Gender Euphoria

A blog dedicated to exploring gender dysphoria and reaching gender euphoria. Blogger is agender and uses they/them pronouns.

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Hello

I have created this blog as a good shooting off point for people who believe they may be experiencing gender dysphoria or might be transgender. There is currently a lot of disinformation and misinformation that is spread online and on social media sites when it comes to the transgender experience. I wish to fight back against that with information provided by scholars and other trans individuals, so that everyone regardless of the gender they are, is able to experience gender euphoria and understand who they are a person.

Below you will find my citations, media that explores gender, and a link where all original posts for this blog may be found.

[justcallmedom31]

[justcallmedom31]

[terraswallows]

The boy who enjoyed fallout as a kid, still enjoys it as a woman.

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Shoutout to weird girls who became weird boys and weird boys who became weird girls and weird girls and boys who became both or neither. Let's all be weird and strange together

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Definitions

Gender Identity - One's internal, deeply held sense of gender.

Gender Expression - External manifestations of gender that is expressed through one's clothing, hairstyle, voice, behavior, pronouns, and name.

Gender Euphoria - The joy and comfort one experiences when they are living and being perceived in a light that matches their gender identity, or lack thereof.

Gender Dysphoria - An incongruence between one's lived/experienced gender and their assigned gender at birth that causes discomfort in the individual.

Transgender - When one's gender identity does not align with the gender they were assigned to at birth.

Agender - Individuals who do not align with any gender and are genderless.

Non-binary - When one's gender does not neatly fit into either male or female.

Social Transition - The changing of one's pronouns, clothing, hairstyle, and name.

Medical Transition - Undergoing surgery and/or hormone replacement therapy so your outward appearance matches your gender identity and/or removes any gender dysphoria you may be experiencing.

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Gender Media

Below you will find a ongoing list of media that talk about or involve gender exploration or living as a transgender person somewhere within their themes. If you are unsure or are questioning your gender identity, I encourage you to look through these pieces, especially the video games, which give you an opportunity to live as another gender, or someone with no gender, to see how you feel about that experience for yourself.

If you have any recommendations yourself, please send me an ask and I will add it to this list!

Video Games

I Was a Teenage Exocolonist - PC/Switch/PS4/PS5

Dragon Age: The Veilguard - PC/PS5/Xbox

Baldur's Gate 3 - PC/PS5/Xbox

The Sims 4 - PC

Music

Movies

Television

Books

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Psychosocial and Psychopharmacological Interventions

Treatment for gender dysphoria needs to be individualized for the person in question, as the wants and needs for this population vary greatly from person to person. For instance, for me I socially transitioned, changed my legal documents, and had top surgery (a mastectomy), and that is all I currently need at this time in order to experience gender euphoria and not gender dysphoria. For many other transgender individuals though, this could involve hormone replacement therapy, bottom surgery, amongst a variety of other things. Below are four options that people can take to help relieve their gender dysphoria.

Gender Affirming Surgery

- Breast Augmentation/Breast Removal (typically referred to as top surgery or chest reconstruction) - Phalloplasty/Vaginoplasty/Vulvoplasty (Typically referred to as bottom surgery) - Tracheal shave (the reduction of one’s Adam’s apple) - Facial feminizing surgery - Voice feminization surgery - Hysterectomy (the removal of one’s uterus) - Penectomy (the removal of one’s penis) - Orchiectomy (the removal of one’s testes) - Gender Nullification (the removal of one’s external genitals except for urethral opening) - Bigenital surgery (surgery typically done for the individual to have both a penis and a vagina) - Hair transplants

Gender Expression/Social Transitioning

- Changing one’s outward expression of gender, typically through changing one’s clothing, mannerisms, interests, hairstyles, name, and pronouns. - This can also involve genital tucking/packing, chest binding, breast padding, and undergoing voice training to help change one’s voice.

