Does ‘Gender Dysphoria’ actually exist?

[CautiousLurker]

Came across this lengthy post yesterday that explores the way GD/ROGD found its way into the DSM (I think version V, around 2012 ish). It discusses the fact that as a diagnostic label, it was never clinically quantified and defined using measurable indices - making it a unique entry into the handbook.

For anyone not on TwiX, I may be able to copy and paste it, if needed?

https://x.com/Psychgirl211/status/1808825717204922755

Thank you CautiousLurker for this thread. Day after day what little "theoretical" basis for this appalling treatment of children and young people unravels and the deliberate manipulation of the young by adults is exposed.

It's a very interesting read for someone like me with limited knowledge of psychology. Doesn't it call into question the calibre of the qualified professionals who have bought into this dangerous nonsense without exercising any critical thinking?

Surely, yes. Qualified professionals in all fields: teachers, social workers, doctors as well as psychologists.

One of the saddest parts of all this to me is that these children who would have been loved and accepted in all their gender non-conforming glory by feminists are being fed the lie that TERFs are against them. It’s precisely because we’re on their side that we want them to be well and healthy and free to express themselves in any way without constraints.

All the work feminists have done to try and break down those damaging gender binaries has been thrown back at us as if we’re the ones who think people should be stuck in boxes according to their sex. Every time they post photos of Annie Lennox and Boy George they completely miss their own point.

By turning children against the very people who want to keep them safe from harm, isolating them from parents and encouraging them to find solace in the ‘community’ this movement is displaying so many abusive signs. It’s systemic grooming and abuse of vulnerable children and I still can’t quite fathom how so many people have gone along with it as if it’s anything else. Tragic.

I suspect it doesnt, nor am I convinced by ADHD or self diagnosis of autism.

Every time they post photos of Annie Lennox and Boy George they completely miss their own point.

Yeah, it's funny that, isn't it? They seem to think they've found some massive gotcha! 🙄

By turning children against the very people who want to keep them safe from harm, isolating them from parents and encouraging them to find solace in the ‘community’ this movement is displaying so many abusive signs.

This is so true. We know from all available statistics that children and young people alienated from their families do dreadfully in terms of all life chances - all our national data shows this. Yet without any insight or awareness, the adults pushing this ideology at the young, actively promote them cutting ties with family who don't offer unconditional agreement to the self harm they're inflicting on themselves. It's not just a war on the health and wellbeing of young people these adults are waging - it's a war on the fundamental bedrock of the family and in defiance of our safeguarding laws and guidance.

I'm fully convinced of family-diagnosis of autism (my father, after 70 years an understanding of his unpredictable and terrifying rages, his stimming, his resistance to change - but also of his ability to believe in himself and power through to places a person from his background would not have been expected to reach) and self-diagnosis of ADHD (me). But also feel that the so-called neurotypicals are weirdos too, in their way (if they even exist) and that the world would be easier for all of us if the education system and managers stopped treating people as units that have to conform to box-ticking exercises.

And without that box-ticking mindset, maybe the young would be able to see that they don't need to conform to gender stereotypes either.

Anorexia was almost unknown in Hong Kong until a public awareness campaign was launched by Western psychiatrists in the 1990s. Within a few years there was a 2,500% increase in cases.

I worked in Madagascar where suicide had absolutely never happened (ancestors play/ed a huge role in Malagasy society) until the idea of it was introduced by French daytime tv soap operas. Then it started to happen.

And whilst of course CSA occurs in families, my SiL was absolutely a victim of false memory syndrome inserted in ‘memory regression’ therapy by a likely well meaning but damaging unqualified therapist. That led to a complete disruption in her sibling relationships when she tried to insist that their DF had made them abuse each other and all of the rest said this was outrageous.

Those man made mental illnesses were bad enough but for some reason (men, money?) this one has caught like wildfire and, most puzzling, been propagated by adults who ought to know better despite the horrific outcomes for children and young people.

