Caitlyn Jenner's much-anticipated memoir, The Secrets Of My Life, is out today, and it's bound to spark discussions about trans issues. There's already been some debate, based on an episode of Keeping Up With The Kardashians, about whether or not Kris Jenner knew about Caitlyn's gender dysphoria before they got married. That's an issue for the Jenner-Kardashian family to suss out. But, if you're hearing the term "gender dysphoria" for the first time, or need a refresher on what that means, it's totally okay, because it's actually a relatively new term.
Gender dysphoria is a clinical term used to describe the "conflict between a person's physical or assigned gender and the gender with which he/she/they identify," according to the American Psychiatric Association (APA). "It's a broad term that could refer to social dysphoria, discomfort in how one is being perceived, or physical dysphoria, discomfort in one's body," says Eli Erlick, director of Trans Student Educational Resources (TSER). Someone with gender dysphoria might feel uncomfortable with the gender they were assigned at birth, with their body, and/or with the gender roles they're expected to conform to, according to the APA.
Using Jenner as an example, in the first season of I Am Cait, she talks about feeling discomfort around her voice, because she has a lower-register voice, says Aydin Olson-Kennedy, MSW, executive director of the Los Angeles Gender Center. "That's gender dysphoria, even though it's not connected to her physical body," he says. "[Gender dysphoria is] all the things we think about, negotiate, and strategize being trans in a world that's not accommodating to alternative experiences around gender." Generally, someone with gender dysphoria has a "strong desire" to be another gender or be treated as another gender, according to the APA's diagnostic criteria.
"Transgender" is who we are while "gender dysphoria" is what we may experience.
Someone can exhibit symptoms of gender dysphoria at any age, but puberty tends to be a common time, since children might find it harder to identify with their bodies as they begin to change. Some research has found that kids who are more outspoken or persistent in talking about their gender dysphoria are more likely to come out as transgender. It's also important to recognize that not all transgender people experience gender dysphoria, Erlick says.
So what exactly is the difference between someone with gender dysphoria and someone who is transgender? "Transgender simply refers to someone who doesn't identify as their sex assigned at birth, while gender dysphoria refers to those who have discomfort or distress in how their gender differs from their assigned sex," Erlick says. "'Transgender' is who we are, while 'gender dysphoria' is what we may experience."
This distinction is important, because before 2013, the APA referred to those experiencing gender dysphoria as having "gender identity disorder." That term is now considered outdated, since it describes the gender identity itself as a disorder, Olson-Kennedy says. Gender dysphoria, on the other hand, is a label for distressing symptoms transgender people may experience as a result of their identity.
The goal of this name change was to remove any stigma, and "ensure clinical care for individuals who see and feel themselves to be a different gender than their assigned gender," according to the APA's press release about the name change. Olson-Kennedy works at a practice made up of all trans and gender-nonconforming therapists, and says that having gender dysphoria in the DSM can be validating for some people. "When you're in distress, having something like this to say, This is what I have, can be validating and help people feel legitimized," he says.
While Olson-Kennedy says that this new DSM classification isn't without its own problems, from a diagnostic standpoint, someone has to show symptoms of gender dysphoria in order to get insurance coverage for medical intervention, like hormones or surgery. "Medical intervention doesn't 'cure' gender dysphoria, but it decreases and eliminates some symptoms," he says. Unfortunately, because of the stigmas around transgender or gender-nonconforming individuals, painful feelings about gender don't just go away after a diagnosis or even after transitioning, although both of those things can help. "People are startled by the continued struggles of gender dysphoria," Olson-Kennedy says.
Finding the right terminology to describe these nuanced experiences has definitely been (and will continue to be) a process, and there's not necessarily a clear-cut way to handle it, Olson-Kennedy says. (And, actually, he thinks we need a more accurate term than "gender dysphoria.") One thing everyone can agree on is that it's important to be an ally. If you want to help someone with gender dysphoria, your best bet is to just ask them what you can do to be supportive, Erlick says. "Everyone is different, and it's always a good idea to know what kind of help they want — if any," she says.