Report on ICSSR Sponsored National Seminar on Trans Inclusion at Periyar University 21-22nd Jan'2016

A. Mani

All interested stakeholders including researchers, teachers, activists and NGOs were invited. Most of the participation was from south India. Local students from both the sociology and psychology departments formed a substantial part of the participation. Overall the conference may be said to be successful in helping all stake holders interact on such a difficult topic, but it could have been better.

Proper quality control of submitted papers were not apparently ensured and so the acceptance rate was high. Only some of the papers really contributed to the subject in a substantial way and many were either not adding anything new from theoretical or empirical perspectives. Student papers were excusable to an extent. Not surprisingly, some researchers felt that that the time allotted for their presentation was too less. Questions were also not allowed after talks in many sessions resulting in no discussions/clarification of wrong/very questionable views expressed by some speakers. For example, some of the audience was left wondering about the statement that "the transgender problem is due to migration of people to urban centres". Many speakers conflated indigenous cultural groups like 'Hijra', 'Kinnar' etc and groups determined by sexuality with 'transgender' groups.

Of the many visible trans people expressly invited to deliver talks on their own personal experience, only some including Akkai Padmashali, Banu and Prithika attended. All three especially Akkai Padmashali spoke well on core issues facing trans women. Akkai specifically mentioned that the point of ensuring positive change through legislation is broken in the face of the fact that most of parliament is incompetent in matters relating to sex, gender and relationships. This fact entails that activists must specifically focus on educating people on basics. Prithika, who fought her way into the police force, mentioned that she finds the word "third gender" reek of othering and most agreed. Banu, who is a engineering student and thirinangai rights activist, spoke well on her experiences including the challenges faced within her community.

My talk was shifted to the first day and I had more time to speak on parts of an extended version of an earlier paper of mine. It was about connections between loneliness, suicidal tendencies and exclusion of trans women from a grounded and theoretical psychological perspective with analysis of the lives of various qualified trans women. I could really connect with the audience and my talk was much appreciated.

I did interact with many researchers, students, activists and academics from both psychology and sociology (and yes, had number of pictures taken).

Trans people received most of the applause in the conference.

The interesting empirical studies presented by other speakers fell under the following heads (I could not attend all talks as we had parallel sessions on the first day):

• General studies on samples from specific regions in South India.
• Representation of trans people in the media.
• Analysis of secondary data.
• Problems of trans children
• Clinical Studies on mental health
• Effect of Policies and
• Caste and trans communities

The last subtopic was not covered in any depth, but speakers did mention that indigenous gender non conforming/cultural groups were divided on lines of caste.

Some studies focused on poor use of mobile phones by indigenous gender non-conforming/cultural groups, some on socio-economic aspects, some on political and others on intra community social dynamics. Spandana's clinical study confirmed that trans people in general have lower levels of self-esteem and mental well being than cis people. There were 125 papers in all and at least 75% of these were presented (of course, I am not going to cover much in this report).

The number of theoretical papers were less and presentations that I attended included the following:

• Evolution of the terms Transgender and Transexuality (not comprehensive)
• Gender Diversity and
• Deconstruction of the concept of gender (queer study perspectives).

Trans men were all missing at the conference. That says a lot about the patriarchy.

As far as differences between states is concerned, Tamil Nadu is ahead of others - trans people can get even their birth certificate and school records modified to reflect the gender they identify with - other states and universities are still unclear on updating old records. The literacy statistics of Kerala is inaccurate because trans people and people with disabilities were excluded from the survey.

Funding for the seminar was apparently limited, but more efficient use could have been used of the spent resources. It was obvious that organizational responsibilities could have been shared in a better way. Logistics part of the seminar was not good - outstation participants were expected to find their own way. Student volunteers had to do a lot of work - their work load should have been reduced.

Whatever it was a nice conference conference as it brought together a wide spectrum of people from academia and outside for fruitful interaction.

Note: An edited version of my Paper (another version is at RG) can be found at Feminist-India site and the slides of my talk can be found at Research-Gate.

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Connections Between Loneliness and Suicidal Tendencies of Trans Women

Note1: I have added a  Preprint of this article at research-gate. 
Note 2: Updated version with input from Brenda.
 

It is well known that a large percentage of trans women experience social exclusion, isolation, loneliness and suicidal tendencies at various stages of their life. An alarmingly large percentage actually attempt suicide at some stage of their life. For details of the situation in the US and EU, one can refer to the surveys indicated in the references [1,2,3]. Since loneliness is a subjective internal experience, all of these surveys and much of activism has been centred around social exclusion, isolation and discrimination. In this article the nature and existence of connections between loneliness and suicidal tendencies is explored. 

Social Isolation and Concepts of Loneliness

Loneliness (or 'real loneliness') is best seen as an interior, subjective experience that is influenced by external objective conditions in different ways [4,7,10]. Two different individuals do not in general generate identical degrees of response in similar loneliness inducing objective contexts.  It is not the same thing as being alone and one may feel severe loneliness in the company of others.

Loneliness can have a number of negative consequences on humans that include: reduced lifespan, heath problems, lowered level of trust levels in others, feelings of social incompetence, victim mentality and self consciousness [4,5,6,9].

Stokes and Levin'1986 [8] in a couple of studies on social networks found that men may use more group oriented criteria in evaluating loneliness, whereas women focus more on the qualities of dyadic relationships. Other studies confirm similar phenomena [10], but the nature of loneliness in trans people and coping mechanisms that they may adopt is not well understood. 