"Gender Dysphoria was created by committee. Some people sat down in a room in 2013 and simply invented its diagnostic properties"

i don't agree with this, Gender Dysphoria as a condition wasn't just plucked out of the air in 2013, it evolved from the previously defined condition, Gender Identity Disorder which was in DSM 3 and DSM 4.and had similar diagnostic criteria. I believe they dropped the word disorder because it was felt to be stigmatising.

Incidentally, I think I'm correct in saying that one of those people revising the definition prior to 2013 was the same guy who spent decades on the Eunuch Archives and wrote the Eunuch chapter for Wpath.

@Thingybob I did see that GID is in the DSM, but it seems that the definition of GD is markedly different in tenor, to me at least.

GID references ‘strong preferences’ (for opp sex clothing, toys, playmates), of which 4 must be present to satisfy the clinical diagnosis. By contrast GD talks about ‘strong desires’, of which only 2 need to be present. I had to look up whether this was significant, and apparently ‘desires’ are object driven (desire to specifically have breasts, or a penis) but a preference is comparative (between males and females clothing, for instance).

GID seems very socio-cultural (ie its about the way the sexes are perceived to present, play, dress); whereas GD is very much focused on the desiring to have - or get rid of - physical objects of one’s sex? Hence the breast binding and mastectomies. And also it’s about the desire to be ‘treated’ as the other sex (which seems to have been excluded from the GID definition as thy state it was not about the ‘perceived cultural advantages’).

GD seems to be extrinsically driven in that it’s about wanting to be perceived as the other sex (ie its about how others see you, about ‘passing’, pronouns), whereas GID if you really parse it, seems to be intrinsically driven, given it’s really about being gender non-confirming and wanting to ‘do’ what the other sex does/wear what they wear/etc.

So although I can what you are saying about GID being a precurser, it feels (to me) to be quite distinct in its characterisation psychologically. I can also see how you would ‘test’ for GID though observing play and questionnaires/inventories, given the diagnostics are ‘preference’ based, but how do you observe/measure ‘desire’?

True. But I think society as a whole is far more horrified by this than by "gender affirming care"

I think it's a socially communicated and iatrogenic condition.

It's striking how many trans people say in their own words that their dysphoria got progressively worse after they came out and began presenting as the opposite sex. Continued to get worse after hormones and surgeries.

It's like, in the world of eating disorder treatment, it's increasingly recognised that in patient treatment can actually make sufferers worse because they spend all their time focussing on their illness and also learning tips from/competing with each other. I think GD is the same. Socially communicable, iatrigenic.

Great thread! Also, really interesting article.

I'm completely in two minds about how helpful it is. As a non-believer (I don't believe that we all have a gender identity), I'm in agreement with what she's saying. However, I'm now going to contradict myself and say that gender dysphoria does "exist"... for anyone who a) believes that we all have a gender identity and b) feels distressed that their perceived gender identity doesn't match up with their sex.

The concept that we all have a gender identity goes back thousands of years and spans multiple cultures, much like religions. The book "Trans", by Helen Joyce, explores all of this brilliantly. Yes, in some homophobic cultures it's a convenient "fix" for homosexuality, but it's still got enough of a base to be a worldwide belief.

I'm taking a sanity break from X/Twitter ATM and only created my account to contribute to the discussion about children being pulled in to this belief. When I first joined, I deliberately entered discussions with believers to get my head around what they were saying. Yes, I got insulted lots (which I expected) but a recurring theme (which I also expected) was that apparently I did have a gender identity, I just didn't realise it yet because mine was "aligned" with my body. It's remarkably similar to the idea that Jesus will apparently be there for me when I'm ready to let him in to my heart. As with my now ex-belief in god, I used to believe that I did have a gender identity but I no longer do.

IMO there's a risk that if psychologists approach gender dysphoria as if it's predicated on a false belief, they'll limit the positive impact that they can have to help those who are affected by the problem.

