What Does Dysphoria Feel Like?
By: Riley Black
Tags: Transitions, Transgender, Dysphoria, LGBTQ, Gender

If you go and Google dysphoria, the first results are clinical. The Mayo Clinic, one of the top hits, summarizes:

Gender dysphoria is different from simply not conforming to stereotypical gender role behavior. Gender dysphoria involves feelings of distress due to a strong desire to be of another gender than the one assigned and by the extent and pervasiveness of gender-variant activities and interests.

The American Psychiatric Association adds:

People with gender dysphoria may often experience significant distress and/or problems functioning associated with this conflict between the way they feel and think of themselves (referred to as experienced or expressed gender) and their physical or assigned gender.

Distress. Problems. Distress and problems that doctors themselves inflamed by treating transgender and genderfluid identities as pathological for decades. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition only dropped “gender identity disorder” in 2013, a recent shift away from telling trans people they shouldn’t exist and towards alleviating the pain of dysphoria. The World Health Organization was even further behind the curve, only making the change to no longer classify being transgender as a disorder in 2018.

And throughout all the years that doctors and bureaucrats debated definitions and disorders, people like me have lived with the experience. Where are our voices in all this? Why are flat and academic statements from advisory boards the first results when I search for dysphoria rather than the perspectives of people who know this ache?

Perhaps it’s because dysphoria is incredibly individual. “Distress” is correct, but how that distress manifests varies in its center and expression. I feel relatively neutral about the genitals I was born with, but someone else might feel those parts, on their body, are awful and incongruent with who they are. Meanwhile, I often look at the angles of my face and my torso with despair, while someone else might not be bothered much. And while I am slowly grinding through whole-body changes step by step, other people might experience dysphoria only about specific parts.

The common denominator of dysphoria is distress, but that’s about all. Much like depression — which I’ve also struggled with for much of my life — the experience itself is incredibly individual. The hurt is what’s shared, but where that hurt resides, and what relieves that hurt, can only be articulated by each person. It’s not necessary to quantify, measure, or boil down to a graph to know it’s there. We feel it.

In that sense, I can only speak for myself. Perhaps you’ll recognize these feelings. Perhaps not. But since I startled awake, feeling like I awoke in a body I never wanted, I’ve been turning over my dysphoria like a particularly strange insect I found in the yard, trying to identify what makes it so peculiar.

My dysphoria is cowardly. It’s not there every moment of every day, beating a drum and chanting that my body is wrong. Ambush is more its style, waiting until I’m already feeling burdened by depression and worry. If I’m sad, and I eat comfort food, then my dysphoria will point to the patch of flesh under my chin or the shape of my stomach and say “Makes you look like a dude.” The parts of myself I’m proud of can be turned against me. “Yeah, you’ve got tits, but everyone still sees you as a man, and shame on you for equating breasts with femininity.” (Guilt likes to jump in to help.) If I have an argument with my girlfriend, I’ll fret and worry that the tone of my voice sounds like a condescending man or that I’ve transmitted any of the ways my father used to erupt at me even if I draw on everything I’ve learned in therapy to be empathetic and productive.

It never feels like a pain. There’s no pinprick or physical sensation beyond the effects of alarm or anxiety. It can be maddening — my body is telling me something is wrong, but there’s no obvious physical threat, and so my mind races to find something to match the sensation, to validate it. Retraining is difficult work. I can pick out five things I see, four things I can touch, three things I can hear, two things I can smell, and one thing I can taste to help me wind down, but even though techniques can feel like an old forgotten bandaid from the back of the medicine cabinet — too weak to stick, too small to cover the damage.

My dysphoria feels like an evil alter ego, a presence that keeps score on every count and remembers those weak points with precision. It’s the worst manifestation of my inner critic, taking in every time I’ve been misgendered, glared at, and shouted down, fitting each into a pattern that becomes a message of “Why couldn’t you have just been happy? No one is ever going to see you for who you want to be. Why are you asking for so much? You don’t deserve it.”

I’ve heard this things before. From my father. From an ex. But the message never comes through in their voice. It’s always my own, speaking for them. I push back. I tell myself that the whole reason that microaggressions and misgendering matters is because I know how it feels so feel unwelcome, unseen, unreasonable. That a lack of social acceptance makes the dysphoria worse. It’s not a feeling that only bubbles up from the inside, but is reinforced every single day, even time I have to chirp “Oh no, it’s Miss, please” in an attempt to stand my ground without getting worse treatment.

Logic can only go so far. Dysphoria can be distracted, but it can’t be reasoned with. If it slinks off for a while, and it’ll be back the next time depression starts to tell me that my day would be better spent entirely asleep. That maybe there is not a future for me. That perhaps where I am not is as good as I’m ever going to feel, and asking to be happy would be too much. It’s a tension that creeps across my shoulders and the back of my neck, making me forget to breathe.

I try to center myself on variation. I’m a science writer, and I’ve spent most of my career writing about evolution. Despite science’s obsession with typology — making boxes to put all of nature into — evolution couldn’t happen without a whole spectrum of traits within a species, all of them valid. Whatever I am feeling dysphoric about — whether it’s the size of my hands, the way the fat on my stomach sits, the sound of my voice, or whatever it may be — there is a femme-presenting person who shares those traits with me, and I wouldn’t dare call them less of a lady for it. Even sex-based traits I was taught are definitive — like the angle of a notch in the hip — are on a spectrum. How much of my distress comes from boxes that other people made and I never asked for?

Running through the exercise can help, trying to reason against my dysphoria. But it’s also a feeling, and one that can snap unexpectedly. Sometimes the most I can do is let is pass and shamble off. Will it stop me from taking my hormones? No. Will it stop me from doing the same tomorrow? No. It can make me feel awful, but it can’t stop me. Dysphoria can only use the power it’s given. Let it starve.