Skip to main content

Gender Dysphoria

  • 1368 Accesses

Abstract

Gender membership is a fundamental component of our general identity, and it provides a sense of biographical continuity of that identity. There are individuals who have uncertain or confused gender identity or who are transitioning from one gender to the other. The extreme of this continuum is represented by gender dysphoria, defined as the distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender. For gender dysphoria persons, the primary source of suffering is the sense of dissonance with the gender assigned to one’s anatomical sexual characteristics. From a phenomenological perspective, we might view gender dysphoria is a manifestation of a disturbance of lived corporeality. Indeed, the external reality of the body and the inner subjective perception do not match, preventing a harmonious relationship between the internal representation of the body and the body itself, which results in a consequent feeling of estrangement within oneself. For this condition, the process of self-identity construction is interfered with by a profound uneasiness toward one’s own body.

Keywords

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • American Medical Association. (2008). Resolution 122 (A-08). Retrieved from http://www.ama-assn.org/ama1/pub/upload/mm/471/122.doc

  • American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, Fifth edition. Washington, DC London, England.

    Google Scholar 

  • Bandini, E., Fisher, A. D., Castellini, G., Lo Sauro, C., Lelli, L., Meriggiola, M. C., et al. (2013). Gender identity disorder and eating disorders: Similarities and differences in terms of body uneasiness. The Journal of Sexual Medicine, 10(4), 1012–23.

    Article  PubMed  Google Scholar 

  • Bayer, R. (1981). Homosexuality and American psychiatry: The politics of diagnosis. New York: Basic Books.

    Google Scholar 

  • Bockting, W. O., & Goldberg, J. M. (2006). Guidelines for transgender care (special issue). International Journal of Transgenderism, 9(3/4).

    Google Scholar 

  • Bradley, S. J., & Zucker, K. J. (1997). Gender identity disorder: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 872–880.

    Article  CAS  PubMed  Google Scholar 

  • Brown, G. R. (2009). Recommended revisions to The World Professional Association for Transgender Health’s Standards of Care section on medical care for incarcerated persons with gender identity disorder. International Journal of Transgenderism, 11(2), 133–139.

    Article  Google Scholar 

  • Bussey, K., & Bandura, A. (1999). Social cognitive theory of gender development and differentiation. Psychological Review, 106, 676–713.

    Article  CAS  PubMed  Google Scholar 

  • Cohen-Kettenis, P. T. (2005). Gender change in 46, XY persons with 58-reductase-2 deficiency and 179-hydroxysteroid dehydrogenase-3 deficiency. Archives of Sexual Behavior, 34, 399–410.

    Article  PubMed  Google Scholar 

  • Cohen-Kettenis, P. T., Delemarre-van de Waal, H., & Gooren, L. J. G. (2008). The treatment of adolescent transsexuals: Changing insights. Journal of Sexual Medicine, 5(8), 1892–1897.

    Article  PubMed  Google Scholar 

  • Cole, C. M., O’Boyle, M., Emory, L. E., & Meyer, W. J., III. (1997a). Comorbidity of GID and other major psychiatric diagnoses. Archives of Sexual Behavior, 26, 13–26.

    Article  CAS  PubMed  Google Scholar 

  • Cole, C. M., O’Boyle, M., Emory, L. E., & Meyer, W. J., III. (1997b). Comorbidity of gender dysphoria and other major psychiatric diagnoses. Archives of Sexual Behavior, 26(1), 13–26.

    Article  CAS  PubMed  Google Scholar 

  • De Cuypere, G., Janes, C., & Rubens, R. (1995). Psychosocial functioning of transsexuals in Belgium. Acta Psychiatr Scand, 91, 180–184.

    Article  PubMed  Google Scholar 

  • De Cuypere, G., Van Hemelrijck, M., Michel, A., Carael, B., Heylens, G., Rubens, R., Hoebeke, P., & Monstrey, S. (2007). Prevalence and demography of transsexualism in Belgium. European Psychiatry, 22(3), 137–41.

    Article  PubMed  Google Scholar 

  • Dessens, A. B., Slijper, F. M. E., & Drop, S. L. S. (2005). Gender dysphoria and gender change in chromosomal females with congenital adrenal hyperplasia. Archives of Sexual Behavior, 34, 389–397.

