Gender dysphoria is for life

[Seethlaw]

Gender dysphoria is a life-long condition, with or without transitioning.

Even after transition and in no particular order:

• Gender dysphoria is the unrelenting knowledge that under it all, despita everything you've done, your body is still and always will be the wrong sex.
• Gender dysphoria is scars on your body.
• Gender dysphoria is feeling guilty because you make your loved ones' life more complicated.
• Gender dysphoria is having to choose which pre-transition memories you can share and/or having to carefully rewrite them in the opposite sex.
• Gender dysphoria is having to choose between telling your new healthcare provider about your transition and your hormonal treatment, or risking them giving you inappropriate care.
• Gender dysphoria is a lifetime of medication and specialist appointments.
• Gender dysphoria is never being sure whether people truly support you or only humour you.
• Gender dysphoria is being clocked every once in a while and wondering how many people figured you out and you didn't notice.
• Gender dysphoria is wondering how and when you're going to explain to that new person you like that you weren't born the sex you present - and being anxious about how they are going to react.
• Gender dysphoria is never having the sex you really wish you had because even the best fake plumbing is nothing like the real one.
• Ironically, gender dysphoria can even be wishing you could dress or present in a more genderfluid manner, but anything that takes you closer to your birth sex presentation makes you feel worse, no matter how great you think it looks on other people of your desired sex.

And so forth and so on.

The idea that transition ends gender dysphoria is a harmful myth. Gender dysphoria is something that all trans people must learn to live with, whether they transition or not, and no matter at what age they transition. There's no avoiding it; there's no ending it. There's only managing it, carving a happy life for yourself around the good bits, and learning to handle the bad parts in a productive way.

I wish more trans people faced that reality, instead of insisting on living in a fantasy where going through the perfect transition and forcing people into behaving in the perfect manner would mean never having to suffer gender dysphoria ever again.

Many mental illnesses are for life. I had body dysmorphia in my teens leading to anorexia and bullimia. I wouldn’t say it’s have gone away entirely but with treatment they don’t define my life anymore and I’m no longer anorexic.

It seems logical to me that enabling a person with gender dysphoria to transition isn’t going to cure it, in the same way allowing someone with body dysmorphia to keep starving is unlikely to have them reach a point where they say ‘ok, I’m thin enough now I’ll start eating again’ with no other support.

Nothing will ever be enough for somebody with this kind of mental illness without proper mental health intervention to change the thinking patterns which lead to somebody believing their body is wrong. Changing the body isn’t the solution, it’s about changing the thought processes to cure the mental illness.

I am very interested to read what you have to say about life pre-transition, 'passing', and what and when to tell other people about your history, because these topics are a big source of political tension.

TRAs typically argue that everyone should be allowed to conceal their sex, and that pre-transition life should be erased, to the extent that even the slightest reference to it is gravely offensive. I feel this approach is untenable:

It puts people under pressure to take medical steps to pass.

Some people will never pass – this makes them 'second class'.

It puts people under pressure to transition early and in haste, because pre-transition life is seen as a worthless waste of time

Erasing pre-transition life hurts the person's family and friends by rewriting their lives too.

Having a convention of 'concealment' of something which is usually obvious is infuriating to people who are being forced to lie.

And sometimes we must know someone's sex, for data integrity, medical safety, applying sex-based rights, safeguarding, and fairness in competition.

Is it feasible to move to a paradigm where trans people are 'out and proud' and pre-transition is just another part of their life with its own joys and sorrows? I note you say:

I didn't proceed with the transition until I felt absolutely certain that, "It'll be okay, because I'll have been true to myself until then, and those few years will have been better for it."

This means you never have to have a big reveal, never worry about passing, don't risk wrong medical treatment etc, and can talk freely about your past. The downside is being 'a transman, but not a man'. I am aware that 'outing' is a big deal, but really it shouldn't be, because there's nothing wrong with being trans.

Of course, people could continue to believe that TWAW and TMAM in some sense, but it would have been delinked from its legal and physical consequences, which are what are causing all the trouble.

What a thoughtful and reflective thread, thanks @Seethlaw .

The TiM I knew fell into OPs trap. Realities of the operations complications, his kids cutting him off all caused huge pain, the side eye.
That was magnified by suddenly "becoming" on paper, a female 60 year old jobbing consultant, and suddenly all the jobs vanished. The actual 60 year old female consultants in the sector were unshocked, but the misogyny came as a surprise to him it seemed.

I've contacted MNHQ. We'll see if they can help me out here.

Can you give some examples?

I think we've briefly chatted along these lines before, OP, but you've brought up the concept of 'true trans' - what do you mean by that? And what do you make of people - I would say this is the main push behind the current 'trans' movement - who say that gender dysphoria is not required to be transgender, it's 'medicalising' people for being their true selves?

Basically the (original?) concept that 'trans' means 'wanting to be the opposite sex' is in opposition with 'actually 'man' and 'woman' means feelings, not the sex of the body, and a man is any person (m or f) with feelings, and a woman is any person (m or f) with feelings, but different, therefore trans just means the feelings you have don't align with the feelings assigned to man/woman' - invoking this thing called a 'gender identity' which is unrelated to sex?