Research on connections between gender differences and loneliness should be reviewed in feminist perspectives for useful conclusions to be drawn, as the focus used in many studies seem to be unsuitable for application. There are many studies on loneliness in the literature (do have a look at the references [4--10] if you want to explore more) and some of the conclusions are used in this article. 

On Suicidal Tendencies of Trans Women

People can, in general, plan their suicides in many different ways and they do kill themselves in many ways, but I will not be concerned with the suicide act as such. Here my concerns will be about the maturity level and nature of suicide plans of transsexual women during their pre-transition days or during transition. The exercise should be useful for formulating/defining concepts of reasonable social transition process and in accessing extent of damage due to social isolation and loneliness.

Of the various patterns in trans women suicides in their pre/post-transition state or transition the following are fairly prominent:

•  Those who have killed themselves at a relatively young age (< 25), have done so due to social oppression, persecution and inability to find the means to escape from them. The number of women in this category who actually commit suicide for reasons of wrong self-diagnosis is comparatively small. The number of people who kill themselves for their own inability to come to terms with their state may seem to be large - but blame should be put on social conditions for precipitating such a state of affairs through intersectional feminist perspectives (at least).

• All of the above also apply to the class of people who kill themselves at relatively older ages (> 30), but there are important differences - studies of which are still insufficient. For this class the reasons also  tend to center around problems of body transformations and insurmountable defensive adaptations of pre-transition period.

 

The insufficiency mentioned above is in choice of paradigms for empirical studies that pervade across age groups. It is known that problems like depression, social isolation and poor quality of life are common among "late bloomers". These have been confirmed in recent duplication studies. It is also possible to collect large sets of data from people, but the problem of predicting failure or success is not easy because the coupling that matters may not be available for expression at all times and may also be consciously hidden by the subject of study in question. A relevant but limited study that attempts to answer some of questions is [17].  

Digression

I am also working on the problem from a vagueness related mathematical perspective. Essentially it is about problem representation and finding multi-stage reducts (or removing the chaff). Simplified schematics  have the following form:

So let us call our subject X.

X is a trans women of chronological age > 30

X wants feature sets F and maybe G as part of her transition process.
This F may be graded in various ways.

X has developed a set of adaptations S in response to loneliness (or 'real loneliness' if you like) connected with gender dysphoria. It should be mentioned that not all trans women feel that way.

Typically X is likely to commit suicide on realizing that critical parts of F would not be possible. In ideal situations, this and connections with S suffice to predict a "mature suicide". But other social factors do matter and related prediction models are bound to get more complex.


Knowledge of feminism with all its intersectionality is an important life saving skill that is sometimes omitted by some trans women with terrible consequences because for them 'feminism' is a bad word. For people in the scope of 'mature suicide', there may often be no further sources of suicide mitigation.

Loneliness of the Dead

Examples for these patterns are not difficult to find, but ones with volumes of additional records are less common as in case of late Jess Shipps [11] (/u/lumberchick at Reddit). Jess Shipps produced many popular you tube videos, was a moderator of few trans related subreddits, had plenty of social connections, was often vocal, expressive, positive and rarely seemed to lack empathy - all that is from her online expression and views of her friends. Yet, she was experiencing real loneliness (without social isolation), unemployment (and mentioned these as the primary reasons for her suicide) and was not really passing by her own standards (the last part is deducible from her posts in reddit). She needed wigs and make-up to pass and also believed that the "idea of a woman is distorted by mainstream media and nobody is perfect". Maybe her suicide note was influenced by her position in trans advocacy... maybe not, but her suicide was the result of coupling of multiple factors and not just one of them.  

Eventually it was the lack of material and emotional support that killed her. But it is surprising that she was actually looking forward to getting emotional support - that amounts to a tactical mistake.
 

Loneliness in the Living:

 

Personal Experience:

Though I realized that I am a woman in my pre-teen years, my transition was well after my 30th year. I had to manage extremely high degree of loneliness in my pre-transition times - that was despite being fairly active in many academic and geek groups. The methods of adaptation included workaholism (through multiple careers), extreme degree of involvement in studies and research in solitude (but that is more about being a genius!), cutting off people and bigots for a variety of reasons and restricting all interaction to bare essentials.

The nature of my suicidal tendencies during my pre-transition period was so mature that I had a definite plan that can be summarized in "suicide is admissible if no transition option becomes available and body has been sufficiently poisoned by testosterone".

Physical part of my transition was very easy for me as I was already good looking, femme, healthy, athletic, response to hormones was excellent (that stabilized at estrogen levels of ~360+ pg/ml (very high female range)), had no complications, a partial class advantage and an Asian advantage. Details of some aspects of my transition can be found in my blog. Suicidal tendencies vanished completely on commencement of HRT itself, but am yet to fully come out of the grips of loneliness related adaptations of pre-transition period. Apparently this relates to a lack of open lesbian culture, prevalent transphobia and lesbophobia (am in Kolkata, India) among substantial sections of the older generation and a subhuman society. Hitting it off with women interested in women is easy for me, but not all lesbians are bold enough to break free of the patriarchy. A related aspect is that a generation of more Internet savvy urban upper class lesbians tend to be more confident in deviating from patriarchal norms in comparison to the women with far too limited opportunities to even explore themselves.

