Gender dysphoria is the mental health term for a disruptive inner conflict between one’s physical/biological gender and one’s personal identification as male or female. The American Psychiatric Association (APA) began using this term in 2013 when it released the newest edition of its Diagnostic and Statistical Manual of Mental Disorders. In a study published in June 2013 in the Journal of the American Academy of Child & Adolescent Psychiatry, a multinational research team identified some of the factors that influence whether or not early early-age gender dysphoria will continue into adolescence.
Gender Dysphoria Basics
Prior to 2013, gender dysphoria was officially recognized by the American Psychiatric Association as gender identity disorder. However, the APA decided that the terms used to define this disorder unnecessarily stigmatized people who have mental/emotional conflicts with their biological gender, and chose new terminology to express these conflicts in more neutral language. While the gender identity disorder definition and placement within the Diagnostic and Statistical Manual (DSM) characterized gender dysphoria-related issues as inherently unhealthy or damaging to the individual, the new definition and its placement within the DSM focus on the challenge of coping in a healthy manner with the emotional/psychological conflicts that come from feeling that one’s physical and mental genders don’t match up. Conservative estimates indicate that roughly one out of every 30,000 women and one out of every 11,000 men have gender dysphoria. However, figures are only available for people who seek help from mental health professionals, and the condition almost certainly occurs substantially more frequently. In addition, some people who don’t identify with their biological gender don’t feel harmed by their dual mental and physical status, and therefore don’t meet the criteria for gender dysphoria. Some affected individuals first feel significant gender conflicts from a very early age, while others may only feel these conflicts as they grow older. No one knows exactly why gender dysphoria occurs, although proposed underlying factors include genetic predisposition, certain changes in the chemical environment surrounding a developing fetus, and the ways that gender roles are portrayed in a young child’s home environment.
In the study published in the Journal of the American Academy of Child & Adolescent Psychiatry, researchers from the Netherlands and the U.S. assessed the relative importance of several factors in increasing the chances that a child with gender dysphoria will still experience that dysphoria as a teenager. They made this assessment by examining 127 teens who received an initial diagnosis for gender dysphoria before reaching age 12. Some of these adolescents no longer had dysphoria-related symptoms, while others still had those symptoms. Each participant was assessed according to such factors as his or her state of mental/emotional health, socioeconomic background, level of social integration, severity of childhood gender dysphoria symptoms, severity of current gender dysphoria symptoms, self-described gender preference, and physical self-image. After reviewing the collected data, the study’s authors found that the largest single predictor of gender dysphoria during adolescence is the presence of especially prominent dysphoria symptoms during the earlier stages of childhood. Children born as biological girls also have greater chances of experiencing teen gender dysphoria than children born as biological boys. Other factors that may influence the likelihood of continuing gender dysphoria during adolescence include the development of dysphoria symptoms at a relatively early age and an early childhood transition toward social roles stereotypically associated with one’s opposite biological gender.
Negative outcomes associated with gender dysphoria in teenagers include increased risks for diagnosable anxiety disorders or depression, as well as increased risks for serious conduct problems. However, the authors of the study in the Journal of the American Academy of Child & Adolescent Psychiatry note, specific outcomes of the disorder can vary significantly between biological teen girls and biological teen boys. For this reason, they explain, mental health professionals working with gender dysphoria-affected adolescents need to take biological gender into account when developing individualized treatment plans for their patients. Some adults with gender dysphoria undergo sex change operations in order to bring their mental and biological genders into alignment. However, teenagers under the age of 18 are not typically candidates for this type of surgery. Doctors also commonly don’t perform sexual reassignment surgeries on people who have not adopted their desired gender in non-surgical ways for a period of at least two years before making a request for reassignment.