Understanding Gender Dysphoria

“I’m so angry at you,” Sam said to mom and dad. “I should’ve been born a boy,” Sam continued. 

Sam’s parents bought him boxers because he refused to toilet train otherwise. Sam was also very upset when asked to use pink scissors or line up with girls during PE. Other parents were befuddled that this boy was named Samantha. 

However, the world around Sam quickly evolved to integrate him. Sam’s teacher told the class to refer to Sam with male pronouns and the school allowed him to use male bathrooms. 

Realisation can begin at a young age, and many times it happens, but unfortunately, few can boast of having supportive parents or environments. 

Nikki is a testimony to that. “School was extremely difficult. I got bullied a lot. I was picked on for being too thin, for being feminine, for not liking football, for hanging around with girls, for having long hair.”

When someone feels like he or she is in the wrong body, does it mean that the person is mentally unsound? It is indeed a mental condition, but it is not because they are delusional, but DSM-5 has clinically diagnosed this phenomenon to acknowledge the distress or impairment that it can bring. Gender dysphoria encapsulates the strong desire to be of another gender, which may include yearning to change primary and/or secondary sex characteristics. 

strong desire to be another gender

Even though not all transsexuals experience dysphoria, this mental and physical disconnect is often repudiated by society and can cause severe distress, anxiety and depression. 

“I felt repulsed towards my body,” shares Shane, a trans male, about his growing up days.“ Shane described his days before transition as characterised by “extreme loneliness and helplessness” and said, “I had a couple of times when I had strong suicidal thoughts to end this miserable life.”

Many who experience gender dysphoria live in anguish because they harbour strong enmity with their physical self, and feel incarcerated to their bodies. Research has shown that transgender people are at disproportionately high risk for family and social rejection, discrimination, violence, poor health outcomes, homelessness and poverty, drug and alcohol abuse and suicide.

“Listening to yourself talk and hearing your voice getting deeper, or looking at your face and noticing you have to shave because there’s hair growing on your face,”

Abby Parmelee, the then 18-year-old said. “I just felt like I wasn’t worthy of anybody, not even worthy of myself.” She developed an eating disorder and even contemplated suicide.

Gender Affirmation 

The pitfall of many is to assume that transgender people are trying to make a choice with their gender, but most of them assert that they did not choose this path for themselves and usually repress their gender identity until it becomes a psychological and medical predicament. 

How can we ameliorate the situation for those experiencing gender dysphoria? In 2017, the American Academy of Pediatrics released its guidelines “Supporting & Caring or Transgender Children”, and advises us to take steps to affirm the gender that feels comfortable and authentic to the child. This applies to adults, and we can start with using the right pronouns in addressing them. 

Gender affirmation can also include procedures to transition an individual. These include hormone therapy, genital reconstruction, breast reconstruction, facial plastic surgery, speech therapy, urologic and psychiatric services and primary care. In Singapore, it is mandatory for one to be diagnosed with gender dysphoria by a certified psychiatrist and undergo counselling sessions before they are legally permitted to take the leap. 

Only after finding out that he could transition did Shane find hope in life. Even though it was not an easy process because he had to travel to Thailand for surgery, he is now happily married to a woman and lives in a Build-to-Order (BTO) flat in Singapore. 

Because of the high prevalence of psychological distress, one can face during gender dysphoria, finding the right therapist can be paramount to recovery. Just like for Parmelee, the therapist can liberate the transgender from the shackles of mental torture. 

gender affirming

After years of distress, Parmelee eventually sought treatment and started to see a counsellor for her eating disorder and gender dysphoria. After many sessions, she was able to come out as female to her close friends and family. Eventually, her depression subsided and she is a public advocate for transgenders on her YouTube channel. 

Finding the correct private therapist starts from approaching LGBTQ+ friendly ones. With their experience and knowledge of relevant issues, the client does not have to worry about being discriminated against in a supposed safe space.

Let’s not undermine the obstacles that transgender face, and work towards building a gender affirming community. 

More Articles

Where private practice meets
A Space Between provides flexible co-working office spaces for rent to therapists and other professionals in Singapore.

A Space Between is a destination for mental health therapy activities. Counsellors utilise our many conducive therapy rooms for consultations. Located conveniently downtown and offering your independent therapists rent by the hour, we house many professional mental health practitioners, including LGBTQ+ friendly ones. To find out more about the therapists practising in A Space Between, write to us at [email protected].

Subscribe to our newsletter!