We Indians love to think that we are a very traditional country with no “modern age rubbish” in our society. However, gender dysphoria and transgenderism is as old as India itself. But how many of us feel okay to talk about it? No one is talking about gender confusion in people close to us. So, we here at OurClearMinds thought we might give it a try.
There is Much Confusion
First of all, let us clear one thing out early. Transgenderism and gender dysphoria are not repeat NOT the same things. Transgender people are born with complications in sexual organs and/or hormone production issues. Gender dysphoria is something that comes to your mind despite having a perfectly standard male or female human body.
Gender dysphoria (GD) neither is a sexual orientation issue. For example, if you’re a man and you like men in a sexual way, that does not automatically change your gender to a woman — that just makes you gay. Which is a great thing if you can embrace your proper sexual orientation, despite social issues.
The most common misconception in India is that sex and gender are the same. Oh NO they are NOT. Let us clarify this further.
Your sex is directly dependent on your body. What sexual organs you have (internally and externally), what hormones your body produces, and how your body functions in the matter of sex and reproduction are the indicators of your sex.
If your body is a standard one representing a majority of males or females, then your sex is male or female. But if your body has a mix of both sides (or you choose to make it so), then you can be a transgender. It’s completely about your biology, not feelings.
Your sex is completely your private matter and no one has any business about it except yourself (unless, they are trying to have a baby with you).
However, gender is purely psychological and a personal choice. That is to say, if a physical male feels everything in a feminine way, then he can actually be a ‘she’. It’s all about how you feel inside, not about what is dangling between your legs (or isn’t).
Your gender is something you decide, not something you were born with. This is harder for transgender people since they are often confused about their physical sex. And that causes no end of psychological problems in them — we will discuss these issues in more articles.
Your Gender is how you appear to people and therefore it is more of a social matter than private physiology. Meaning, you can technically use a female restroom even if you can pee standing, provided you fully identify with the female gender, represent yourself that way, and pose no threat to the other biological females using the facility.
Sexual mating choices are yet another part of the whole matter of human sexuality. There is hot debate about whether it is a choice or it is something innate — but everyone agrees that it is completely irrespective of either your sex or gender.
Male/female, masculine/feminine, trans — all can mix and match in the wonderful spectrum of mating choices. And yes, all combinations are possible (given consent and opportunity). This is also a social matter since this matter concerns choosing a partner.
With that out of the way, we can concentrate on the actual subject of today’s article: gender dysphoria.
What is Gender Dysphoria
Gender dysphoria is when you can’t be happy with who you are sexually. The way you were born may not be adequate for your emotional needs — it is quite common to want something different. For example, there are plenty of men who are totally awed by female orgasm and want to have that kind of feeling. (Of course, precious few ever talk about that sort of stuff, let alone admit it.)
A person with gender dysphoria is often at war with their own body parts. They may not like their external sexual organs like penis, vagina or breasts. They may also dislike other body features that are indicative of sex (like hips or beard). They may not like how they walk or talk and make a conscious effort to sound or act like the opposite sex.
A type of gender dysphoria is all about how your own mind feels to you. You may not have any problems with your body, but with your mind itself. These people hate how they behave in certain situations where sex plays a role. They honestly intend to react more like the opposite sex. However, since there are no defined rules about how a man or a woman should act in a given scenario, this mostly is a battle with social norms of gender identity.
Be that as it may, GD is not just a phase you’re going through. It is a recognized, noted, and defined medical condition, and it is treatable. Treatment may cause you either to come to accept your biological sex, or to decide to change it. Either way, peace of mind is the goal here.
While it is not a very common matter — transgenderism is more common — there is still a high number of GD cases around the world. According to the American Psychiatric Association, there may be over twenty million people in the world with gender dysphoria. That’s nearly as much as Australia’s population!
That number can actually be much higher than that assumption. The cases of gender dysphoria are much more hard to detect in developing and third-world countries such as in South Asia. Simply put, people don’t want to talk about it.
Think about it. If any of us was unhappy with their penis or breasts, do you suppose they would go to a doctor and ask about it? No chance, they would suppress it and it would come out in some other grotesque manner, often including some kind of hate.
Effects of GD
If you hate yourself in any way, depression is most often the quickest outcome. Gender dysphoria, too, works the same way. Dysphoric people are often highly depressed and lonely, and some of them even go suicidal. Some try to drown their suffering in booze or drugs. If this happens from childhood (commonly it does), their studies and performance would be significantly hurt.
Some gender dysphoric people try to hurt or change their bodies. There are girls who bind their breasts tightly so that they have a flat chest, at the cost of health. Some boys tie up their penis and push in the testicles to make them disappear. Some who have access to special equipment torture their genitals with electric shock or burn.
They may also inflict self-harm in other ways, like cutting on their other body parts. The pain works like a drug on them. They hate their bodies so much that they hide behind pain.
As we said before, suppressed gender dysphoria can come out in bizarre, horrible ways. Transphobia and homophobia are two very common examples where the phobic person him/herself had secret longing to be the opposite sex but was disgusted of this craving, and hated self for it.
The suicide rate among gender dysphoric people is quite high. Understandably, one can want to destroy themselves if they can’t stand being in their own skin. In India, half of transgenders have attempted suicide at least once.
Milder cases of gender dysphoria may come with behavioral changes. For example, cross-dressing, or some sexual perversion or fetish (pegging or similar), or choosing to pee like the opposite sex, etc. While these are not a cause of concern by modern sociological norms, these people should watch themselves closely in case it hurts someone.
Treatment of Gender Dysphoria
First of all, gender dysphoric people are as normal as anyone else. It’s just that their sex and their gender does not match and they are frustrated because of that. Modern science is quite capable of understanding and fixing the issue.
If a dysphoric person has issues with just one body part, that can be changed surgically quite easily. Many women choose to undergo breast reduction surgery to make their chests as flat as boys. If one has problems with his penis, it can be removed and a pipe can be fitted for hygiene quite easily.
However, complete sexual change is much harder to achieve, not to mention expensive for countries like us. Not only by medical means, a person will have to change socially as well. Both of these are monumental achievements in a person’s life. But they are achievable, and there are plenty of examples of people living happily after the transformation.
The majority of gender dysphoria patients (over 75%) are male-to-female (MTF) so far in India, so we will discuss the procedure of that change here. A sexual man can become a sexual female, almost fully, by going through certain medical procedures. These include:
- Hormonal Replacement Therapy (HRT) to replace male hormones with female hormones in the body.
- Permanent removal of facial hair and any other unwanted hair, generally with laser.
- The female hormones (mostly estrogens, antiandrogens, and progestogens) gradually change the body shape and hair growth from male to female.
- After HRT has been going on for a year or so, at least two unconnected psychiatrists must reevaluate the mental condition of the subject. Because, it is seen that many people become happy with the external appearance changes, and don’t want to undergo the surgery.
- If the person still wants to change the actual genital organs, the Sex Reassignment Surgery (SRS) takes place.
- SRS removes the penis and testicles and reshapes the genital area to curve inwards, making a kind of makeshift vagina.
- Some people also choose to remove their adam’s apple from the throat, change vocal tone to a higher pitch, and get bigger breasts.
The female-to-male (FTM) version of sex change is not much different from this, except the surgery is much more complicated. We may talk about it another day.
If you are unhappy with your sex organs or your body shape and you secretly want the shape/organs of the opposite sex, chances are that you have some form of gender dysphoria. You can talk to a psychiatrist to come to terms with your present body, or if you can afford it (physically, socially, economically), change your gender. Both are completely fine.