A reader writes: “Is it normal to feel transgender but not really have body dysphoria?
“I never told anyone I wanted to be a boy as a child, and indeed, never knew what a penis was until I was at least nine or ten. When looking at my female body parts, I sort of just mentally block them out. Can people psychologically deal with their transgendered state in different ways?”
The answer to both your questions is yes, but it depends on how you define “transgender.” Transgender is not a diagnosis – it is a label applied to a condition, personal identity, and/or group, depending on who is doing the defining. However, it is sometimes linked with the diagnosis of Gender Identity Disorder (GID).
If you are speaking of the actual diagnosis of GID, there are some specific criteria that go with that diagnosis, although therapists today are much more flexible with regard to those criteria, knowing that not everyone fits into the little charts offered by the DSM.
When we look at the DSM, or even certain books that have been written to describe our “condition,” we are given a set of criteria that we are then expected to “match up” with our own situation. For some people, this can be incredibly affirming and relieving – “Yes, this is me, 100 percent, exactly, finally it all makes sense!” For other people, it can be very confusing – “That’s not like me and that’s not like me, so what’s my problem? Do I not qualify as trans, even though I feel this way?”
In the very beginning, when I was just discovering that I was not the only one in the world who had this odd “condition,” I was told to read a book called True Selves. At the time, it was almost the trans bible. Literally everyone I met in the community had read it. And it was helpful – but there was a lot in there that had nothing to do with me and that I couldn’t relate to.
I was also told to read Stone Butch Blues. At the time, it was almost the trans man bible. And it was a great book, and Leslie Feinberg is one of my earliest role models/idols, but it had nothing to do with me. I couldn’t relate to it. It wasn’t my life.
So I think that there are a couple of pitfalls to avoid for people questioning their gender identity or their identity as trans (or even the possibility of a GID diagnosis). Those pitfalls are: 1) taking specific sets of criteria too seriously, and 2) not taking specific sets of criteria seriously enough.
Taking Criteria Too Seriously
This relates to your first question – Is it normal to feel transgender but not really have body dysphoria?
The specific criteria listed in the DSM for Gender Identity Disorder do not reflect me much at all. Nevertheless, I have that diagnosis and I transitioned medically. It was the right thing for me to do. If I would have tried to match myself up with those criteria, or with what I read in any of the clinical books out there (or even books like Stone Butch Blues), I could not have done it, and I would have been back to questioning what the hell was wrong with me, because I obviously didn’t fit here.
So it’s important to see those criteria as general guidelines that fit some people to a “T” (no pun intended) and do not fit others. Many (possibly most) people who transition have some kind of body dysphoria, and it can be very severe. Others do not. It is certainly one thing that therapists look at, and if it is present, it can be a pretty good indicator of what’s going on, but if it’s not present, it does not necessarily mean that a person is not transgender. It might or might not affect the necessity of transition.
But here we are equating transgender with GID, and that is where we get into dangerous territory, because those two things are not the same. So when looking at clinical criteria, don’t take it too seriously with regard to your own situation and don’t feel that you have to “match” it in order to give your feelings and identity a label that you’re comfortable with, which might be “transgender,” or which might be something else.
Not Taking Criteria Seriously Enough
This relates to your second question – Can people psychologically deal with their transgendered state in different ways?
At the opposite end of the spectrum, we have the danger of expanding the criteria or parameters for “transgender” so broadly that anyone experiencing what he or she perceives as a gender identity/physical body misalignment feels that there is only one possible explanation, one possible identity, and one possible path – transition – even if changing the body is not really what’s right for that person.
Transition is a medical necessity for many people. It’s not something that we do for fun. It’s something that we have to do in order to survive. But transition is not the answer for others. There are many ways to deal with a gender/sex mismatch, depending on the amount of psychological anguish and discomfort it is causing.
For example, you can live as a “masculine” female. You can live as a man without any type of medical intervention (although changing legal paperwork might be difficult). You can live as a man privately and a female publicly. You can live as both genders or as neither gender. You can also live as a “feminine” female, or you can adopt or express specific traits, regardless of how they are labeled by your culture. You can really live any way that you want to, as long as you are living and not merely clinging on by your fingernails. (It’s important to stress that these are options for some people – transition is a medical necessity, and for those who transition, there are no other options.)