I think Dr P is great, and the hypothesis-style title of this thread is too but to borrow from the Dr P article: if the "doctors" in Salem had started from the equivalent premise that there is no such thing as gender identity, therefore gender dysphoria can't exist (this is Dr P's previously stated position), they would have been telling the teenage girls in Salem that possession by the devil is impossible because there is no such thing as a devil. To use more modern analogies, this is like telling the Waco/Jonestown Christians that there is no point undertaking mass suicide because there is no god or the Manchester Arena suicide bomber that the "self-sacrifice" of taking himself out along with his victims was pointless as there is no such thing as Allah.

Despite what I personally believe or don't believe (as it happens, I do believe in ghosts.. for what I see as good reason.. and I'm fully aware that I'm holding cognitive dissonance re "souls" etc in doing so) there will continue to be people who believe that everyone has a gender identity. Personally, I find the Mia Hughes approach to addressing it more helpful as it avoids directly challenging the belief. Copied from the Dr P article:

Interestingly,
@CryMiaRiver_
thinks Autogynephilia should have its own diagnostic category and that Gender Dysphoria, (such as it is), should become a secondary diagnosis to a primary diagnostic category, for example of autism or depression

This still addresses the distress but shifts the focus from the belief to the most obvious issues to address first, via a differential diagnosis approach. It would also presumably work with anyone thinking that they were possessed by a devil or who felt that they had no other option in life but to commit suicide. Beliefs are innocuous until they lead to radicalised behaviour. In the case of gender identity belief, people enter radicalised behaviour patterns very quickly e.g. compelling others to hold the belief (enforced pronouns, women's sports) or body modifications, to address the distress, that aren't supported by a standard evidence base of medical research.

The concept that we all have a gender identity goes back thousands of years and spans multiple cultures, much like religions. The book "Trans", by Helen Joyce, explores all of this brilliantly.

It's a while since I read it, but I don't remember that at all. Can you tell me which part of the book it's in?

Wow thanks OP; great read. Especially the increase in anorexia or suicide where previously unknown
GD definitely appears to be socially contagious. If you don’t have a gender identity then how can you have GD?
It’s been said before about the lack of commonality (right term??) between adult men/young teens re GD.
Perhaps the Loxodonta in the room???

To add:

There are a couple of common sleights of hand that TRAs use when defending the need for medical support for trans(-identified) people. Both fall apart under very little scrutiny as long as you spot the "flip" moment:

1. There's no such thing as ROGD
2. Not everyone who "is trans" has gender dysphoria

Both have come up in this thread.

My response to these would be as follows:

1. It is indisputably observable from the GIDS data that there is a significant spike in teenage girls being referred to gender identity services. The only unanswered question is "why?" It hasn't been proven that ROGD doesn't exist because nobody has researched this hypothesis empirically. Lisa Littman wrote a paper advocating for the hypothesis to be tested and this was clearly too controversial, so got shut down before it could even be tested as a hypothesis. There seems to be a movement towards dusting this off and going on to test the hypothesis. Zucker, Littman and a couple of others are working on it again (there was a thread ages ago on this), plus there has been some more recent activity too, e.g. the article in this thread:
   https://www.mumsnet.com/talk/womens_rights/5151258-gender-dysphoria-in-adolescence-examining-the-rapid-onset-hypothesis-neuropsychiatrie-july-2024

2. Indeed. There are all sorts of reasons why someone declares a gender identity. It will range from pure external influence, acutely felt gender dysphoria through to autogynophilia, sometimes with a blend of these and sometimes with clearly obvious red flags that point one way or the other. Amongst the variations, there will be patterns that can be spotted depending on whether someone is a) a child b) a teenage/young adult female who identifies as non-binary or male c) a teenage/young adult male who identifies as non-binary or female and d) a middle-aged man who identifies as non-binary or female (most likely it will be a female identity).

