Is there a difference between Gender Dysphoria and Body Dysphoria

[pamela7]

The thread on "HRT, GD, and tolerating life pre transition" has raised something for me, wonder if you all can input here.

Some thoughts on the thread are concerned about body shape and attractiveness; something GG's will have to face anyway - under the welter of media pressure for perfect figures and marketing for cosmetic surgery.

I perceive that we have two things here to separate and address properly. The GD will only be addressed by transitioning to the degree needed, but surely the body dysphoria is something that can be treated; we all have to accept the limitations of our body at some point.

I'm curious what other TS here think about this subject.

thanks, Pamela

[LeaP]

Decided you wanted to dive into the swamp, did you?

"Gender dysphoria" is defined and used in different ways by different people depending on the context. I'm not speaking about casual definitions, either. So if you are using it in the psychiatric sense, you would use one of the accepted definitions (or diagnoses) in the reference of your choice. (E.g., the DSM5) Even the psychiatric definitions and usage very, however. You will see all kinds of differences and inconsistencies in the commentaries and in publications that refer to the standards documents.

People speak about the term as if it were something more than it is. Though the term originates in psychiatry, it has wide use outside psychiatry where it is subject to no particular standardized definition. It doesn't help that the term's origins dates to before physical sex and gender were distinguished. So right out of the gate you have to be clear about the context.

I have advocated for a very strict reading of the term as used in the DSM, distinguishing between the distress brought on by dysphoria and the dysphoria itself – the latter of which I take ONLY in the sense of "body dysphoria" (body – mind conflict as it relates to physical sex) ... as it applies to transsexuals. Some academics would agree with that. Some would not.

Though I dislike the imprecision, I recognize that the term is used to apply to both people who have the aforementioned mind to body conflict as well as those who have a gender problem. That works as long as you're clear about the conditions and their differences. Unfortunately, most people not only muddle the difference, some, for a variety of reasons, would prefer to conflate them anyway.

I think what your question hints at is the nature of transsexualism. Transsexualism, though, is not defined by dysphoria, which is strictly speaking "just" a psychiatric condition. THAT condition can be brought about by a transsexual living a conflicted life, but is not transsexualism itself. That is, unless you take transsexualism to be solely a psychiatric manifestation. I do not.

[pamela7]

Thankyou Lea, er yes, it's one way to learn - the deep end. I don't hold much truck with DSM tho that's a whole other story. I was using the term "body dysphoria" to also include people who hate their body, perhaps not their physical gender body, and to use the gender dysphoria to represent the dissonance between sexual identity/nature and the physical body's presenting gender.

I'd rather see the whole can of worms though, it will help me, and maybe others.

[Jennifer-GWN]

Pamela;

To pile on the complexity is issue gd or is it envy as sometimes these as well get intermixed.

Have fun.

Cheers... Jennifer

[Michelle789]

I believe that gender dysphoria and body dysmorphia are two separate things. However, people who suffer from gender dysphoria often (maybe usually or always) suffer from body dysmorphia as well.

Body dysmorphia is unhappiness with your body. GGs often feel body dysmorphia because of the media pressure for perfect figures and the cosmetic surgery industry. They commonly feel they hate parts of their body and wish they could make themselves look younger and more attractive.

People who suffer from gender dysphoria sees a disconnect between our internal gender identity and the one assigned to us at birth. This can include social disconnect - wanting to be seen and treated as a woman. Identity disconnect - wishing to go by a female name and pronouns. And body dysmorphia. We hate our male bodies - we hate our genitals and the masculinization effects of testosterone to our bodies. We face not only the same pressure that GG's face to have the perfect young and attractive body, but really hate the maleness of our bodies and desire a body that matches who are really are on the inside. A female body - even if it isn't perfect, but one that is female enough, with flaws, that represents who are truly are.

Some people may argue that this is not body dysmorphia and consider to be a symptom of GD instead. I just see it as body dysmorphia being a symptom of GD. In the end of the day, it's just arguing over definitions.