A clinical diagnosis and medical transition are simply not the remedies for everyone, and broadening the criteria to encompass every possible manifestation of what might be seen as transgenderism can lead to a feeling of being limited in your options. There are many ways to deal with being transgender, and you have to find the one that works for you.
I don’t know how you define transgender. My definition is very narrow and tends to run along clinical lines – a person whose gender identity and physical body are not in alignment. In my definition, the remedy for this situation is often, though not always, transition. But in my definition, once a person has transitioned, he or she is not transgender anymore – the situation causing the misalignment (causing the person to be “across” from his or her gender) has been corrected.
There are, however, many people who have transitioned and still consider themselves transgender. There are also many people who have transitioned and have never considered themselves transgender. This is where language and concepts get sticky, and this is where people can get confused.
My definition is not the popular or generally accepted one today. Most people seem to prefer a much broader category that encompasses anyone who intentionally (or sometimes unintentionally) deviates from standard gender norms, particularly those who are subject to negative repercussions because of that deviation. There are other definitions as well, and they often include people or groups who would not define themselves as transgender if they were doing the labeling. This is one of many reasons why I prefer a narrower definition.
Regardless, it’s not my definition that matters – it’s yours. You have to decide what being transgender means to you and how you are going to deal with it. Sometimes a therapist can help with this, and if you are considering transition, I would recommend that you try to find a knowledgeable one. Sometimes an online or in-person support groups can help you sort out where you are and where you might want to be.
But don’t cling too tightly to any particular standardized set of criteria that makes you feel as if you have to be one certain way in order to fit. On the other hand, don’t dismiss established criteria as meaningless. It can be very helpful in figuring out who you are and who you are not, which then can expand your options.
This was a difficult post to write because of the wide variations in language and definitions throughout our community. I am very interested to hear what readers have to say.
I think this is a very good post, and good advice for anyone who wonders.
Your definition of “transgender” is interesting. I haven’t wanted to describe myself as “trans” anything because I’ve thought it referred to the individual, not the situation, because it’s used as a noun (e.g. “transman” as opposed to “man”). I liked what you said about a person who has transtitioned no longer can be described as transgender because what made them “across” from their gender has been corrected. This means it’s the situation, and not the individual, that causes the “trans”-ness.
In that case, many FtMs (me included) and some MtFs would never leave the trans phase, because there’s still a mismatch between gender and physical sex, due to the limits of surgery and hormone treatment. This is very much how I feel. My body is still wrong, only less wrong than before, which means I’m still trans… Not as a person, but because of my situation. You could also remain trans in a cultural sense, in the same way as someone who has immigrated to a foreign country might still feel somewhat like an immigrant even if they officially have become a citizen of their new country. Not only because of different socialization, but also because of different experience. My country haven’t been at war since the early 19th century, so we have grown up without experiencing war. Many immigrants who come here have fled from war or other extreme conditions, which means they have very different experiences from us. There’s a part of them that we might never be able to understand. The same goes for people with trans experience; we have experienced things that many people will never understand, which means we’re immigrants. This doesn’t mean we should have stayed in the “old country” -after all, life was intolerable there. But it might make us feel a bit alienated at times and want to talk to other immigrants who knows something of what we’ve been through. (This wasn’t really about the topic, though the similarity between transsexuals and immigrants is something I’ve been reflecting on for a long time.)
I really like that metaphor!
plastbaronen, What you said about being immigrants summed up exactly how I feel. I just didn’t understand the concept. Now I do, and I thank you for that.
Yes, I am a stranger in a strange land. Actually, a stranger in an even stranger land. It is a land where who you are largely depends on what’s between your legs. I hate what is between MY legs, and I have little patience with those who insist on categorizing me by it. Sure, there are so many people I’ve educated in the theories and concepts (such as I understand them) or transgender, and most of them accept me for who I am. But others don’t. And don’t kid yourself that it’s all conservatives and evangelical religious nuts who are the problem. It’s also the radfems who insist on defining everything by the organs we were born with. Or as I reread that last sentence, maybe the radfems ARE religious nuts in a way.