    Article  PubMed  Google Scholar 

  • Di Ceglie, D., & Freedman, D. (1998). A stranger in my own body: Atypical gender identity development and mental health. Front Cover. London: Karnac Books.

    Google Scholar 

  • Di Ceglie, D., & Thümmel, E. C. (2006). An experience of group work with parents of children and adolescents with gender identity disorder. Clinical Child Psychology and Psychiatry, 11(3), 387–396.

    Article  PubMed  Google Scholar 

  • Erikson, E. H. (1970). Identität und Lebenszyklus. Frankfurt am Main: Suhrkamp.

    Google Scholar 

  • Factor, R. J., & Rothblum, E. D. (2007). A study of transgender adults and their non-transgender siblings on demographic characteristics, social support, and experiences of violence. Journal of LGBT Health Research, 3, 11–30.

    Article  PubMed  Google Scholar 

  • Fairburn, C. G. (2008). Eating disorders: The transdiagnostic view and the cognitive behavioural theory. In Cognitive behavior therapy and eating disorders (pp. 7–22). New York: Guilford Press.

    Google Scholar 

  • Feldman, J., & Bockting, W. (2003). Transgender health. Minnesota Medicine, 86(7), 25–32.

    PubMed  Google Scholar 

  • Fisher, A. D., Castellini, G., Bandini, E., Casale, H., Fanni, E., Benni, L., Ferruccio, N., Meriggiola, M. C., Manieri, C., Gualerzi, A., Jannini, E., Oppo, A., Ricca, V., Maggi, M., & Rellini, A. H. (2014). Cross-sex hormonal treatment and body uneasiness in individuals with gender dysphoria. The Journal of Sexual Medicine, 11(3), 709–19.

    Article  CAS  PubMed  Google Scholar 

  • Freud, S. (1962). Three essays on the theory of sexuality. New York, NY: Avon. Original work published in 1903.

    Google Scholar 

  • Gaffney, B., & Reyes, P. (2009). Gender identity dysphoria. In M. Lanyado & A. Horne (Eds.), The handbook of child and adolescent psychotherapy: Psychoanalytic approaches. New York, NY: Routledge.

    Google Scholar 

  • Giordano, S. (2011). Sex and gender: Issues of public health and justice. In M. Boylan (Ed.), The morality and global justice. Colorado: Perseus Academics. Chapter 18.

    Google Scholar 

  • Giordano, S. (2012). Children with gender identity disorder, a clinical, ethical and legal analysis. London and New York: Routledge.

    Google Scholar 

  • Golombok, S., Cook, R., Bish, A., & Murray, C. (1995). Families created by the new reproductive technologies: Quality of parenting and social and emotional development of the children. Child Development, 66, 285–289.

    Article  CAS  PubMed  Google Scholar 

  • Golombok, S., MacCallum, F., & Goodman, E. (2001). The ‘test-tube’ generation: Parent–child relationships and the psychological well-being of in vitro fertilization children at adolescence. Child Development, 72, 599–608.

    Article  CAS  PubMed  Google Scholar 

  • Gómez-Gil, E., Trilla, A., Salamero, M., Godás, T., & Valdés, M. (2009). Sociodemographic, clinical, and psychiatric characteristics of transsexuals from Spain. Archives of Sexual Behavior, 38, 378–92.

    Article  PubMed  Google Scholar 

  • Gooren, L. (2006). The biology of human psychosexual differentiation. Hormones and Behavior, 50, 589–601.

    Article  CAS  PubMed  Google Scholar 

  • Gooren, L. (2011). Clinical practice. Care of transsexual persons. The New England Journal of Medicine, 364, 1251–7.

    Article  CAS  PubMed  Google Scholar 

  • Green, R. (1987). The “sissy-boy syndrome” and the development of homosexuality. New Haven: Yale University Press.

    Google Scholar 

  • Green, R., & Fleming, D. T. (1990). Transsexual surgery follow-up: Status in the 1990s. Annual Review of Sex, 1, 163–174.