Hormone Replacement Therapy

- Receiving estrogen or testosterone in order to influence the outward appearance of one’s body. Dosage of the hormone is often dependent on how much of a change and how quickly the individuals want to see changes. Non-binary individuals have been known to microdose hormones to make these changes much slower and more complex than the basic female and male appearance changes that happen from estrogen and testosterone respectively. It should be noted though that some changes brought from hormone replacement therapy are not reversible if someone were to stop taking the prescribed hormone. Breast development from estrogen, and voice deepening, clitoral enlargement, scalp hair loss, and facial and bodily hair growth from testosterone will not go away once hormones are stopped. (Hedian, 2024)

Behavioral Health Therapy

- A type of therapy where one explores their gender concerns while trying to ease their gender dysphoria. This therapy can help someone build a support network, help them make decisions about their medical treatments, address the emotional and mental impact from discrimination, how to share or address gender identity when it comes to work, school, family, and friends, and how to expression one’s gender identity in a way that that person finds comfortable. (MAYO Clinic, 2022)

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Etiology

(Factors connected to the development of gender identity)

Failure to Manipulate Gender Identity Subsequent to Birth

When some children are born intersex from non-hormonal causes, such as from cloacal exstrophy of the bladder, penile ablation, or penile agenesis, gender assignment surgery is done to align them to a specific sex. One study found that of 46 XY newborns born with these intersex conditions and who had gender assignment surgery done, only 47% of these individuals lived without gender dysphoria when they reached adulthood. (Vin Tangpricha, 2019)

Association of Androgen Exposure on Gender Identity and Gender Expression

If there are any issues with adrenal functioning or the person has an insensitivity for something like androgen, it is very common for an individual’s gender identify to be affected. For instance, XY individuals who have Complete Androgen Insensitivity Syndrome usually identify as female. (Vin Tangpricha, 2019)

Endogenous Biology

Gender identity is non chromosomal; however, it should be noted there is some underlying endogenous component impacting gender identity, as studies involving twins have found that twins who are identical versus fraternal were more likely to share the gender identity of their twin. (Kauffman et al., 2022)

Neuroanatomy

There are some neuroatomic structures that can differ between female and male. Typically speaking the amygdala and brain volume for men tends to be larger, whereas the hippocampus and cortical brain is larger in women. These changes were present in early brain development and are not the result of hormone replacement therapy. From postmortem studies they were able to see neuroatomic structure differences in transgender women that were similar to their cisgender women peers, and saw differences in the structures between transgender women and transgender men. (Vin Tangpricha, 2019)

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Possible Impacts to Social Functioning

Bullying and harassment is common and that can lead to suicidal thoughts and actions to those affected. Roughly 81% of transgender adults have thought about suicide, with 42% having attempted it and 56% having engaged in non-suicidal self-injury. (Dowd, 2023)

Gender dysphoria can result in difficulties for one's work, school, and social relationships, especially if those environments and relationship are non-supportive and non-accepting. This can lead to unemployment, homelessness, and direct violence from others (American Psychiatric Association, 2022)

This also impacts their ability to receive medical care and mental health services, as structural barriers in place make it so their experiences with the medical world are at best uncomfortable with inexperienced practitioners or they are met with actively hostility from these institutions. (American Psychiatric Association, 2022)

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Prevalence

At this time there has been no large scale studies on gender dysphoria, with most data on prevalence coming from the number of people who seek treatment at specialty clinics. Many people with gender dysphoria often do not seek these clinics due to barriers like financial concerns, fearing increases in the amount of transphobia if they were to go through with medical transition, and a combination of little to no clinics like these existing in their country. It should be assumed the numbers we do get are an underestimate of the true number of people with gender dysphoria that exists in the populace. (American Psychiatric Association, 2022)

The prevalence for people assigned male and those assigned female at birth experiencing gender dysphoria, per the DSM 5, is at about 0.1%, but this is data taken solely from specialty clinics. When self-reporting surveys were done in the United States and Europe, those who identify as transgender ranged from 0.6 to 1.1%, those who feel they are a different sex ranged from 2.1 to 2.6%, and those who desire to undergo medical treatment such HRT or gender reassignment surgery ranged from 0.2 to 0.6%. *American Psychiatric Association, 2022)