How do I define myself? I am simply ME. Robyn Jane. Mother, daughter, sister, aunt, wife. But I am also more than that. I fathered two daughters before transition, and so I am also a grandparent. I am married to a wonderful woman who has been with me every step of the way. Indeed, I came out to her with my plans to transition even before we started dating.
Ultimately, for me, it all comes down to this: who do YOU say you are? That’s all that matters.
“There are, however, many people who have transitioned and still consider themselves transgender. There are also many people who have transitioned and have never considered themselves transgender. This is where language and concepts get sticky, and this is where people can get confused.”
Yup, I agree. It’s hard to use language that changes with each individual. I’m one of those people you mentioned that has transitioned and still considers himself transgender – going by my definition of transgender, anyway. For me, a trans man is one of several different kinds of men – not half a man or a pseudo man, but just another type. That’s not to say that I think all trans men (or trans people) should identify as I do, however. To each his/her own.
I like plastbaronen’s comparison of trans people to immigrants and I have a similar description: I compare myself to Tarzan.
Tarzan was human, of course, but he was raised with animals in the wild, so when he was found and taken back to the world he would have grown up in if he hadn’t gotten lost as a baby, he had a hard time adjusting and his jungle upbringing colored everything he did and saw in that world. Similarly, as a guy who was raised in the world of women instead of men, it’s not always easy to adjust to things as a guy now and my socialization as a female certainly informs the way I relate to that world. This is why I consider myself a trans man – that is, one variety among several. Of course, in the end Tarzan returned to the jungle and I have no intention of returning to live as a female, so that’s where the comparison ends (I think he just disliked having to wear all those clothes, and I don’t blame him?) 
But back to the original point – yes, language IS sticky and confusing and we should be sure we know people’s definitions in these discussions. And to the reader who asked the question: yes, there certainly are different ways to deal with our transness. We are all unique individuals, so why should we all be exactly the same in our trans identities?
[...] website | Different ways to be transgender Gender Pirate – by Rose [...]
[...] Internet site reference: http://tranifesto.com/2012/07/09/ask-matt-are-there-different-ways-to-be-transgender [...]
Huh — I don’t have much lower dysphoria, and I wasn’t exposed to penises as a child, either. I’ve always wondered if there was a correlation. I think I relate to my genitals in a way similar to the asker — I don’t mind living with them, but it’s kind of awkward to think about them (mostly because of the cultural associations between my genital configuration and “womanhood”).
For years I’ve been a master at mentally blocking out huge parts of my body; I think it’s one common way of dealing with dysphoria, actually.
[...] Matt’s latest post deals with a question I’ve had for a long time myself: “Can people psychologically deal with their transgendered state in different ways?” Which is to say, can people who have gender identity disorder find ways of coping besides [...]
I like to differentiate transgender from transsexual. For me, what is mostly described in this post defines a transsexual person, not a transgender person.
As a transsexual, my legal, social and medically sex has been changed through court decree, social agreement, hormonal introduction and surgical intervtion, which BTW, are all more than adequate for living as a fully functional male.
I find that the term transgender gets used to describe a very dynamic and divergent group of people: genderqueer, gender variant, third gender, omnigender, two spirit, transsexual, cross dresser, etc. Because of this, there is no agreed upon usage of the term, who is included and whether or not some want to be labeled as such.
I for one, do not refer to myself as transgender and do not like to be lumped into a “transgender umbrella” construct, because it seems to rarely mean and/or include transsexuals. Therefore, I use the terms ‘trans man’ or ‘man’ to describe myself.
I did not “need” to transition, but I am so glad that I did. I did not have body dysphoria, but I do prefer life as a man. Life as a visibly masculine female, for 25 years, was both difficult and empowering. I spoke my mind, was encouraged to challenge oppression, and found much satisfaction in rebuking social expectations and gender norms.
Now, as a man, I am chastisized for speaking my mind, assumed to be exerting power over others, and labeled a conformist to the gender gender system.
Gender politics & policing are rampant in and towards the “Trans*” community(ies), which is a primary reason, cited by many trans men that I know, for why they no longer align themselves with, nor participate in the “transgender community”. This is unfortunate!
ZK
That’s why this post was so hard to write – because of the language. Language has changed since I transitioned, and I believe that it is also regional and community-based. So when someone is trying to determine the parameters of “transgender,” or what is okay and not okay for a transgender person to feel, I have a difficult time trying to answer that, because there is such a variety of usages for that word.