[MarieTS]

Sorry, but I see the two as inextricably linked. I think they both go hand-in-hand.

[LeaP]

There is no relationship between body dysmorphia and GD. Completely different diagnosis, symptoms, etiology, treatment, outcomes, etc. This isn't a difference of definitions or perspective. Body Dysmorphia is a form of severe psychosis. In short, GD is not.

Pam, you used the phrase "body DYSPHORIA". Hopefully, you weren't using that to convey dysmorphia. "Body dysphoria" is a phrase you hear every once in a while to clarify that someone is talking about dysphoria that is rooted in the mind-body conflict that defines transsexualism.

Gender dysphoria is both a symptom and a diagnosis. As a symptom, it pops up as a manifestation of many conditions unrelated to transsexualism. Even as a diagnosis, it only describes a limited pattern of psychological issues that that only some transsexuals and gender variant people have. GD is not a matter of not arguing definitions, it is a PRECISELY detailed and agreed definition.

My point, though, is that GD gets too much attention. (In fact, the medicalization of transsexualism gets too much focus.) Oh, I get it (GD) - literally! - but have come to view it as a sideshow. The main event is the identity problem, by which *I* mean ... wait for it ... not gender, but body mapping. A female brain expects a female body (including female hormones). The drive to resolve that is transsexualism. It may or may not involve ANYTHING in the category of GD! GD isn't the problem, it's something that fades with the problem's resolution. "Gender" is a point of confusion in all this because there is SO much variation in individual expression as a *manifestation* of one's sex. Transsexuals don't have have a gender problem except as a symptom!

[PaulaQ]

Some people use the term "body dysphoria" to indicate discomfort with one's primary or secondary sexual characteristics. Such discomforts are but one of the symptoms of GD. You can suffer from GD, and transition, and suffer from relatively little concern over the configuration of your genitals. Or you can find that attempting to throw yourself off the roof of a building seems more sensible than living with them for one more minute. There are a number of different symptoms of GD, and trans people suffer from them to varying extents.

A minor point of disagreement with LeaP - I think the social components of gender are as important to many trans people as physical components. I agree that the problem is our identities. But that goes beyond the physical, and into our social interactions and even our internal though processes. Our problem is our minds know what our gender is supposed to be - having the rest of the world invalidate that identity is incredibly damaging. (I think we agree on that, and possibly all of it, if I misunderstood what you said.) Having strong reactions inside our minds about the configuration of our bodies not matching that of our minds only makes all of this much worse. In effect, seeing ourselves in the mirror, we often self-invalidate.

[Krististeph]

Dysphoria refers to dissatisfaction with life, so gender dysphoria would be the dissatisfaction of like because of gender, whereas the body dysphoria is related to dissatisfaction due to body attributes.

Technically.

There is a lot of overlap and grey area, yes indeed. The problem using language for logical though is that we all have different connotations and attachments to words. In this case I think it would be appropriate to consider defining "gender" and "body" ad hoc - for the purpose of distinguishing the two in terms of the question.

Gender can mean a lot of things, and for better or worse, it is not rigidly defined by all people. For instance- the political intent can mean something much different than the medical or even social intent- even when speaking about the body parts- female genders have babies- but what about an infertile female? She is in no way a male.

So i think clarification of the question, perhaps by explaining (roughly) what several various answers would mean to the person asking, is reasonable. We want to give our ideas, but we don't want to give ideas that might not be what we really intend. This is the problem with multidimensional issues- open questions may be desired in some cases, but it seems like you are asking something more specific here.

You want to define a specific division, how do you see the division described? It is a great question, in that (IMO) is requires backtracking and clarification, and some real reflection.

Body and gender are different things, even biologically, from a certain point of view. BUT without further clarification- I'm still saying YES for several reasons: Perception of body is more physical than perception of gender, overall, I think. And if I'm reading into your question correctly, Pam, it seems if you are asking 'does the body need to fit the idea of the gender?'