The wikipedia articles on sex, gender and sexuality would be rated as pornography by majority of the populations stuck in religion and/or conservative heterosexist norms. No wonder the default goal of most of the whole LBT spectrum is to "emigrate".

 

Experiences of Other Indian Trans Women

The only trans woman that I know of personally is myself. But I have communicated with few others by email and through forums. That is after two years of my coming out. 


Brenda is a scientist who completed her doctorate from IMSC, Chennai before moving to Germany. Some of the issues that she faced are documented in [15]. This is what she has to say on the matter :
"1. Growing up it's easy to assume (for myself) a hetero-normative appearance but once puberty hits, randomness + self questioning begins.
2. No matter how much I tried to hit this part, it doesn't stay buried, if I hang out with male friends all those random comments about women bothers. (not exactly misogynistic just to be clear)
3. At some point you are unable to express and process your own feelings especially sexual. (pansexuality in my case was more than fun , just for the record)
4. Also with lack of proper sex education + information on sexual `and` gender diversity, it was hard for me to process my sexuality from gender identity.
5. Plus most of the common example of trans identity (pertaining to India) comes from media and what I see on the streets, which incidentally was almost never positive.
6. The only two positive instances of media portrayal of trans I remember in my childhood were (pardon me if my memory is not right) - I think the movie was sadaak and sadashiv amravpurkar played transperson who is in charge of a brothel (not a positive trans character but not one which was made a caricature of just for fun, which is what usually happens in Indian media)
    - the second one was I think was once in which a female infant is abandoned  but adopted by a trans woman and the story revolves for the first part about their a daughter and her parental relationship.
7. I enjoyed the above two movies but rarely spoke about it with friend or family for fear of being ridiculed.
8. With dissonance in relating with real life friends, video games were easy to relate.
9. In fact this is my common observation , in here if I meet another younger trans person, I would say with 70% certainty that video games are a safe topic to discuss and bond with.
10. sadly I have also seen a fraction of trans people take refugee in alcohol or weed. (I am grateful I neither of them are on my list).
11.Luckily my transition to Germany was a boon since the LGBT group is a bit wide and I never felt loneliness.
12. In fact in the 4 years I made like 5x the times of friends I have in all through my 28 years in India (and bear in mind, Germans are known to be a conservative lot, in terms of personal space)."
  
Anamika, a student of IIT Kharagpur (as of this writing) experienced dysphoria since her early childhood. She suppressed all desired gender expression and behaviour, and tried to act normal in the sense of the decadent patriarchy for much of her life. Not surprisingly she remained as lonely as ever at the institute. When she did try to explore herself, this was the result in her own words [16]:
“Amidst these feelings, changing my body to match my gender for the better seemed a far fetched reality at least in the near future and having dealt with the emotional pain and self-abuse for a decade, I didn’t see any further hope. So at the start of my 3rd semester, I cut off all my contacts and was about to attempt suicide, when a senior (who later became one of my closest friends) contacted me. I didn’t tell him anything about myself then, yet he suggested that I consider visiting the Counselling Center as an option before taking any such step (I could always go back if it didn’t help) and it seemed a reasonable bargain to me. That small decision turned out to be a life changing event. I always had a very low self-esteem with almost negligible self-worth and self-love, so accepting myself as a transgender girl wasa bitter experience. It took me almost 2 years of therapy to accept myself and become comfortable to open-up to others.”  

 

Trans Women in Developed World

Sub-optimal conditions prevail for trans women in the so-called developed world and some attempts at quantification has been attempted through surveys. To really understand we need to look at personal writings and blogs.

Being openly trans matters a lot. Natalie Yeh agrees [12] with this. She is an Asian American trans woman living in Los Angeles. She transitioned after 30 and her musings on her post transition loneliness suggest that she is tired of explaining herself to others to the point that
" “Maybe I’ll just live out a simple, solitary life…it’s not so bad, many people do it,” I’ve been finding myself muttering as of late."


Naomi Ceder did not have suicidal tendencies despite being closeted all through her long pre-transition years in a hostile environment. In one of her blog posts [13] she says “For a trans kid in this environment self hatred was inevitable. There was literally no one I knew who was like me, no one I could dare talk to, for fear of exposure and humiliation and worse.”

Rebecca Williams has this to say on loneliness [14]:

“I think one of the things that can trigger acute feelings of loneliness is being "different". Being different could mean anything, in this world. .... I think people internalize this difference as sense of wrongness early on in their lives. They learn to be ashamed of their difference, of themselves. In a sense, they learn to hide that part of themselves away. It is that part, that sense of self that feels lonely. I think people are in the most part resilient, especially as children, and they learn to cope and adapt around this sense of difference. Sometimes these coping mechanisms work OK, other times they don't.....

But to foster a culture of tolerance and kindness can only be a positive thing for everyone, so everyone can learn to be more themselves, a little more different, a little bit more individual.”

Here “learn to be ashamed ” necessarily requires propaganda by bigots of various grades to happen.

Research Problems

It is clear that when we read 'gender' as a plural concept, then loneliness is related to it. But the concept of 'gender identity' is unrelated or 'less related'. Two problems that seem to be some interest are:


* How can we define usable concepts of 'gendered loneliness'?

* What is the relationship of gender dysphoria to such possible concepts of 'gendered loneliness'?