I don’t consider myself transgender. I was transgender(ed) prior to transitioning. I consider myself transsexual, and I refer to myself as a trans man, which is short for transsexual man. However, I don’t get upset when people refer to me as transgender, because with the word usage the way it is today, I can’t really expect people in or outside of the community to know how to refer to me unless I tell them specifically.
Because so many transitioned people use the word “transgender” to refer to themselves, and because the media has been told to use this word to refer to people like me, I don’t try to fight it. The biggest problem is just that it sometimes makes it more difficult for those on the outside looking in to figure things out, and for those on the inside to find their way and their path.
“The biggest problem is just that it sometimes makes it more difficult for those on the outside looking in to figure things out, and for those on the inside to find their way and their path.”
I concur wholeheartedly!
Reblogged this on Zander's Blog.
Thanks for a great discussion, Matt (and Zander too!). I love that you both defined your personal meanings for the T-words and took ownership for them. If everyone did that, there would be far fewer misunderstandings. I’ll add that the same gender diversity terms may be used in different contexts of human phenomena, social identity and diagnostic nomenclature, with very different meanings. For example, the word, transsexual, has extremely divergent meanings as a phenomenon, as an affirming social identity and as a mostly derogatory label of mental illness in the ICD. So it’s important for us to be clear about the context in which we use these words, too.
Speaking just for me, I use the TG and TS terms in the context of social identity, as inclusive of all who identify as TG and/or TS, and excluding those who don’t. I proudly identify as a transgender woman, in solidarity with all whose gender identities or gender expressions differ from our birth-assigned stereotypes. I also proudly identify as a transsexual woman, in solidarity with those trans people who need or needed access to medical transition care. I identify as both feminine and geek-queer (Goddess help me), and I do not see them as mutually exclusive. And I identify as both bi and lesbian, and I do not see them as mutually exclusive.
Diagnostic language, with the power to both stigmatize and provide or deny access to medically necessary transition care (for those who need it), is a special case and the subject of my book. I urge everyone to transition from using “Gender Identity Disorder” (GID) terminology to Gender Dysphoria wording, as the American Psychiatric Association has announced this key change in the pending DSM-5 diagnostic manual. It’s important to remember that GID, in the DSM-IV and IV-TR, was authored by trans community adversaries at the Clarke Institute (now called CAMH) to discourage transition, malign transition itself as symptomatic of mental illness, and encourage harmful and scientifically bankrupt gender-conversion psychotherapies. GID was literally intended to mean “disordered” gender identity. Changing the label to Gender Dysphoria (from a Greek root for distress) clarifies that the core of the problem to be treated is not a person’s gender identity, but rather a discomforting incongruence between assigned gender, current physical sex characteristics, and inner, experienced, gender identity. Not all trans people experience gender dysphoria. For those who do, transition is proven effective in relieving its distress and is recognized as medically necessary. Within my own narrative, I was in the past painfully gender dysphoric, and, more specifically, anatomically dysphoric. I no longer am, because I was fortunate to have access to medical transition care. I will always socially identify both a transgender and transsexual woman, because I choose to stand with those communities.
Thanks for commenting, Kelley! I urge everyone to check out Dr. Kelley Winters’ book, Gender Madness in American Psychiatry, and her website, GID Reform Advocates.
I am happy to stop using GID. I don’t like it, and I rarely use it. I was trying to distinguish between a term that can have a variety of meanings and usages and a diagnosis, and I used it because it’s still in the DSM as of now (but not in the upcoming edition, as you say).
Your comment is very helpful with regard to this and a lot of other situations, so thanks for your insight, as well as your personal experiences!
I definitely fall under the “transgender” umbrella, but still haven’t figured out just where. And I’m at a place where it’s not life or death, but rather I see gender as something I have to explore, a mystery (in the spiritual sense), to fully understand myself. Transmasculine, genderqueer, two-spirit, and other-gendered or agendered all seem appropriate to me to describe my present self. I might add genderfluid to describe my life history. I went from being a tomboy, to being a lesbian-identified butch young adult, to being a crunchy earth mama trying too hard to play the part, to wfinding my inner boy waking up and insisting I assert my manhood, even as I remain comfortable being mom to my kids, socially and biologically. I present as masculine in my professional and peer social circles, more or less, and while I continue to contemplate the desirability of T, intend as I pass into the next phase of my life to seek partial physical and social transition (hysto, maybe top surgery, and legal name change). Not fitting any category neatly is something I’ve come to accept. The DSM-V approach to gender may fit me, but on the spectrum of severity it’s not too bad. I can live with the body I’ve got; changing it would be nice, but not vital to my survival.
