Gender Dysphoria and Transgender/Nonbinary Identities

Gender dysphoria is currently described in the DSM-5 as follows:

> Gender dysphoria refers to the distress that may accompany the incongruence between one's experienced or expressed gender and one's assigned gender. Although not all individuals will experience distress as a result of such incongruence, many are distressed if the desired physical interventions by meeans of hormones and/or surgery are not available. The current term is more descriptive than the previous DSM-IV term *gender identity disorde*r and focuses on dysphoria as the clinical problem, not identity per se.
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In earlier versions of the DSM (III and IV), people experiencing gender dysphoria had been diagnosed with "gender identity disorder," which brought with it some heavy implications about gender non-traditional people and perpetuated some harmful ideas about gender nonconformity. With the DSM-5 came a different perspective and a focus on treatment by targeting the dysphoric feelings rather than the identity itself.

Organizations such as PFLAG and Human Rights Campaign have created glossaries that establish shared language in order to facilitate constructive conversations around these and other diverse populations.

**Gender Dysphoria, Transgender/Nonbinary Identities, and Healthcare**

As mentioned in the definition of Gender Dysphoria when people do not feel they are congruence between their experiences and expressed gender may go on to feel further distress. One of the reasons for the feelings of distress is when a person does not have access gender-affirming surgeries and hormones. The process to receive gender affirming surgeries can be stressful and difficult. The he pathway to receiving gender-affirming surgery requires a multidisciplinary team to ensure all aspects of the transition are properly completed.  Due to the increase in demand there is an increase in surgeons who will perform high quality gender-affirming surgeries. Although there is an increase for supply and demand there is not universal education on the specific needs of the patients receiving these surgeries since they are relatively new to the field. Given the gap in education there needs to be the opportunity for formal training in order to address all of the complexities that are involved in aiding patients of the transgender community with gender-affirming surgery.

The benefits of receiving gender affirming surgery is that it has shown to decrease rates of depression, anxiety, and suicidality. The healthcare profession should afford each person the right the be affirmed, respected, and not criticized for their identities or their choice to do gender-affirming surgery.  While there are immense benefits not everyone agrees that gender affirming surgery is necessary or even ethical. There are even laws in 15 states like Iowa that have banned or plan to gender affirming surgeries for children. These bans prevent people from living their most authentic lives but there is a push for legislators to pass bills in support of transgender rights. Specific areas that need to be addressed are to first recognize transgender health is a right not a politicized issue, that there should not be bans for medical treatment for members of the transgender community, and promote further education on the necessity of gender-affirming surgeries. Until further legislative changes can be made there still is hope because there are medical providers who promote transgender health and well being.

**References**

1. ↑ American Psychiatric Association. (2013). *Diagnostic and statistical manual of mental disorders* (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
2. ↑ American Psychiatric Association. (2000). *Diagnostic and statistical manual of mental disorders* (4th ed., text rev.).
3. ↑ American Psychiatric Association. (1987). *Diagnostic and statistical manual of mental disorders* (3rd ed., rev.).
4. ↑ Byne, W., Karasic, D. H., Coleman, E., Eyler, A. E., Kidd, J. D., Meyer-Bahlburg, H., Pleak, R. R., & Pula, J. (2018). Gender Dysphoria in Adults: An Overview and Primer for Psychiatrists. *Transgender health*, *3*(1), 57–70. https://doi.org/10.1089/trgh.2017.0053
5. ↑ 5.0 5.1 5.2 5.3 Weissler, J. M., Chang, B. L., Carney, M. J., Rengifo, D., Messa, C. A., 4th, Sarwer, D. B., & Percec, I. (2018). Gender-Affirming Surgery in Persons with Gender Dysphoria. *Plastic and reconstructive surgery*, *141*(3), 388e–396e.
6. ↑ 6.0 6.1 6.2 https://www.aamc.org/news-insights/what-gender-affirming-care-your-questions-answered
7. ↑ de Vries, E., Kathard, H. & Müller, A. Debate: Why should gender-affirming health care be included in health science curricula?. *BMC Med Educ* 20, 51 (2020).
8. ↑ 8.0 8.1 8.2 Abreu, R. L., Sostre, J. P., Gonzalez, K. A., Lockett, G. M., Matsuno, E., & Mosley, D. V. (2022). Impact of gender-affirming care bans on transgender and gender diverse youth: Parental figures’ perspective. *Journal of Family Psychology.* Advance online publication