References

Surveys:

[1]. Injustice at Every Turn - National Transgender Discrimination Survey: Full Report Sept'2012, NCTE Download Link.


[2]. EU LGBT Survey' December'2014: Results at a Glance
EU Agency for Fundamental Rights, Dec'2014, Download Link.


[3]. Labia Collective: Labia Collective Survey' 
April'2013, Download Link.

Loneliness:

[4]. Russell, D.
UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure.
Journal of Personality Assessment, 66, 1996, 20--40.

[5]. AIPC Article Library:
Symptoms, Causes and Effects of Loneliness,
July'2012, Link to Article
(accessed on 15th June'2015)

[6]. AIPC Article Library:
Counselling Strategies for Dealing with the Lonely Client,
July'2012, Link to Article 
(accessed on 15th June'2015)

[7]. Aspel, Melaine, Ann.
Let’s talk about feeling lonely.
New York; Rosen Publishing, 2001.

[8]. Hackney, H., Cormier, S.,
The professional counsellor – a process guide to helping.
Boston: Allyn & Bacon, 2005.

[9]. Stokes J, Levin I.
Gender differences in predicting loneliness from social network characteristics.
J Pers Soc Psychol. 1986 Nov.51(5).1069--74.

[10]. Yang, J.
Relationship between gender traits amd loneliness: the role of self-esteem.
Master's Thesis' Brandeis University Feb 2009, 41pp.

Blog and Social Networking Links:

[11].  Jessie Shipps:  Suicide Note, Discussion
         Jessie Shipps: Reddit Userpage

[12]. Natalie Yeh: The Lonely Journey of a Transsexual Woman, 
2013,  Blog Post

[13]. Naomi Ceder: Thoughts on a Trans Teen Suicide,
2015,  Blog Post

[14]. Rebecca Williams: Loneliness
2013, Blog Post

[15]. Brenda Jacksh:  Acceptance and Denial, 2012, Blog Post. 
 
[16]. Anamika: Fear Can Hold You Prisoner, But Hope Can Set You Free,
2015, Blog Post

Study

[17]. Moody, C., Smith, N. G. Suicide Protective Factors Among Trans Adults
Arch. Sex. Behav. (2013) 42:739–752
 

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Attitudes and Trans Inclusion in Indian Academia

(A slightly more subtle version of this article has been published  as "'Attitudes & Trans Inclusion in Indian Academia' by A. Mani" in Gaysi Family on 5th Jan'2015).

In this article, I draw upon my limited personal experiences to try and classify the diaspora in Indian higher education on nature of attitudes towards gender diversity in general and trans women in particular. This in turn can be used to estimate vectors of discrimination and exclusion of trans women at least. I do have some empirical data at my disposal and yes, many of the subjects are known to me - that hopefully means better data reliability.

Relative my experiences, some professors and researchers have been excellent, some have been reasonable, many have been barely able to cope with the complexity and very few have indulged in blatant trans misogyny, bigotry and deliberate micro-aggressions. Most women are very comfortable with transsexual women and transsexual semantics - which is pretty much consistent with feminist perspectives and studies on behaviour.

Most accounts of transsexual women in the media and literature have been of women from the west, while Indian accounts have been limited and not every trans woman has a clear understanding of feminist dynamics. Many tend to focus on themselves and so broader pictures fall off from their accounts. Further the use of umbrella terms including ones for indigenous genders/cultural identities contributes to alienation and erasure of transsexuals and binary-identified transsexuals. All this extend to academic and FOSS environments naturally.

The brainwashing caused by the patriarchy/intersectionality/discriminatory order structure even on relatively younger men is often severe. They have many issues in interacting rationally with people not confirming to their hetero-normative, cissexist, colonial/religious ideals and stereotypes. Skewed ideas of entitlement, misogyny and trans misogyny are part of such brainwashing. While there are plenty of exceptions to these generalities, even supposedly educated men perpetuate evil on the basis of such thinking and vitiate professional environments with such. Unfortunately we still have gaping holes at the policy level - that can help in rectifying the situation.

Some of my observations are 

• People making greater use of vernacular/local languages in all interaction tend to be at a poor stage of development as opposed to those interacting more often in the English language.
• Gender identity is less stressed (as opposed to gender expression) in narratives of queer women (in the state) who interact more often in the vernacular languages. This may also be contributing to the problem.
• For a large set of contexts, belief in misogynistic premises predispose one towards trans misogyny and conversely. 
• An interesting belief of some academics including senior ones is that their backward colleagues can never be educated on these matters and that bigotry is god.
• Women learn far better than men on matters of gender and sexuality.

It is very important to teach people about gender diversity, sexuality and tolerance- the lack of it invariably leads to skewed ideas of entitlement to abuse and suppress people of all gender identities and expressions. Prevalent cis-sexist and hetero-normative attitudes shared by many in the academia should be countered with policy and education at all levels. Otherwise scope for rational discourse may continue to remain elusive forever because brainwashed people do not like to reason rationally.

Teaching Strategies:

My coming out strategy in 2012-2013 was roughly group-wise and mostly through the Internet. Educating people was not too hard, though difficult at a personal level. Things did not seem to work out too well with primers and other links to online resources on gender, trans-sexuality, feminism and women. So eventually I had to start this blog to get my points across. Some people apparently identifying as men do stick to their bigotry, usually I point them to basics - such people would not even pass a basic course on human sexuality and gender because of their brainwashing and consequent insecurities. 


There are other trans women in higher academia in West Bengal. Their struggles and tribulations have forced them to maintain low profiles across far too many spaces -- the relevant attitude painted in the despondent "We do not have enough resources to destroy collective idiocy".

The Family Value Conundrums:

Ideas of family values are deeply entrenched at different levels of bigotry in the Indian society. It makes lot of sense for the lesbian movement to make inroads by way of equality at related social constructs and operations.

I have often had to deal with events, projects and other academic work frequently since mid nineties of the last century. Most related workplaces have been male-dominated.

Pre-transition, I had a butch presentation and my body chemistry was also determined by estriols - was seen by some as being very queer/queer woman. Still I would be part of conversations like the following with senior people in position (I remember more than fifteen of these. Remarks in square braces are mine) :


Conversation-1

 Are you married?

Me: No

I have a daughter.

[I know most girls are naughty. Thank you for your interest in lesbian rights.]

She is doing her undergraduate studies

Me: Good
[Some women like younger women.]

Shall I proceed?
Me: I ... I need to think

[Actually my life plans were for a shorter term and I had no intention of falling for any tools of oppression.]

During transition, there were other similar conversations. But these were more informed ones as I had already been open about my orientation.

 
Conversation-2


After more than an year of HRT, there was this conversation.

Me: Hello!

I don't know you.

[- serious version]

Me: OK, I must have seen you at ...
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I can write a whole monograph (time permitting) on the concept lattices of trans semantics instead of such a cryptic posts ... will wait for another day.

One comment on this article was rather interesting from the point of feminist theories as well. I will leave the last word (translated) to her :"Mani, when I see write-ups like these, then I see many zombie daemons and daemons. I get chills through my spine!" 

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All Rights Reserved, Copyright A. Mani' 2014

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Do You Have Gender Dysphoria or Incongruence? (2nd Edition)

(This article was published first as "Do You Have Gender Dysphoria or Incongruence?"  by A. Mani
in Gaysi Family on 17th June'2014).



Transsexual people are becoming increasingly visible in public life and more and more people are 'coming out'. Some of them realize their trans-sexuality early in life, while many take their time. This scenario is not completely due to society's concept of gender but has to do also with limited understanding of dysphoria and its ramifications among the populace. Gender dysphoria, in simple terms, refers to the perception of mismatch between a person's sense of self and internal and external parts of the body (in relation to gender identity and expression).  In this article, I try to formulate a simple guide for discovering gender incongruence or dysphoria with exclusive focus on trans women – because it is difficult to write unified guides across even a couple of trans categories.

First of all a few words about the terminology. The concept of "gender incongruence" is sometimes advanced to replace "gender dysphoria" for removing the stigma associated with the latter term ("Dysphoria" is the preferred term in DSM-5). It has also been proposed that the former term should be considered outside of DSM in the first place. The older term, 'Gender identity disorder' pathologizes gender variance itself (and is still part of ICD-10 CM), while 'gender dysphoria' pathologizes the discontent. Importantly the term "dysphoria" is preferred by WPATH. So I will stick to this terminology in the article. Feel free to replace the term with "incongruence" if you like it.

Before I proceed, it is necessary to clarify basics of sex and gender as these concepts are not understood in a uniform way. Scientifically, sex of a person is best seen as a tuple of parameters corresponding to hormonal sex, brain sex, clinical sex, chromosomal sex, physical sex and more. Population data relating to this cannot be properly classified.  Gender is a vague social concept characterized by arbitrary norms and prescriptions. Modern people recognize that genders exist on a spectrum and do not abide by religious ideas of binary gender with its rigid prescriptions of hetero-normativity. Gender identity of a person is the person's own sense of gender without regard to expression of the same in society. Recent research does prove that a part of the gender identity of a person is in the brain and that it develops in the fetal development state itself – this is almost the same thing as "brain sex" as the latter includes structural and functional differences between brains.

A plural concept is a concept with multiple facets or dimensions. Well known trans feminist and biologist Julia Serano uses the term 'gender' in a plural sense in her latest book -Excluded: Making Feminist and Queer Movements More Inclusive”. She recognizes that biology, culture and environment all interact in an unfathomably complex manner to generate gender diversity and argues that people tend to end up limited ideas of gender, sexuality and sexism because of limited life experiences and social situation. The complexity of interactions therefore forces us to view the components separately. In "what it means to be a women”, she says “I used to think it was a contradiction that some dykes abhorred me for my masculinity while others hated me for my femininity, until I realized that being a woman means that everyone has a stake in seeing what they want to see in me”.

Since gender is such a plural term and transsexuals evolve in so many different ways, it is only natural that self-discovery of gender dysphoria can take on so many forms. You can infer that you have gender dysphoria by simply reflecting on your gender identity and comparing it with other people's experience of dysphoria or with prototypical models of dysphoria. It is possible that your experiences may not tally with those of others and still you may be having dysphoria.  

It is fairly well known that for a given gender identity on the gender continuum a wide range of gender expression may be associable. Thus for example, a person identifying as a woman may have so-called butch features. Some of these women may identify as gender queer women and some may identify as cis women or simply as women. Even people with gender dysphoria have diverse gender expression and some part of this expression can be related to dysphoria – but the centrality of gender identity stands tall in self-discovery of dysphoria.

