The definition of gender identity is one that many experts say differs from sex. Genetic factors usually define someone’s sex, but gender references how they identify personally.
- Only an individual can determine their gender identity or their gender expression.
- Gender and sex don’t necessarily have to be the same.
- Gender is how someone feels in the internal sense but also expresses these feelings externally. People might use their appearance, behavior, and clothes to express their gender identity.
- According to the World Health Organization (WHO), gender is a social construct in terms of the female gender role and the male gender role.
- Sex, by contrast, is based on biological factors like genes, hormones, and reproductive organs.
- Neither gender nor sex has to be binary. The gender binary follows the idea there are only two genders.
The LGBTQIA+ community has many gender identities that people can use.
- An agender person doesn’t identify with any gender. This is also called neutral gender.
- A cisgender person identifies with the sex assigned at birth.
- At the same time, the LGBTQIA Resource Center uses gender expansive as an umbrella term for people who broaden their perspective of gender definitions and expression.
Our understanding of gender, the wide range of gender roles, the concept of being gender fluid, gender language, and intersex people have all grown so much in just the past five years.
What is Gender Dysphoria?
There’s a term, transgender, which references someone assigned a sex at birth who doesn’t feel that aligns with their psychological sense of gender or sense of identity. Some people who are transgender have gender dysphoria. Gender dysphoria is something called gender identity disorder, but many feel this terminology is harmful and not representative of the reality of people’s experiences of their core gender identity.
Gender dysphoria refers to psychological distress from not feeling like one’s gender identity and sex assigned at birth align with one another. For many people, gender dysphoria starts in childhood, but some don’t experience it until after puberty or even later in life. As with so many parts of our identity, scientific evidence shows us there’s a wide variety of environmental factors and other things that play a role in the experience of gender.
Someone who’s transgender might go through different routes to affirm their psychological gender.
- This could include social affirmation, like changing their gender pronouns and name.
- There’s a legal affirmation, like changing the gender listed on a government-issued ID, and there are medical interventions and affirmations which can include the use of puberty blockers or gender-affirming hormones.
- Finally, there’s a surgical affirmation, but not all people who are transgender use all aspects of gender affirmation as personal decisions.
Gender identity isn’t the same as sexual orientation, which is the people someone has an emotional attraction, romantic attraction, and sexual attraction to.
Diagnosing Gender Dysphoria
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) does include criteria for diagnosing gender dysphoria. There are different criteria for children versus teens and adults.
In teens and adults, dysphoria is an incongruence between your expressed or experienced gender and your gender assignment that’s lasted for at least six months. There must be at least two symptoms present, including:
- Incongruence between expressed or experienced gender and primary or secondary sex characteristics such as external genitalia
- A strong desire to get rid of primary and/or secondary sexual characteristics because of incongruence with experienced or expressed gender
- Having a strong desire for primary or secondary sex characteristics of the other gender. For example, biological or genetic males might strongly desire to have breasts or a vagina, which they feel would better match their social gender and concept of gender identity.
- A strong desire to be the other gender or a gender different from what’s assigned
- The presence of a strong desire to be treated as another gender
- A conviction of having the feelings and reactions of another gender
Different treatment plans may work well for people with gender dysphoria. For example, according to the American Psychiatric Association, open-ended exploration of gender experiences, identity and expression are important. Attempting with psychology to force someone to be cisgender when they’re transgender is considered unethical and linked to negative mental health outcomes.
Support may also include affirmation.
What Are the Effects of Being Transgender on Mental Health?
It’s important to realize that feeling rejected by their families and society because of their gender identity strongly predicts mental health challenges for people who are transgender. Transgender people face discrimination and stigmatization.
These effects can negatively influence self-image and lead to higher rates of other mental health disorders.
- People who are transgender are at higher risk of health crimes and being victims of other discriminatory harassment than the general public.
- Suicide rates among transgender people are significantly higher than in the general population.
- Transgender children and teens may face bullying and discrimination. This can cause negative mental health outcomes as well.
- Another factor adversely affecting mental health challenges in getting appropriate mental and physical health care and a lack of insurance coverage for relevant services.
Mental Health Risk Factors
Not only for transgender people but members of the entire LGBTQIA+ community, mental health risk factors include:
- Coming out: Society has become generally more accepting of LGBTQI people, which is a protective mental health factor. However, this has led more people to come out and share their sexual identities and gender identity at younger ages in their development. This can impact relationships and social experiences and negatively impact mental health in some cases.
- Rejection: Around 86% of LGBTQ young people reported in a 2019 survey they’d experienced harassment or assault at school, impacting their mental health. A 2022 report from The Trevor Project found that only 37% of LGBTQ youths felt their home was an affirming space.
- Trauma: Transphobia, homophobia, bullying, and shame stemming from one’s identity can lead to trauma. There is a much higher risk for PTSD among people in the LGBTQI community than people who identify as cisgender and heterosexual. Gender-based harassment can affect the human brain in long-lasting ways.
- Substance abuse: The use of substances like drugs and alcohol can be higher among people who are in the LGBTQIA+ community, often because they’re used as a way to self-medicate. For example, LGB adults are almost twice as likely as heterosexual adults to have a substance use disorder. According to the American Psychological Association, people who are transgender are nearly four times as likely to have a substance use disorder compared to cisgender individuals.
- Lack of mental health care: The approach to providing mental health care to people in the LGBTQIA+ community is often a blanket one, where every community is treated the same. This is problematic because each community faces its unique challenges. For example, someone with a unique experience of gender isn’t necessarily going to have the same mental health concerns as a person who has an attraction to people of the same sex. These are all different concepts from one another, requiring special care.
This isn’t to say all trans people or anyone in the LGBTQIA+ community must have mental health issues. Some people have mental health issues unrelated to being transgender, but their mental health and gender identity are related to some people.
Mental Health Treatment in San Juan Capistrano, CA
Being transgender is not a mental health disorder. When you desire to convey gender in the way you feel is appropriate for you, it’s a form of human expression.
If you’d like to learn more about mental health treatment options or ask questions you may have, our Orange County team is here and available to talk. We’re sensitive to the needs of every client, no matter their sexual orientation, sexual identity, or gender expression. We look through the lens of individual experience for every patient we work with. Call Story Wellness at (866) 476-2823st to learn more.
