What is Gender Dysphoria…???
The term “transgender” refers to a person whose sex assigned at birth (i.e. the sex assigned at birth, usually based on external genitalia) does not align their gender identity (i.e., one’s psychological sense of their gender). Some people who are transgender will experience “gender dysphoria,” which refers to psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity. Though gender dysphoria often begins in childhood, some people may not experience it until after puberty or much later.
People who are transgender may pursue multiple domains of gender affirmation, including social affirmation (e.g., changing one’s name and pronouns), legal affirmation (e.g., changing gender markers on one’s government-issued documents), medical affirmation (e.g., pubertal suppression or gender-affirming hormones), and/or surgical affirmation (e.g., vaginoplasty, facial feminization surgery, breast augmentation, masculine chest reconstruction, etc.). Of note, not all people who are transgender will desire all domains of gender affirmation, as these are highly personal and individual decisions.
It is important to note that gender identity is different from gender expression. Whereas gender identity refers to one’s psychological sense of their gender, gender expression refers to the way in which one presents to the world in a gendered way. For example, in much of the India ., wearing a dress is considered a “feminine” gender expression, and wearing a tuxedo is considered a “masculine” gender expression. Such expectations are culturally defined and vary across time and culture. One’s gender expression does not necessarily align with their gender identity. Diverse gender expressions, much like diverse gender identities, are not indications of a mental disorder.
Gender identity is also different from sexual orientation. Sexual orientation refers to the types of people towards which one is sexually attracted. As with people who are cisgender (people whose sex assigned at birth aligns with their gender identity), people who are transgender have a diverse range of sexual orientations.
Gender dysphoria might cause adolescents and adults to experience a marked difference between inner gender identity and assigned gender that lasts for at least six months. The difference is shown by at least two of the following:
• A difference between gender identity and genitals or secondary sex characteristics, such as breast size, voice and facial hair. In young adolescents, a difference between gender identity and anticipated secondary sex characteristics.
• A strong desire to be rid of these genitals or secondary sex characteristics, or a desire to prevent the development of secondary sex characteristics.
• A strong desire to have the genitals and secondary sex characteristics of another gender.
• A strong desire to be or to be treated as another gender.
• A strong belief of having the typical feelings and reactions of another gender.
Gender dysphoria may also cause significant distress that affects how you function in social situations, at work or school, and in other areas of life.
Gender dysphoria might start in childhood and continue into adolescence and adulthood. Or you might have periods in which you no longer experience gender dysphoria. You might also experience gender dysphoria around the time of puberty or much later in life.
Your health care provider might make a diagnosis of gender dysphoria based on:
• Behavioral health evaluation. Your provider will evaluate you to confirm the presence of gender dysphoria and document how prejudice and discrimination due to your gender identity (minority stress factors) impact your mental health. Your provider will also ask about the degree of support you have from family, chosen family and peers.
• DSM-5. Your mental health professional may use the criteria for gender dysphoria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
Gender dysphoria is different from simply not conforming to stereotypical gender role behavior. It involves feelings of distress due to a strong, pervasive desire to be another gender.
Some adolescents might express their feelings of gender dysphoria to their parents or a health care provider. Others might instead show symptoms of a mood disorder, anxiety or depression. Or they might experience social or academic problems.
Undiagnosed or Untreated Gender Dysphoria
Gender dysphoria isn’t an illness. But the distress from it may be linked to mental health problems, such as anxiety disorders, schizophrenia , depression, substance abuse disorder, eating disorders , and suicide attempts. Some estimates say that 7 out of 10 people with gender dysphoria will have some other mental health diagnosis in their lifetime.
The goal is not to change how the person feels about their gender. Instead, treatment is to address their distress and other emotional harm.
“Talk” therapy with a psychologist or psychiatrist is for a key part of treatment for gender dysphoria. Many people also decide to take at least some steps to bring their physical appearance in line with how they feel inside. They might change the way they dress or pick a different name. They may also take hormones and other medication or have surgery. Treatments include:
• Puberty blockers. These are hormones that suppress physical changes of puberty. For someone who is an assigned female, the blocks may hold back the growth of breasts.
• Hormones. Teens or adults may take the sex hormones estrogen or testosterone to develop traits of the sex that they identify with.
• Surgery. Some people choose to have sex-reassignment or gender-affirming surgery after a year of hormone treatment. This used to be called a sex-change operation. Experts recommend surgery only after age 18 and after the person has lived in their desired gender for 2 years.
With the help of therapists and doctors, people can choose the treatment that’s best for them. That may depend in part on if they’re satisfied with their new social role, hormonal side effects, and whether they want surgical changes.
Surgery for adults
Some people may decide to have surgery to permanently alter body parts associated with their biological sex.
Based on the recommendations of doctors at the gender dysphoria clinic, you will be referred to a surgeon outside the clinic who is an expert in this type of surgery.
In addition to you having socially transitioned to your preferred gender identity for at least a year before a referral is made for gender surgery, it is also advisable to:
• not smoke
• lose weight if you are overweight (BMI of 25 or over)
• have taken cross-sex hormones for some surgical procedures
It’s also important that any long-term conditions, such as diabetes or high blood pressure, are well controlled.
Surgery for trans men
Common chest procedures for trans men (trans-masculine people) include:
• removal of both breasts (bilateral mastectomy) and associated chest reconstruction
• nipple repositioning
• dermal implant and tattoo
Gender surgery for trans men includes:
• construction of a penis (phalloplasty or metoidioplasty)
• construction of a scrotum (scrotoplasty) and testicular implants
• a penile implant
Removal of the womb (hysterectomy) and the ovaries and fallopian tubes (salpingo-oophorectomy) may also be considered.
Surgery for trans women
Gender surgery for trans women includes:
• removal of the testes (orchidectomy)
• removal of the penis (penectomy)
• construction of a vagina (vaginoplasty)
• construction of a vulva (vulvoplasty)
• construction of a clitoris (clitoroplasty)
Breast implants for trans women (trans-feminine people) are routinely available at Dr. Arun pandas Bodyskulpt aesthetic clinic Navi Mumbai, Vashi
Facial feminization surgery and hair transplants are routinely available at Dr. Arun pandas Bodyskulpt Aesthetic clinic,Vashi
As with all surgical procedures, there can be complications. Your surgeon should discuss the risks and limitations of surgery with you before you consent to the procedure.
Gender dysphoria can affect many aspects of life, including daily activities. People experiencing gender dysphoria might have difficulty in school due to pressure to dress in a way that’s associated with their sex assigned at birth or out of fear of being harassed or teased.
If gender dysphoria impairs the ability to function at school or at work, the result may be school dropout or unemployment. Relationship difficulties are common. Anxiety, depression, self-harm, eating disorders, substance misuse and other problems can occur.
People who have gender dysphoria also often experience discrimination, resulting in stress. Accessing health services and mental health services can be difficult due to fear of stigma and a lack of experienced care providers.
Adolescents and adults with gender dysphoria without gender-affirming treatment might be at risk of thinking about or attempting suicide.
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Address: Dr. Arun Panda, Bodyskulpt Aesthetics, F1/ A-4, Aditi Apartments, Sector 9, Vashi, Navi Mumbai-400703