Obviously patterns have exceptions but there will clearly be those who feign gender dysphoria "since childhood" in order to hide in plain sight.

Perhaps it's just my interpretation of reading it, but when she explores (with well-reasoned cynicism about internalised homophobia) the appropriation of the fa’afafine, hijra and two-spirit cultural beliefs by the TRAs in chapter 3, as far as I understand it behind each of these is the notion that it's possible to have a "gender" that is separate from the body. Some refer to it as the third sex.
When I speak to people IRL about gender identity, most seem to believe that they truly do feel female or male and that therefore it makes sense that "we all have a gender identity". This is what I meant by the concept going back in history and across cultures.

Hmm. Most of the traditional third-gender cultures are so far removed from the modern concept of 'trans' I'm not sure it's possible to extrapolate. And I think none of them have the idea of having an identity only of the 'opposite' gender.

Two Spirit beliefs arguably encompasses a man having a sort of woman identity, or vice versa, but as an addition to their own not substitute. And in virtually all the others it's a question of needing a box for not-men or failed-men in a society that doesn't permit variance among men, or doesn't allow everyday matters to be done without men.

Thank you for posting this, OP.
As is often the case with topics like this, I'm in two minds.
When I first came across the concept of gender dysphoria, my difficult childhood experiences suddenly became clear, and I would willingly identify myself as having had GD as a child. But only to myself, I don't go around wearing it as some kind of badge of 'specialness'.
So I can't agree 100% with an article that says it doesn't exist, because I believe I experienced it; and, happily, grew out of it.

I am a lot more more comfortable going along with the criticism of it being treated so enthusiastically as it currently is as a mental health disorder. I was unhappy and out of sync with the world as a little girl, but the 'treatment' would have been for society not to have imposed a set of gender expectations on me that I hated. My loving family, with zero awareness of MH/GD/anything like that, mitigated my unhappiness by buying me 'boys' toys' and, apart from school and on formal occasion, not making me wear girly clothes.

That was ages and ages ago, and if society had moved along as the Women's Movement suggested, 'Gender Dysphoria' would be less common rather than more common as little girls like me would be free to behave, dress, play and dream in a non-gendered way, free to just be a child who will grow up to be a human being. No medical intervention necessary, just no stereotyping.

Very much this. I am sure it DOES exist, but I'm very unhappy that so many situations are being enthusiastically gathered under the Trans umbrella.
As in the anorexia mentioned before. It exists, and the bandwagon also exists.
Surely we can condemn the bandwagon without denying the distress of those genuinely affected.
We need much more research and discussion on what the causes are, because I have a nagging suspicion that, caught early and treated correctly, many of these cases would not progress and harden into long-term GD. This is one of the saddest aspects of the current polarisation.
I'm not sure if I've expressed myself very well here...

I recognise much of the elements of GD in myself too - and had an ED through teens into early twenties. I think though that I would consider it more a body dysmorphia - not liking my body, its curves, the mess of periods (I started just before I was 10). I’m not sure I understood it in terms of ‘gender’ but definitely did not want to progress into adulthood/womanhood so my dysphoria had a sex-based element to it, if that makes sense? I think had GI been around I might have absorbed this and it may have coloured the les through which I understood this, both at the time and in retrospect.

I think it is these aspects - the fear of change, of maturing into adulthood/womanhood, the sudden acute physical changes, etc - that Dr P is drawing upon when she says that GD doesn’t really exist but is a contemporary/GI way of reframing pubertal angst that has always existed, been treated, and put in our pasts as we age.

I may be wrong, and perhaps I read that article through my own biased lens on this basis, but I do know that one of the ex Tavi defectors is doing a doctoral paper on the incidence of GD in in families where there is a maternal history of ED as it is so common (as is ED/ARFID) in many of the girls with GD.

The body dysmorphia idea is compelling. When it's combined with lesbianism, a touch of adolescent bullying and a whole bunch of people pushing you down the GI path, that's a potent force.