When it comes to race, I was able to find that of the transgender individuals surveyed in "The National Transgender Discrimination Survey, which says that about 0.6% of the adult population in the United States Identifies as transgender, 55% identified as white (non-hispanic), 21% hispanic or latino, 16% black (non-hispanic), and 8% other race/ethnicity (non-hispanic). (Flores et al., 2016) From a different article I was able to find that when it comes to receiving a diagnose of gender dysphoria and receiving gender affirming care, black American youth were the least likely to receive a gender dysphoria diagnosis, and those who were on Medicaid or another type of government insurance were less likely to receive gender affirming care than their peers who were on private insurances. (Kahn et al., 2024)

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Diagnostic Criteria

I will first begin by going over the basic diagnostic criteria for gender dysphoria, as an understanding of how it is viewed in a medical sense is necessary if one wishes to undergo any medical procedures associated with one’s gender dysphoria. Some people’s gender dysphoria can be treated through social transition, which typically involves changing one’s pronouns, clothing, hairstyle, and first name; however, it is very common for people to need to undergo hormone replacement therapy and/or gender reassignment surgery in order for them to experience gender euphoria instead of gender dysphoria. (Olson et al. 2022) It should be noted that that it is possible for someone to be transgender without ever experiencing gender dysphoria. (Perrotta, 2021)

(Per the DSM 5th edition text revision)

(American Psychiatric Association, 2022)

Differential Diagnosis

(If what you are experiencing does not fit with what is described above, I encourage you to click on the links below. They go into further detail about what those disorders entail)

Nonconformity to gender roles

Transvestic disorder

Body dysmorphic disorder

Autism spectrum disorder

Comorbidity

It is common for those diagnosed with gender dysphoria to also show elevated levels of anxiety and depression, or possibly develop a PTSD if they experience violence or harassment. There is a prevalence of those who have gender dysphoria also have autism spectrum disorder more than the general population. (American Psychiatric Association, 2022)

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Citations

American Psychiatric Association. (2022). DSM-5-TR (5th ed.). American Psychiatric Association.

Dowd, R. (2023, July 20). More than 40% of transgender adults in the US have attempted suicide. Williams Institute. https://williamsinstitute.law.ucla.edu/press/transpop-suicide-press-release/

Flores, A., Brown, T., & Herman, J. (2016). RACE AND ETHNICITY OF ADULTS WHO IDENTIFY AS TRANSGENDER IN THE UNITED STATES RACE AND ETHNICITY OF ADULTS WHO IDENTIFY AS TRANSGENDER IN THE UNITED STATES | 2. https://williamsinstitute.law.ucla.edu/wp-content/uploads/Race-Ethnicity-Trans-Adults-US-Oct-2016.pdf

Hedian, H. (2024, October 25). Gender-Affirming Hormone Therapy (GAHT).

Hopkinsmedicine.org. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/gender-affirming-hormone-therapy-gaht

Kahn, N. F., Asante, P. G., Coker, T. R., Kidd, K. M., Christakis, D. A., Richardson, L. P., &

Sequeira, G. M. (2024). Demographic Differences in Gender Dysphoria Diagnosis and Access to Gender-Affirming Care Among Adolescents. https://doi.org/10.1089/lgbt.2023.0273

Kauffman, R. P., Guerra, C., Thompson, C. M., & Stark, A. (2022). Concordance for Gender

Dysphoria in Genetic Female Monozygotic (Identical) Triplets. Archives of Sexual Behavior, 51(7), 3647–3651. https://doi.org/10.1007/s10508-022-02409-1

MAYO Clinic. (2022, February 26). Gender dysphoria - Diagnosis and treatment - Mayo Clinic. Www.mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/diagnosis-treatment/drc-20475262

Olson, K. R., Durwood, L., Horton, R., Gallagher, N. M., & Devor, A. (2022). Gender Identity 5

Years After Social Transition. Pediatrics, 150(2). https://doi.org/10.1542/peds.2021-056082

Perrotta, G. (2021). Etiological factors and comorbidities associated with the “Gender

Dysphoria”: Definition, clinical contexts, differential diagnosis and clinical treatments. International Journal of Sexual and Reproductive Health Care, 4(1), 001-005.

Vin Tangpricha. (2019). Transgender Medicine, An Issue of Endocrinology and Metabolism Clinics of North America. Elsevier Health Sciences.