You would not be asking this if you thought "yes" or if you thought "no". The answer is "Splunge". (Sorry, I just had to...). Your question, is it not, is "to what degree?" To what degree does one want to change their body to fit their ideal? This can be a completely TG neutral question.

That said, it does not make it any easier. First- and i know you are going to hate this- remember that the question is the first step. Second- remember that a question is (can be) a tool rather than a reality checker, in this case. What is the ideal of the gender to the observer? If one goes for overall structures, then bone density, bone structure, etc. this is going to take some work. If one considers physical details- arm/leg shape- body shape- facial muscles, these can be dealt with surgically. If one considers gender to be a spiritual component, this is less invasive physically, but more invasive mentally. You must learn to walk the way you want to walk, flirt the way you want to flirt, practice, practice, and practice. None of this 20 hours gets you 80%. Joe Pareto does not apply to TG mannerisms. You have to live it. 2000 repetitions (no source/reference offered for now) is a typical standard for committing something to subconscious. That is about 2 years of 90 minute sleep/wake cycles on the job, and why it take about 2 years before you begin to get comfortable in a job (my personal hypothesis).

Dysphoria is dissatisfaction. We will always have it.

Might I postulate that an equitable question might be "what level or category of gender dysphoria is acceptable or manageable?" These are just thoughts Pam, but don't think i'm being glib in this case. I'm trying to volley appropriately, FWIW. :-)

[pamela7]

Going back to my OP, KristiSteph, with a "splunge". It really was my surmise from that other thread, that there are two distinct albeit related phenomena - among the many. I'm not even going to agree a "brain pattern" defines gender as to male or female identity, because the brain patterns are socially programmed. I'm one who never thought of gender until I discovered the question here, and I truly wonder how many people out there also never pondered how one knows one's gender once the observable genitalia are taken out of the equation, and the whole XX/XY thing unknown, and intersex being a further complication.

I feel a number of pains - the physical pain of my testicles being the foremost physical dysphoria signal, and then the emotional pain - an unresolved sadness alleviated through becoming female through and through, maybe testosterone is a toxin in my body? I don't "hate" my body, but i do have an intense desire for boobs, and I do have to have the orchie to relieve the pain, and i do need the hormones - i don't know why i just intuit i'll know why once i'm on them. I don't need further GRS beyond this, as i see it, obviously though only time on hormones can prove if that remains true down the line.

I actually believe I have aspects of intersex, that my physicality and mentality and emotionality are trans-gender in the meaning of not belonging to either and yet belonging to both. My transition will place me fully into a N or dual gender-ality; neither one nor the other, but intending to live and present as female for the remainder of this life. Hey, this might change next week, but it is my present truth.

Why did I ask the question? because it was there.

xxx Pamela

[becky77]

Since going full-time I feel no issues living as a woman, so I guess the GD has gone.
Is GD not tied in naturally with Identity issues? the only reason your identity is in question is because you're not living the correct gender.

However I do still have a mix of body issues (some of which are female hangups related to not measuring up, I try to remember not to attribute it to GD), some are because of male markers eg genitals.
Does my need to have SRS mean it's body dysphoria or still gender dysphoria?
Typically a woman doesn't have male genitals so from that point of view it's a gender problem, but some TS identify as female yet have no need for SRS, so is it body dysphoria related to a binary expectation?

I'm intrigued by LeaPs ideas, are you saying if you are TS and therefore know your Identity but seek Transition to live true, that in fact you have no GD it's all identity and body dysphoria?
In other words it's only GD while you are at odds with your gender but once you have found acceptance in essence the GD is gone and only body dysphoria remain?

If we are sure of our internal gender despite it being biologically different is this in fact 'Sex Dysphoria'?
I guess it comes down to how you define gender external or internal?

Let's say you know from day one that your gender is female but you have been born male, is that still GD or is it another form of dysphoria? You're not questioning your gender, you're questioning your body.

