Interventions for Gender Dysphoria

In the grand scheme of things, researchers know very little about gender dysphoria. The Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) – basically the mental and behavioral health Bible – lists it as a mental health disorder, while the American Psychiatric Association (APA) defines it as “…a conflict between a person’s physical or assigned gender and the gender with which he/she/they identify.” Google talks about it with a binary understanding, and Hollywood omits it from stories about transgender individuals.

Gender dysphoria looks different for everyone. Some transgender and gender non-conforming individuals don’t experience it at all, while others suffer daily from the strain of their bodies and brains not getting along.

For many transgender individuals, gender dysphoria takes two different forms: prolonged aching and episodic panic. Prolonged aching is the daily dysphoria grind: you wish your body looked and felt different, there are pangs of depression, self-loathing, and anxiety, and sometimes you get jealous of cisgender folks who don’t have to worry about their gender identities. It’s a subtle sort of misery that makes everything harder.

Episodic panic is the overwhelmed, ugly cry under your bed panic attack that makes you want to curl up in a ball and disappear. Unlike prolonged aching, episodic panic happens in short, intense bursts of feeling, and usually comes with an emotional hangover. These states can be manic or depressive, and are often characterized by impulsive behavior. While no studies have ever differentiated between prolonged aching and episodic panic, the high suicide rates among transgender youth (between 30 and 51% attempt suicide once in their lifetimes) likely happen in a heightened state of episodic panic.

There are currently no evidence-based interventions recommended specifically for coping with gender dysphoria. Research about queer youth suicide assesses the causes of suicidal ideation and completion among trans and gender non-conforming youth, but there has not yet been a study regarding prevention and intervention methods.

Research is great until it’s not. Folx need strategies for coping with and managing gender dysphoria now. As a community, we don’t have the twenty years it takes to do enough randomized controlled trials (RCTs) for an intervention to be considered legitimate. This section offers tested interventions, backed by personal experience, that have been found to mitigate gender dysphoria in the moment.

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