As a point of clarification, at least for the purpose of denying me insurance coverage for doctor visits, but not hormones which is covered under my prescription plan, I have officially been diagnosed with “transsexualism.” I am also being covered for at least 5 visits to my psychotherapist as “medically necessary, which for my purpose, at least, is to be certified for bottom surgery under WPATH guidelines. Interesting, huh?
I believe that different people manage body dysphoria or other body symptoms of being trans differently. For example I didn’t have full blown dysphoria, despite having a sense of “wrong body” because I’m just not the type. As I was born with some malformations, I have learned as a small child to look at my body and connect with my body in a specific way, that is, I don’t expect my body to be the way it should be. I know that I can just ignore stuff that I don’t like and deal with (health) problems that stem from that. Also, because I was born with health issues, the health and well being of my body is what interests me most. I look at transitioning very differently than most other people I know.
I used to think I was a bit strange but recently I met another trans guy with similar health issues, and he is exactly the same as me.
On the other hand, I’d say I’m transsexual, not transgender, because for me it’s all about the body, and very little about social aspects.
Added
Maybe that’s good way to think about trans: people deal differently with disabilities or illnesses. But generally, all ways are valid, none is “better”.
At the age of 16 or 17, circa 1962, I read that FtM transsexuals (not the terms used back then) hated their penis else they were transvestites. Thus, since I was young and stupid I concluded that I was a transvestite. I struggled mightily until a little over six years ago when I met a woman who is transsexual at a conference, ESPRIT. While initially I concluded that while her story was interesting it didn’t pertain to me because I was merely a crossdresser. Long story short I soon realized that I to am transsexual and quickly began my transition. I have never looked back, for the first time in my life I am at peace.
However, it seems to me that I am an aberration to the extent that I am an atypical MtF transsexual. I say this judging how I live my life. Most people tell me that I am very passable, whatever that means yet I don’t seem to live by “the manual”. Perhaps this is a privilege granted by my age, 66, but I see no reason to “be a certain way, a stereotypical womb, whatever that is.
I am engaged in my community which I define in the broadest of terms. I am living my life on my terms. I was recently granted the title of “Old Bitch” by a 40 something man who tried to intimidate me (nothing to do with being trans). I refuse to succumb to other peoples ideas for what it means to be a woman. I LOVE getting really dressed up to go to the ballet or opera just as much as I do riding my bike 50 miles or backing in the wilderness by myself.
fit the DSM definition of a transsexual. I fit my own definition for what it means to be a woman. For the first time in my life I like who I am and wakeup each morning thankful for this opportunity to live my life, my way.
I advise all people to live THEIR truth, THEIRS, not someone else’s idea about who they should be. Live your life openly, honestly as the person you are. To go forth into the world with their head held high, proud of who they are, and don’t forget to smile. I offer this to your readers Matt. Powerful and empowering at least for me.
As Dr Suess once wrote “Be who you are and say what you feel, because those who mind don’t matter and those who matter don’t mind.”
LIVE YOUR TRUTH!
I think we lump things together too much. The variety of things even that get labeled as GID are different enough that the same interventions don’t help everyone.
For me, the important part was physical. I actually resonated more closely with stories of people who had bodily integrity disorder than GID, because “gender” wasn’t the point for me, changing my body was. I was lucky to find a therapist who was understanding and supportive. Other people seem primarily invested in how the people around them view them and the physical may not be important at all, while yet others seem primarily concerned with their private identity. Sometimes you get the whole package in one, but it seems rare.
Partially I think these variations just highlight our inability to define “gender” in any sort of cohesive way. The definition of gender is not consistent or objective; it is a subjective internalizaton of categories, and which parts of those categories fit depends partially on what definition we’ve internalized.