    Google Scholar 

  • Gur, R. C., Turetsky, B. I., Matsui, M., Yan, M., Bilker, W., Hughett, P., et al. (1999). Sex differences in brain gray and white matter in healthy young adults: Correlations with cognitive performance. The Journal of Neuroscience: The Official Journal of the Society for Neuroscience, 19, 4065–4072.

    CAS  Google Scholar 

  • Haraldsen, I. R., & Dahl, A. A. (2000). Symptom profiles of GID patients of transsexual type compared to patients with personality disorders and healthy adults. Acta Psychiatrica Scandinavica, 102, 276–81.

    Article  CAS  PubMed  Google Scholar 

  • Hoshiai, M., Matsumoto, Y., Sato, T., Ohnishi, M., Okabe, N., Kishimoto, Y., Terada, S., & Kuroda, S. (2010). Psychiatric comorbidity among patients with gender identity disorder. Psychiatry and Clinical Neurosciences, 64, 514–9.

    Article  PubMed  Google Scholar 

  • Husserl, E. (1912–1915). Ideen zu einer reinen Phaenomenologie und phaenomenologische Philosophie. II. Phaenomenologische Untersuchungen zur Konstitution. Den Haag: Nijhoff.

    Google Scholar 

  • Johansson, A., Sundbom, E., Höjerback, T., & Bodlund, O. (2010). A five year follow-up study of Swedish adults with gender identity disorder. Archives of Sexual Behavior, 39, 1429–379.

    Article  PubMed  Google Scholar 

  • Kinsbourne, M. (2002). Brain and body awareness. In T. F. Cash & T. Pruzinsky (Eds.), Body image: A handbook of theory, research, and clinical practice. New York: Guilford Press.

    Google Scholar 

  • Kohlberg, L. A. (1966). A cognitive-developmental analysis of children’s sex role concepts and attitudes. In E. E. Maccoby (Ed.), The development of sex differences (pp. 82–173). Stanford, CA: Stanford University Press.

    Google Scholar 

  • Kraemer, B., Delsignore, A., Schnyder, U., & Hepp, U. (2008). Body image and transsexualism. Psychopathology, 41, 96–10027.

    Article  PubMed  Google Scholar 

  • Lee, T. (2001). Trans(re)lations: Lesbian and female to male transsexual accounts of identity. Women’s Studies International Forum, 24, 347–357.

    Article  Google Scholar 

  • Maccoby, E. E., & Jacklin, C. N. (1987). Gender segregation in childhood. Advances in Child Development and Behavior, 20, 239–287.

    Article  CAS  PubMed  Google Scholar 

  • Matsumoto, Y., Sato, T., Ohnishi, M., Kishimoto, Y., Terada, S., & Kuroda, S. (2009). Stress coping strategies of patients with gender identity disorder. Psychiatry and Clinical Neurosciences, 63, 715–20.

    Article  PubMed  Google Scholar 

  • McCarthy, L. (2003). Off that spectrum entirely: A study of female bodied transgender-identified individuals. Unpublished doctoral dissertation, University of Massachusetts, Amherst.

    Google Scholar 

  • Merleau-Ponty, M. (1996). Phenomenology of perception. Engl. Transl. by Colin Smith. New York: Humanities Press.

    Google Scholar 

  • Meyer-Bahlburg, H. F. (2005). Gender identity outcome in female-raised 46, XY persons with penile agenesis, cloacal exstrophy of the bladder, or penile ablation. Archives of Sexual Behavior, 34, 423–438.

    Article  PubMed  Google Scholar 

  • Meyer-Bahlburg, H. F. L. (2010). From mental disorder to iatrogenic hypogonadism: Dilemmas in conceptualizing gender identity variants as psychiatric conditions. Archives of Sexual Behavior, 39, 461–476.

    Article  PubMed  PubMed Central  Google Scholar 

  • Meyer-Bahlburg, H. F. L., Gruen, R. S., New, M. I., Bell, J. J., Morishima, A., Shimshi, M., et al. (1996). Gender change from female to male in classical congenital adrenal hyperplasia. Hormones and Behavior, 30, 319–332.

    Article  CAS  PubMed  Google Scholar 

  • Money, J. (1971). Transsexualism and the philosophy of healing. The Journal of the American Society of Psychosomatic Dentistry and Medicine, 18, 25–26.