My feeling is that most people would absolutely accept that someone with gender dysphoria needs some kind of help and compassion.

But pushing the idea that all women are actually only women because of unspecified feelings - because that framing, removing any definition of 'woman', is the only way TRAs can say TW are literally women - just reveals totally sexist, homophobic and contradictory thinking.

I feel the muddling of the two approaches has actually caused more people to consider medical transitioning than persistent gender dysphoria.

Sorry, I'm aware that probably isn't very clear...

I've found your posts very interesting and valuable @Seethlaw

I count among my blessings, feeling happy in my own skin. Albeit there's a bit more of it, and me, than would be ideal - but that's by no means unusual in a busy middle aged desk worker.

As for the gender feelings, I've always struggled to fit in with Bloke Life and the sexist expectations underlying it. It never once made me feel I'd rather be a woman but I've often felt like I'm not really Manny Enough, iyswim.

Ironically discussions here with the majority female posters has clarified my thinking and given me some useful understanding and language to describe my thoughts and relationship to what can broadly described as masculine gender.

Well am I glad I read the whole thread before posting!!

I had taken issue - more in sorrow than in anger😔with what I thought Seethlaw was saying about GD being a life-long condition, full stop.

Reading, on I see you say it is [potentially] life-long if not dealt with appropriately when it first manifests itself, you are not saying it is 'for life'.

Except that you kinda did, in the very thread title, so you can't be surprised that that's what a number of posters responded to, and I nearly did😏

The point that I was making in the post that I will not post now cos it would be missing the point..was that:
it's really important to assert the truth that it is entirely possible for a child to have really serious, extreme 'gender dysphoria' [if it exists, it is not an accepted term, but I'll use it as a shorthand] and to come to a place of healing and harmony with the reality of their body and its biological sex.

It seems to me that that place of balance and acceptance and body positivity is harder to achieve in an environment where PBs, social transitioning at school, hormones, surgery, flags, legislation, etc etc are on offer.

I'm sure the Child Me would have wanted to camp out overnight to be sure to be first in the queue for the PB trial. That said, I had parents who saw their job as parenting, not 'being an ally' so I think one of my mam's famous 'looks' would have nipped that plan of action in the bud
.My parents were as pragmatic as they were loving, and that's what got me through the period in my childhood where I secretly planned killing myself before puberty started -

I gradually accepted what they taught us: that you can't change what you are, but you can change who you are and how you live what you are. They meant in terms of education, social background, etc., but I applied it to my sex/gender confusion.

So here I am now. Not dysphoric at all

'Informed consent' for children about PBs has to include the information that even extreme cases of GD - like my 'I'd rather kill myself than grow up to be a woman' - can and do resolve themselves without any medical intervention.

Seethlaw is making the valuable point that 'those who think that transition will make dysphoria disappear, will discover that it doesn't work that way.'
which is another important piece of information needed to be considered before 'informed consent' is possible.

I'm glad I read on and didn't over-react to 'Gender dysphoria is for life' in the thread title, Seethlaw - you're such a thoughtful and considered commentator on here, you're like a regular down the pub who I'd stop and have a few* friendly words with 'Hiya, how are you? how's life treating you? Good? grand so! see you around. Take care. Bye now' before going to meet my pals.

We might even sit down and have a chat about being gender diverse, growing up different, somehow holding on to our sense of humour, and style, comparing notes about where our journeys diverged... maybe.

*'a few friendly words' in Ireland usually means a short paragraph of
'howya how's it going nice to see ya are ya doin well grand so sure lookit as long as you're winnin, what? grand so I'll see ya around g'luck now bye bye now bye bye bye bye...'
diminuendo as the speaker disappears😁

Yes! A hundred times yes. I've only read the SEGM piece for now, but honestly, it feels so good to read such reasonable material already.

The article concludes that until these questions are clarified, gender-affirming interventions should not be offered as part of standard medical care to young people, following one of the oldest guiding principles in medicine: first, do no harm.

Exactly!

And also:

Many of these young people also present with co-occurring psychiatric conditions, histories of trauma, or dysphoria that emerged relatively suddenly—a more complex clinical picture poorly served by the assumption that each person harbors an innate gender identity waiting to be discovered.

Those kids are not trans. They just happen to experience the same symptom as "true trans" people do. But a symptom can point to different conditions, and those kids are not trans, and shouldn't be transitioned; that's just not the right treatment for them.

I hope many other papers come out in the coming years supporting this one.

I totally understand, and I'm actually glad it's been pointed out to me how my title and OP can be read. I really don't want to be seen as promoting the doom view that nothing can be done about gender dysphoria!

I find actual gender dysphoria really interesting.
But always have in the back of my mind that two of the symptoms in children are

"A strong preference for the toys, games or activities stereotypically used or engaged in by the other gender"
"A strong rejection of toys, games and activities typical of one's assigned gender"

The idea that toys are even 'tied to a sex' in the first place is a symptom of a massive societal problem, if you ask me!

Some other symptoms in children are:

A strong dislike of one's sexual anatomy (that would raise red flags for me in younger children)

A strong desire for the physical sex characteristics that match one's experienced gender - I don't understand what that means - surely 'experienced gender' is the one you are being brought up as?

I particularly liked this take, by SEGM:

…the new publication points out that "gender identity" is defined circularly as an internal sense of "gender" which itself is not independently defined. The article's author, Professor Mikael Landén, points out that this ambiguity had little practical consequence when the concept applied to a small, homogeneous group of mostly mature adult males seeking to live as members of the opposite sex. The stakes are considerably higher now that the primary patient population is youth viewing their adolescent experiences through the poorly defined but culturally promoted lens of "gender identity."

In essence, back when there were a handful of mature adult men wanting to undergo so-called sex-change surgeries, the fact that the definition of “gender” or “gender identity” was so ridiculously woolly was thought of as kind of unimportant. It was a handful of men, what effect would it have to define their “dis-ease” more carefully?

And now we see what effect it has. Slippery slope.

@RareGoalsVerge

I completely empathise with and understand everything you've described in your post.

I just have a minuscule quibble with the conclusion:

But that's not a position that one can decide on rationality grounds to adopt, the heart feels what it feels and wisdom accretes as slowly as a stalagmite and cannot be sped up by effort of will or reading a convincing post on mumsnet.

I would argue that each convincing post on mumsnet is a drop that contributes to making the stalagmite grow 😉One post won't do the trick, sure, but post after post, you know? Still, I agree that the heart feels what it feels, and sometimes we have to resign ourselves to the heart and the brain not being quite aligned.

the heart feels what it feels, and sometimes we have to resign ourselves to the heart and the brain not being quite aligned.

I'm reminded of what the central character's mother says in Oranges Are Not The Only Fruit:

‘So just you take care, what you think is the heart might well be another organ.’

She meant that it might be indigestion, as far as I remember..😁

@Seethlaw I think you and I are very much in alignment in our thoughts. I just learned a very long time ago how futile it is to tell people how wrong they are on the internet and I know that the "ploppers" who drop in to tell us that we are all meanies for not understanding that TWAW are never going to be convinced by the well-researched and well-evidenced replies that set out the rational basis for our position. Yes for some, hopefully for the lurkers who read these threads trying to make sense of it all, each convincing post on mumsnet is a drop that contributes to making the stalagmite grow

Thanks so much for writing and sharing this @Seethlaw We found out 2 weeks ago that our son started hormones in January 😭

@Seethlaw I don't recall if you were on the thread about the Finnish study, but it's worth a read, particularly for the graphic showing long term psychiatric outcomes (attached).

The outcomes were much worse for GD subjects who received GAC than for those who didn't, despite starting off, on average, with much lower rates of psychiatric morbidity.

It's still not possible to say that GAC didn't improve psychiatric outcomes compared to what they otherwise would have been, because the data need further disaggregation of treatment arm versus initial morbidity, and possibly of incidence of psychiatric events versus period elapsed (with no guarantee of maintaining significance). But you can say for sure that GAC is no guarantee of psychiatric plain sailing in the coming decades!

@Seethlaw Thank you for all your thought provoking posts. I have learned a lot from you. Aside from that I live in France & wish that I could write colloquial French as well as you write English. Your command of English would put many a native speaker to shame.

@Seethlaw thank you very much for this thread. As mother of an adult who has recently transitioned (and me a regular on this board) you’re confirming what I suspected. It’s not for me to decide but I don’t think my adult child has gender dysphoria - I think it’s a mix of trauma, psychological and neurological issues and the welcoming arms of T/Reddit leading to a mistaken conviction and retro fitting of childhood.
Can only wait it out supportively - a parent of an independent adult has little leverage or weight here. I’m there in every way they need or want me to be of course.

Solidarity. Similar situation for me 😭

How do you feel about the work done by the trans lobby that has removed gender dysphoria as being part of being trans?

Quite frankly, I think it's evil, because they are quite clearly trying to aggregate people who have nothing to do with being trans, under the trans umbrella, in order to legitimise their de-psycho-pathologisation(?) push. Except that not only do they end up pathologising those other conditions (people who are not trans at all end up transitioning), but I also don't agree with the whole depathologisation in the first place.

Gender dysphoria as I'm experiencing it is clearly a pathology. I mean, I literally don't see my body as it is! There's no rational frame of thought under which this is normal. Moreover, and that's the crucial bit I think, this distorted viewing interferes quite strongly with my life. It has pushed me into making quite severe changes to my body, and it still brings me a measure of dissatisfaction. Taken all together, that's clearly pathological. So arguing that the whole of "trans gender" should be depathologised just doesn't sit well with me.

And then at the same time, they argue that people will kill themselves if they don't transition, and that the NHS should carry the whole cost of transition. Hypocritical and dishonest, much!?

Bad news, guys: I've asked MNHQ if changes could be made to the title and/or the OP, but they say the changes would change the meaning too much, and would change the context of the replies that have already been posted.

Ah well, that'll teach me to be more careful when posting. Sorry, everyone 😟!

💯

Interesting - thanks for posting!