My experience was similar to yours – my dysphoria was very body-centric, and only way after I started taking care of that, and learning about trans/gender/sexual, did I start to think about the possibility of social dysphoria.
In my blog I’ve frequently made a point to differentiate the two, as some people experience both, or one but not the other, or both but to different degrees.
I actually didn’t think I suffered from gender dysphoria because my transition has been moving along quite uneventfully for the past seven months. I have been living full-time in my new gender role both as an out trans activist while going about my daily business in stealth with my own breasts and without effort except a little eye and lip makeup and a way of walking, talking and being that doesn’t seem to be construed as anything but totally female, that is until Sunday, when a communication of discomfort delivered anonymously for my using the women’s restroom these past six months at my non-religious spiritual community without comment or apparent cause for discomfort by the many women who have accepted me in their sisterhood, set me on a course of emotional turmoil that required emergency intervention of my therapist and a Rape counselor because I felt I had been sexually molested by these anonymous women by putting their mouth in my business where it obviously did not belong. Unfortunately the message was delivered by a man and a long time friend and the effect was so devastating that I had both thoughts of suicide and lawsuits for my anguish for the first time in my not too recent memory.
I am now convinced that my dysphoria is all too real and that my natural way of being does not conform with what’s really up my skirt.
Deanna, I’m so sorry to hear about how you were treated. What you experienced was bigotry, plain and simple, and bigotry is never a pathology or a shortcoming of the victim– bigotry is an illness of the bigot.
Gender dysphoria is different kind of distress– distress with the wrong body parts or with deprivation of the right body parts or with being stuck in the wrong assigned social role. Gender dysphoria (or more specifically, anatomic dysphoria) is what makes hormonal and/or surgical transition care medically necessary, for those who need them. Not all trans people experience gender dysphoria or need transition medical care, but for those who do, such care can be lifesaving. Sadly, most all out-of-the-closet trans people suffer bigotry at some point.
In short, bigotry causes distress from an external source; gender dysphoria, for those who suffer it, is distress from an internal source. Speaking for me, I experienced both. Transition relieved gender dysphoria; it really works. Fixing bigotry is a bigger challenge and requires that we change the world. Just know that you have nothing to be ashamed of; your sanctimonious persecutors, on the other hand, have everything to be ashamed of. Best of luck in your journey.
Thanks for making the definition of GD clear to me now because from what I feel and have felt from within, I know I am ready to go “all the way” with my transition because it is who I have always been. I feel so comfortable now being in my own skin for the first time in my sixty three years of life on this earth that I cannot and will not let anything stand in my way of having the life I have always wanted.
If you have a mind to, you can click on my name to read what I said about this incident on my own WordPress blog for the past couple of days if you haven’t done so.
Godspeed in your journey, Deanna. Thanks for sharing your blog. You can read more of my thoughts (albeit a bit dry and geeky) about gender dysphoria nomenclature and the DSM-5 at http://gidreform.wordpress.com/2012/06/19/third-swing-my-comments-to-the-apa-for-a-less-harmful-gender-dysphoria-category-in-the-dsm-5/
Interesting post and responses!
I identify as either transsexual or transgender – doesn’t matter to me. I have not had any surgeries but am on T. I’d say I’ve always been mildly body dysphoric and still am. I don’t feel like I can’t live unless I have surgery. I’m thankful for that as I can’t afford to do any surgery and I’m old enough to just accept my body but want the ability to present as male as possible – to go with my basically male identity. I tend to hunch over to hide breasts. I could NEVER understand why on earth ANYONE would want to be a woman and wear women’s clothing. I don’t intend to diss the transwomen on here. I never gave them any thought until 3 years ago when I came out into the trans community and met many nice trans women. I learned that they feel the same way about men’s clothing! LOL! I now say for me… and respect everyone’s reality and ways to express themselves.
Although I identify as male, I reject male gender roles enforced by society. If I were born with a male body, I’d be a more feminine male but not a queen by any means. I think we have to all realize that we are all individual human beings and we should be able to proudly be whoever we are or whatever label we want to attach to ourselves. We have to learn from one another and respect one another. Maybe when this happens in our community, the cisgender folk will see that we have a great thing going and we can get rid of the smothering gender roles that do such harm to everyone.