    Google Scholar 

  • Money, J., Hampson, J. G., & Hampson, J. L. (1955). Hermaphroditism: Recommendations concerning assignment of sex, change of sex and psychologic management. Bulletin of the Johns Hopkins Hospital, 97, 284–300.

    CAS  PubMed  Google Scholar 

  • Nuttbrock, L., Hwahng, S., Bockting, W., Rosenblum, A., Mason, M., Macri, M., & Becker, J. (2010). Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons. Journal of Sex Research, 47, 12–23.

    Article  PubMed  Google Scholar 

  • Pfäffl, F. (2014). Identity: A historical and political reflection. In P. C. K. Baudewijntje, T. D. Steensma, & A. L. C. de Vries (Eds.) Gender dysphoria and disorders of sex development progress in care and knowledge. Springer.

    Google Scholar 

  • Pfäfflin, F. (1992). Regrets after sex reassignment surgery. Journal of Psychology and Human Sexuality, 5, 69–85.

    Article  Google Scholar 

  • Rachlin, K., Hansbury, G., & Pardo, S. T. (2010). Hysterectomy and oophorectomy experiences of female-to-male transgender individuals. International Journal of Transgenderism, 12(3), 155–166.

    Article  Google Scholar 

  • Rochman, S. (2006, April 11). Life in the T zone. The Advocate. Retrieved August 24, 2006, from http://www.advocate.com/print_article_ektid28281.asp

  • Schelling, F.W.J. (1801). Darstellung meines Systems der Philosophie. (cp. First outline of the philosophy of nature [2004]. New York: State University of New York).

    Google Scholar 

  • Stanghellini, G., Castellini, G., Brogna, P., Faravelli, C., & Ricca, V. (2012). Identity and eating disorders (IDEA): A questionnaire evaluating identity and embodiment in eating disorder patients. Psychopathology, 45(3), 147–58.

    Article  PubMed  Google Scholar 

  • Steensma, T. D., Biemond, R., de Boer, F., & Cohen-Kettenis, P. T. (2011). Desisting and persisting gender dysphoria after childhood: A qualitative follow-up study. Clinical Child Psychology and Psychiatry. Advance online publication.

    Google Scholar 

  • Steensma, T. D., & Cohen-Kettenis, P. T. (2011). Gender transitioning before puberty? Archives of Sexual Behavior, 40(4), 649–650. doi:10.1007/s10508-011-9752-2.

    Article  PubMed  Google Scholar 

  • Vocks, S., Stahn, C., Loenser, K., & Legenbauer, T. (2009). Eating and body image disturbances in male-to-female and female-to-male transsexuals. Archives of Sexual Behavior, 38, 364–77.

    Article  PubMed  Google Scholar 

  • Wierckx, K., Van Caenegem, E., Elaut, E., Dedecker, D., Van de Peer, F., Toye, K., et al. (2011). Quality of life and sexual health after sex reassignment surgery in transsexual men. The Journal of Sexual Medicine, 8(12), 3379–88.

    Article  PubMed  Google Scholar 

  • Zhou, J. N., Hofman, M. A., Gooren, L. J., & Swaab, D. F. (1995). A sex difference in the human brain and its relation to transsexuality. Nature, 378, 68–70.

    Article  CAS  PubMed  Google Scholar 

  • Zucker, K. J. (1999). Intersexuality and gender identity differentiation. Annual Review of Sex Research, 10, 1–69.

    CAS  PubMed  Google Scholar 

  • Zucker, K. J., & Bradley, S. J. (1995). Gender identity disorder and psychosexual problems in children and adolescents. New York: Guilford Press.

    Google Scholar 

  • Zucker, K. J., Bradley, S. J., Sullivan, C. B., Kuksis, M., Birkenfeld-Adams, A., & Mitchell, J. N. (1993). A gender identity interview for children. Journal of Personality Assessment, 61, 443–456.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Giovanni Castellini .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Castellini, G. (2016). Gender Dysphoria. In: Stanghellini, G., Aragona, M. (eds) An Experiential Approach to Psychopathology. Springer, Cham. https://doi.org/10.1007/978-3-319-29945-7_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-29945-7_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29943-3

  • Online ISBN: 978-3-319-29945-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics