would not and should not, exist.”

Koonz says though social misunderstandings and ignorance intensify her own dysphoria, she still urges trans people to talk to their friends, professors and mental health professionals about their symptoms.

“The lack of social support definitely manifests itself as depression and anxiety in a lot of trans people,” she said. “A big part of it is: unless you tell someone, they’re not really going to know. One of the biggest parts of that journey is actually just talking about it with your therapist. If you don’t talk about it to them, then they’re not going to know.”

Unlike some aspects of society, JSC is considered supportive of trans issues by the students in this article; however, the majority agree that further education is needed to better understand the problems of Gender Dysphoria.

Wyman highlights transgender activist and musician Skylar Kergil’s performance last April in Bentley 207 as a significant moment for JSC regarding transgender issues like dysphoria.

“He talked a lot about his personal experience with dysphoria and his coming out. I think that was a great way for the people who were interested in knowing more to be educated about it because he spoke very well and it was an authentic presentation he was giving.”

Wyman says he hopes to help JSC expand its trans education beyond performances and into regular practice not only for students, but faculty and staff, too.

“…know that if we don’t come to class because of dysphoria, it is a legitimate reason,” he said. “Zach [Fox] had mentioned something about choosing his mental health over a grade, which should never be [a dilemma], especially in college when we’re stressed out all the time. I think it would be really helpful if our professors got the education on gender dysphoria and could actually see it as a valid excuse and no different than being sick. It can be so debilitating.”

JSC media arts major Devon Butt, a transgender male, says he has felt welcomed by the JSC community, minor slip-ups aside. “The faculty I’ve seen have been very accepting… they sometimes struggle with using the right pronouns, but usually when I tell them my name right off the bat, they’re very good on changing the name over.

“As far as students go, I don’t really interact with anyone except for my close friend group,” Butt said. “Though, I did have a presentation in my eco-human experience class and I brought up that, at this time in my life, I was questioning my gender. I saw a bunch of people say, ‘That makes a lot of sense now!’”

Since he moved to Vermont from the more conservative West Virginia, Butt says he appreciates the willingness of the people here to learn about trans-related issues like dysphoria. “[In West Virginia] at that time, there was a lot of joking about a man in a dress, and cross dressing was a huge taboo. People talked about hermaphrodites — it might have been the time or the place. It’s very hard for me to section off which was which because I separated myself from that mindset I was in down there when I moved up to Vermont. It was very bible belt.”

Part of the social transition away from Gender Dysphoria for transgender individuals is finding confirmation of who they are from others, whether that be with romantic or platonic relationships.

This is true for Raymond, who said he often needed support throughout his physical transition. “Before I had my chest surgery, I needed a lot of daily confirmation from other people about the way I looked. I was always seeking it out.

“If [somebody is] having a really dysphoric day about their chest, telling them they’re just being paranoid about it isn’t helpful,” Raymond said. “It’s good when people tell you that your feelings are valid and don’t just play off your dysphoria as something that’s in your head, even though it is.”

Several trans resources like the University of Vermont’s Transgender Youth Program in Burlington help transgender children and their families to access hormones along with mental health care for symptoms of dysphoria.

Both the Pride Center of Vermont and Outright Vermont, also based in Burlington, offer transgender community-based programs and support groups facilitated by transgender adults and allies.

Confirmation and activism, Koonz says laconically, are the best methods of support someone can provide for a transgender person struggling with the darkest parts of Gender Dysphoria.

“If someone says they are going through gender dysphoria and they identify as a certain gender, just treat them as that gender and try your best to not treat them as their assigned sex at birth,” she said. “Don’t just say you support them; actually perform actions and go out of your way to support them.”