Gender dysphoria can be detected even in six year children and younger, but due to the under-developed nature of society and social conditioning many people wait till the problems have become unbearable and have already caused enough damage. Early intervention is important and it would be best if people with gender dysphoria take their own decisions as a therapist's understanding is liable to be affected by the subjective nature of responses.

In what follows, I have used the limited accounts of dysphoria by prominent trans women, discussions with various trans women on multiple forums, formal literature and my own experience as a lesbian trans woman to arrive at possible characterization of dysphoria as is actually experienced. 

Amy Dentata is a writer, game designer, and performer who touches on topics including trauma recovery, mental illness, sexuality, futurism, and trans issues. She started performing music at open mics in her home-town of Cleveland, Ohio, before moving to the Bay to pursue a career as a game artist. She explains the fact that a part of gender identity is an intrinsic part of the person. The interaction of gender identity in the brain with the body towards formation of dysphoria is explained through a brilliant analogy. She does not identify on the binary and her perception of her time-line highlights other aspects of her dysphoria.


Since 2008, Zinnia Jones has been a writer and video-blogger. She's written extensively on the subjects of secularism, feminism, and being a trans woman. She describes aspects of her dysphoric experience in considerable detail in her blog post and notes that many trans women (including herself) fail to recognize symptoms of dysporia as being connected to gender for considerable periods of time. Further she mentions “The real extent of my dysphoria only became clear after I began to transition (motivated largely by the desire to induce physical feminization and prevent further masculinization, rather than the need to treat a clear dysphoria), and these feelings dissipated for the first time ever. Once I had this basis for comparison, I could see that I was indeed experiencing gender dysphoria all along – it was just so indirect that I had failed to recognize it as specifically gender-related”. Some of her proposed symptoms are mixed up with her own general attitude to life and so I had to abstract the essentials from those. 


Rebecca Williams identifies on the binary and describes herself as a “femme, mildly androphobic queer trans feminist”. Her description of dysphoria can be garnered from across many articles in her blog. She says that she cannot possibly describe the wonderful feeling of her hormonal system getting wired up correctly (after HRT) and that even tiny corrections to physical form by HRT are always for the better and that it helped a lot with her social acceptance. The relation between dysporia and normality is expressed thus “I think the thing about specific parts of dysphoria is that once they're treated, it's gone forever. There's no particular feeling other than feeling normal … … I think really, this is what it's all about.  Just wanting to feel normal.”

Below I list a number of severe dysphoria related characteristics (not necessarily without overlap) that a trans woman may have. Various combinations of weak versions of these are sufficient for a diagnosis of dysphoria. 

Body Related:

• S1. Extreme discomfort with most male secondary characteristics.
• S2. Extreme discomfort with most male secondary characteristics to the point of misandry as in "men are degenerate people".
• S3. Strong Aversion to use Pre-HRT genitalia in any sexual activity.
• S4. The distinct feeling of testosterone poisoning.
• S5. Experiences of apparently phantom sensations of female genital stimulation and orgasms as part of regular sexual interaction and fantasies.
• S6. Depression due to inability to eliminate male secondary characteristics.
• S7. Depression due to inability to eliminate testes/genitals.
• S8. Inability to perform sexually due to genital dysphoria by way of suppression of libido.
• S9. Strong suicidal tendencies.

 

Depression Inclusive:

• A. Depression due to inability to fit in desired female role.
• B. Depression due to missing feminization of existing features.
• C. Depression in general due to latent dysphoria (about which subject is not explicitly aware of).

 

Social Interaction Related:

• I1. A strong feeling of interacting in a dehumanized society due to forced male presentation that increases by recursion with the living.
• I2. Strong tendency to escape from gendered social interaction.
• I3. No male role models
• I4. Some female role models
• I5. No interest in acquiring perceived male characteristics.
• I6. Strong desire to acquire perceived female characteristics like smooth, beautiful, evenly-toned, hairless skin.
• I7. Strong desire to behave as per desired as opposed to assigned gender role.
• I8. Adopted features selected from male role models do not have any gender related import.
• I9. Adopted features selected from female role models have strong gender related import.

Other:

• O1. Awareness of glaring differences in spousal expectations (relative their libido) and desired personal presentation.
• O2. Workaholism originating from desire to escape from oppressive social life and effects of testosterone.
• O3. Substance abuse originating from desire to escape from the oppressive social life and effects of testosterone.
• O4. Gender expression in drag-like modes resulting in depression and feelings of inadequacy.
• O5. Severe numbing of emotions due to perceived long-term latent dysphoria.
• O6. Awareness of severe differences in body chemistry in relation to people of assigned gender.
• O7. Androphobia.
• O8. Awareness of being different from others. 
• O9. A notable escalation in the severity of all of these symptoms during puberty.
  
  

It is well known in statistical terms (as well) that the class of transsexual people suffer additional psychiatric problems at the same rate as normal people. So we have additional reasons to exclude any other psychiatric conditions (including mild ones) from the considerations.

In the above S1 or S2 and S4 and any of the S* conditions is a sufficient indication of gender dysphoria. Many weak versions of the above may suffice. Zinnia Jones for example, experienced only a vague and weak version of S1 in her pre-transition period and came to realize the full extent of what she was missing out only after some HRT. Some trans women have reported S1 and O7.  Others have confirmed combinations like S1, a little S2, mild S3, S6, S7, S9 (mainly in the past), A, B, C (prior to 2000), I1, I2, I3, I4, I5, I6, O1, possibly O2, O7. 

