Gender Dysphoria (GD) is the way persons distressed with the mismatch between their physical sex and gender identity are formally diagnosed (Steiner, 2013). Historically, people experiencing GD have suffered from social non-acceptance and stigmatization; more importantly, often they could not accept themselves which produced a disadvantageous psychological picture.
Although it cannot be regarded as the only way to relieve the pressure that persons with GD experience, sex reassignment – if medically approved – can significantly improve sexual, social, and psychological profiles of such persons.
As little back as 1974, gender dysphoria and transsexuality was still considered a disease and the idea of surgical gender transition was deemed “repugnant” even by practitioners (Laub & Fisk, 1974, p. 388). Moreover, contradictory as it may sound, in such studies gender used to be regarded as a choice of each individual. Another point to consider is that gender dysphoria was long ago proved to be non-responsive to corrective psychotherapy and psychotropic medication (Laub & Fisk, 1974).
A few years later, however, the situation has changed. Publications by WTO and APA have raised a voice of medical science in favor of patients with gender dysphoria; it was a first step to public acceptance of GD as a condition other than a disease – or a choice (Steiner, 2013). As far as medical assessment of GD is concerned, such steps were gigantic.
On the other hand, persons facing GD often face other issues as a side effect. Stigma, lack of social support, and misunderstanding still persist, exacerbating such persons’ psychological profiles from the childhood and onwards. It is stated that the higher the intensity of GD during the adolescence – the higher the chances of persistent GD in the future. At that, girls are more subject to persistent gender dysphoria than those whose physical sex is male (Steensma, McGuire, Kreukels, Beekman, & Cohen-Kettenis, 2013).
It is also stated that gender dysphoria, if unassisted, might result in neuroendocrine, psychological, and psychiatric disorders including anxiety and suicidal inclinations (Steiner, 2013). Surgical sex reassignment, backed by psychological assessment, is a way of eliminating the dangerous outcomes of both suppressed gender identity and disabled gender expression, at least partially compensating for the social non-acceptance and stigma.
A significant amount of research conducted in the sphere has demonstrated the effects of sex reassignment on gender dysphoric persons. In 2001, the difference in psychological conditions of adolescents with GD either rejected or approved for transition was established in a follow-up study (Smith, Van Goozen, & Cohen-Kettenis, 2001). The study revealed that a group of persons who undergone the reassignment were no longer suffering gender dysphoria.
Their psychological profile was that of healthy individuals. As to the social picture, they experienced some difficulties socializing and being accepted; however, as it was stated, self-acceptance was what triggered social acceptance. In the end, the ones who undergone the reassignment were functioning relatively good, as compared to those who were not treated.
In several years, the non-treated group have partially recovered from gender dysphoria but still, their psychological profile was less satisfactory than that of the treated ones. They were more likely to have disrupted body image and have severe anxiety and depression, with an overall hostile attitude (Smith et al., 2001).
As to the sexual profile and overall well-being of gender dysphoric persons who have been approved treatment, it is evidentiated that sex reassignment usually improves mood and sexual satisfaction. A 2013 study reveals the effect of hormone treatment on FtM transgender persons who have been questioned as to their sexual and psychological well-being at the baseline and after a year of treatment (Costantino et al., 2013).
It is stated that all the members of control group experienced an improvement of their sexual function during the first year of treatment. After the subjects have gone surgery (excluding metaidoplasty and phalloplasty), there was a substantial decrease in anger/aggression as compared with the baseline levels (Costantino et al., 2013). Although testing the psychological profiles of the subjects was not the primary aim of the study, the findings are nevertheless significant.
Overall, the subjects reported a stabilized and improved level of well-being, both psychologically and sexually. These results indicate a direct positive relationship between the hormone therapy/surgery and the patients’ sexuality and mood, as a consequences of the patients’ satisfaction with their sexual functions.
Non-responsive to psychotherapy and medications, gender dysphoria mainly concerns a person’s feeling toward their body; a poor body image triggers a wide array of psychological disorders. Unlike cosmetic surgery, sex reassignment puts a distinct goal that a gender dysphoric person wants to achieve; the achievement of this goal means well-being and overall life quality improvement.
It is true that the stigmatization and social non-acceptance that gender dysphoric persons’ experience from the society cannot be solved by surgical sex reassignment or hormone therapy alone. However, in the gender dysphoric persons’ battle with themselves – with regard to inability to accept their bodies and sexuality, being aggressive, non-cooperative, anxious and depressed – such treatment appears an optimal solution.
References
Costantino, A., Cerpolini, S., Alvisi, S., Morselli, P. G., Venturoli, S., & Meriggiola, M. C. (2013). A Prospective Study on Sexual Function and Mood in Female-to-Male Transsexuals During Testosterone Administration and After Sex Reassignment Surgery. Journal of Sex & Marital Therapy, 39(4), 321-335.
Laub, D. R., & Fisk, N. (1974). A Rehabilitation Program for Gender Dysphoria Syndrome by Surgical Sex Change. Plastic & Reconstructive Surgery, 53(4), 388-403.
Smith Y. L., Van Goozen, S. H., & Cohen-Kettenis, P. T. (2001). Adolescents with gender identity disorder who were accepted or rejected for sex reassignment surgery: A prospective follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 40(4), 472-481.
Steensma, T. D., McGuire, J. K., Kreukels, B., Beekman A. J., & Cohen-Kettenis, P. T. (2013). Factors Associated with Desistence and Persistence of Childhood Gender Dysphoria: A Quantitative Follow-Up Study. Journal of the American Academy of Child & Adolescent Psychiatry, 52(6), 582-590.
Steiner, B. W. (2013). Gender Dysphoria: Development, Research, Management. Berlin, Germany: Springer Science & Business Media.