A weak form S1 and I1 or I2 in people who are past twenty five is often suggestive of dysphoria that requires more attention – mainly because it is not such a nice thing to wait till the condition worsens.

I3 to I9 are useful for understanding one's own internal evolution of gender expression and realize dysphoria in presence of suitable indications from the S* or I* conditions.

If any person has O5, then they need to be more careful in their analysis because everything probably would be lacking in intensity in their perspective. Depression is pretty common in society and may be organic without reason. So it is necessary to trace the exact reasons for it. If can be due to dysphoria and often (if not always) accompanies it in mild to chronic form.

Some heterosexual/bisexual trans women who apparently take the "gay/drag route" (relative to a conservative society) to realize themselves. O4 is typically experienced by such women. Other O* conditions are not related to sexual orientation. Obviously trans women with S2 are likely to be lesbians. It is known that a majority (as much as 2/3rd in the largest survey) of trans women are lesbians or bisexual. Though trans-sexuality in general is independent of orientation in the sense that a transsexual may have any kind of orientation, connections between dysphoria conditions and orientation are natural – and natural even when we transcend stereotypical expressions of orientation (because people take time to learn). 

All of S2, S4, S6, S9, B, I1, I2, I3, I5, I7, I8, I9, O2, O6, O8, and O9 apply to my experience of dysphoria. A dense account of this can be found in my blog post. Since my high school days,  I have always identified as a lesbian and being a lesbian is not just about my orientation, but is part of my identity. It did affect socialization, but I am not mixing that up with dysphoria related reasons. I never had any real role models, though I have always admired a lot of women (mostly older) and usually abstracted positive traits from them and adapted them in my own way. I* conditions are not about dysphoria per se, but I do feel that they are important for investigating latent dysphoria in people in their social context.

Most of the symptoms associated with dysphoria resolve substantially upon initiating HRT. But that is no way of checking whether one has dysphoria or not.

Hope all this helps you in your gender explorations!

Remark1: One commentator pointed out that I am complicating the situation for dysphoric children below six years. Obviously that class requires a more involved guide. 

Remark2: My article at Gaysi does not include the links and have made a few minor changes.

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All Rights Reserved, Copyright A. Mani' 2014

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Do You Have Gender Dysphoria or Incongruence?

(A more detailed version will appear soon. Treat this as the first edition.)

Transsexual people are becoming increasingly visible in public life and more and more people are 'coming out'. Some of them realize their trans-sexuality early in life, while many take their time. This scenario is not wholly due to the social constructive aspect of the concept of gender and has to do with limited understanding of dysphoria and its ramifications among the populace. In this article, I try to formulate a simple guide for discovering gender incongruence or dysphoria with exclusive focus on trans women – because it is difficult to write unified guides across even a couple of binary trans categories.

First of all a few words about the terminology. The concept of "gender incongruence" is sometimes advanced to replace "gender dysphoria" for removing the stigma associated with the latter term ("Dysphoria" is the preferred term in DSM-5). It has also been proposed that the former term should be considered outside of DSM in the first place. The older term, 'Gender identity disorder' pathologizes gender variance itself (and is still part of ICD-10 CM), while 'gender dysphoria' pathologizes the discontent. Importantly the term "dysphoria" is preferred by WPATH. So I will stick to this terminology in the article. Feel free to replace the term with "incongruence" if you like it.

Before I proceed, it is necessary to clarify basics of sex and gender as these concepts are not understood in a uniform way.

Scientifically, sex of a person is best seen as a tuple of parameters corresponding to hormonal sex, brain sex, clinical sex, chromosomal sex, physical sex and more. Population data relating to this cannot be properly classified. Gender is a vague social unscientific concept characterized by arbitrary norms and prescriptions. Modern people recognize that genders exist on a continuum and do not abide by religious ideas of binary gender with its rigid prescriptions of hetero-normativity. Gender identity of a person is the person's own sense of gender without regard to expression of the same in society. Recent research does prove that a part of the gender identity of a person is in the brain and that it develops in the foetal development state itself – this is almost the same thing as development of a part of "brain sex" as the latter includes structural and functional differences between brains. Some people use the term 'gender' in a plural way (see Julia Serano's latest book for example) - confusions if any should hopefully be clear from the context. Some basics may be found at this link.

Since gender is such a plural term and transsexuals evolve in so many different ways, it is only natural that self-discovery of gender dysphoria can take on so many forms. You can infer that you have gender dysphoria by simply reflecting on your gender identity and comparing it with other people's experience of dysphoria or with prototypical models of dysphoria. It is possible that your experiences may not tally with those of others and still you may be having dysphoria.

It is fairly well known that for a given gender identity on the gender-continuum a wide range of gender expression may be associable. Thus for example, a person identifying as a woman may have so-called butch features. Some of these women may identify as gender queer women and some may identify as cis women or simply as women. Even people with gender dysphoria have diverse gender expression and some part of this expression can be related to dysphoria – but the centrality of gender identity stands tall in self-discovery of dysphoria.

Gender dysphoria can be detected even in six year old children, but due to the under-developed nature of society and social conditioning many people wait till the problems have become unbearable and have already caused enough damage. Early intervention is important and it would be best if people with gender dysphoria take their own decisions as a therapist's understanding is liable to be affected by the subjective nature of responses.

I have used the limited accounts of dysphoria by prominent trans women, discussions with various trans women on multiple forums, formal literature and my own experience as a lesbian trans woman to arrive at possible characterization of dysphoria as is actually experienced. Amy Dentata explains the fact that a part of gender identity is an intrinsic part of the person. The interaction of gender identity in the brain with the body towards formation of dysphoria is explained through a brilliant analogy. She does not identify on the binary and her perception of her time-line highlights other aspects of her dysphoria. Importantly she agrees mostly with ZinniaJones's detailed description of her own dysphoric experience . In contrast to Amy, Rebecca Williams identifies on the binary. Her description of dysphoria can be garnered from across many articles in her blog.

Below I list a number of severe dysphoria related characteristics (not necessarily without overlap) that a trans woman may have. Various combinations (or weaker versions) of these are sufficient for a diagnosis of dysphoria.

Body Related:

• S1. Extreme discomfort with most male secondary characteristics.
• S2. Extreme discomfort with most male secondary characteristics to the point of misandry as in "men are degenerate people".
• S3. Strong Aversion to use Pre-HRT genitalia in any sexual activity.
• S4. The distinct feeling of testosterone poisoning.
• S5. Experiences of apparently phantom sensations of female genital stimulation and orgasms as part of regular sexual interaction and fantasies.
• S6. Depression due to inability to eliminate male secondary characteristics.
• S7. Depression due to inability to eliminate testes/genitals.
• S8. Inability to perform sexually due to genital dysphoria by way of suppression of libido.
• S9. Strong suicidal tendencies.

Depression Inclusive:

• A. Depression due to inability to fit in desired female role.
• B. Depression due to missing feminization of existing features.
• C. Depression in general due to latent dysphoria (about which subject is not explicitly aware of).

Social Interaction Related:

• I1. A strong feeling of interacting in a dehumanized society due to forced male presentation that increases by recursion with the living.
• I2. Strong tendency to escape from gendered social interaction.
• I3. No male role models
• I4. Some female role models
• I5. No interest in acquiring perceived male characteristics.
• I6. Strong desire to acquire perceived female characteristics like smooth, beautiful, evenly-toned, hairless skin.
• I7. Strong desire to behave as per desired as opposed to assigned gender role.
• I8. Adopted features selected from male role models do not have any gender related import.
• I9. Adopted features selected from female role models have strong gender related import.

Other:

• O1. Awareness of glaring differences in spousal expectations (relative their libido) and desired personal presentation.
• O2. Workaholism originating from desire to escape from oppressive social life and effects of testosterone.
• O3. Substance abuse originating from desire to escape from the oppressive social life and effects of testosterone.
• O4. Gender expression in drag-like modes resulting in depression and feelings of inadequacy.
• O5. Severe numbing of emotions due to perceived long-term latent dysphoria.
• O6. Awareness of severe differences in body chemistry in relation to people of assigned gender.
• O7. Androphobia.

It is well known in statistical terms (as well) that the class of transsexual people suffer additional psychiatric problems at the same rate as normal people. So we have additional reasons to exclude any other psychiatric conditions (including mild ones) from the considerations.

In the above S1 or S2 and S4 and any of the S* conditions is a sufficient indication of gender dysphoria. Many weak forms of the above may be sufficient conditions. Zinnia Jones for example, experienced only a vague and weak version of S1 in her pre-transition period and came to realize the full extent of what she was missing out only after some HRT. Some trans women have reported S1 and O7.

A weak form S1 and I1 or I2 in people who are past twenty five is often suggestive of dysphoria that requires more attention – mainly because it is not such a nice thing to wait till the condition worsens.

I3 to I9 are useful for understanding one's own internal evolution of gender expression and realize dysphoria in presence of suitable indications from the S* or I* conditions.

If any person has O5, then they need to be more careful in their analysis because everything probably would be lacking in intensity in their perspective. Depression is pretty common in society and may be organic without reason. So it is necessary to trace the exact reasons for it. If can be due to dysphoria and often (if not always) accompanies it in mild to chronic form.

Some heterosexual/bisexual trans women who apparently take the "gay/drag route" (relative a conservative society) to realize themselves. O4 is typically experienced by such women. Other O* conditions are not related to sexual orientation. Naturally trans women with S2 are likely to be lesbians. It is known that a majority (as much as 2/3rd in the largest survey) of trans women are lesbians or bisexual. Though trans-sexuality in general is independent of orientation in the sense that a transsexual may have any kind of orientation, connections between dysphoria conditions and orientation are natural – and natural even when we transcend stereotypical expressions of orientation (because people take time to learn).

All of S2, S4, S6, S9, B, I1, I2, I3, I5, I7, I8, I9, O2 and O6 apply to my experience of dysphoria. A dense account of this can be found in my earlier blog post. Since my high school days, I have always identified as a lesbian and being a lesbian is not just about my orientation, but is part of my identity. It did affect socialization, but I am not mixing that up with dysphoria related reasons. I never had any real role models, though I have always admired a lot of women (mostly older) and usually abstracted positive traits from them and adapted them in my own way. I* conditions are not about dysphoria per se, but I do feel that they are important for investigating latent dysphoria in people in their social context.

Hope this helps you in your gender explorations!

________________________________________________________________________


All Rights Reserved, Copyright A. Mani' 2014

__________________________________________________________________________ 


Rate my blog at Susan's Place Trans Resources