I'm just playing with the meaning, I've always took GD to mean an issue with mind and body being different genders.
It is interesting to look further into it though, is the congruence worse if you are binary?

[Michelle789]

None of this 20 hours gets you 80%. Joe Pareto does not apply to TG mannerisms.

The Pareto rule basically is stating that things are not distributed evenly. The numbers don't always have to add up to 100%, nor have to be 20/80. In AA, there's a saying that 10% of the people do 90% of the work, and we are usually the 10% who stay sober. It is about distributions, which are percentages. 20 hours and 80% is not a valid comparison tbh. I'm sure that Pareto distributions probably do apply to being TG. Maybe with passability, it is the 10% that are able to pass 90% of the time. Or my doctor, who prescribes me, and hundreds of other L.A. area TG women and men HRT, said that breast growth can occur during the first 30 years of being on HRT, but that 70% occurs during the first year and a half, 30% during the second year and a half. Breast growth and other feminizing changes from HRT are not evenly distributed over time. Have you ever heard of a "growth spurt" - a time where a good deal of growth takes place.

I also think that is true with social integration too. Likely there is a growth spurt socially. While we experience some degree of social integration into society throughout our transitions, there are times where we experience most of it. Maybe 80% of our social integration and getting down mannerisms does in fact come from 20% of our time during the first 4 years of transition. But 20 hours - no way. Nothing in transition happens in 20 hours. But I actually believe that the Pareto rule does apply to our transitions, because it is about distributions - percentages.

http://betterexplained.com/articles/...the-8020-rule/



I also think much of this debate is really about definitions. When said simply, GD consists of an identity struggle, identifying as the opposite (or different) gender than our birth gender, social issues related to that such as wanting to be treated as a woman, and body issues. Our body issues are caused largely (80%) by decades of testosterone poisoning. The rest (20%), especially as our bodies do become more congruent and we are able to pass as women, are body images issues that GG's struggle with. And this is caused mostly by society telling us we're not beautiful enough.

Hollywood, fashion magazines, cosmetic industry, plastic surgery industry, mean family members, mean girls, all pointing out our flaws in our face and body. People telling you "you're nose is too big" or "your breasts are too small" or "you should lose weight" or even "smile", along with society placing prettier women on a pedestal and pushing the rest aside, can cause real self esteem issues even for GG's. Even though GG's were born with female bodies. We have to contend with all these issues along with decades of testosterone poisoning that deformed our bodies into masculine bodies, making it difficult for us not only to reach ideal beauty standards for women but even to look like a very plain, not so attractive woman.

[Tina_gm]

Hope anyone doesn't mind a guest post. I do not believe that I suffer much from GD. With exception to body hair, which I really cannot stand. Especially the hair on my hands, shoulders and chest. My hands I remove everyday. The rest of my body every couple of days. As soon as I feel any stubble it bothers me greatly.

My genitals do not bother me a bit. If I had a choice, or should I say had to choose between having HRT while still living primarily as a man, or having to live full time without HRT, I would pick full time so as to not lose the function of them. The way I see it, HRT, losing the function of them, to me at that point I would probably go ahead with GRS, unless it was a cost issue preventing me from doing so.

I don't have any great deal of discomfort living or presenting as a male. What bothers me is the consequences of presenting as a female will have for my life. So I am not out other than to my wife. There are so many times though, that I just feel more like a woman, internally. I feel like I relate to them more. I understand them more. my struggles, GD or whatever they are seem much more internal. It is not being a guy that bothers me, it is not being a woman that does, even though the outer shell other than the fur does not bother me at all.

[LeaP]

I'm intrigued by LeaPs ideas, are you saying if you are TS and therefore know your Identity but seek Transition to live true, that in fact you have no GD it's all identity and body dysphoria?
In other words it's only GD while you are at odds with your gender but once you have found acceptance in essence the GD is gone and only body dysphoria remain?

If we are sure of our internal gender despite it being biologically different is this in fact 'Sex Dysphoria'?
I guess it comes down to how you define gender external or internal?

Let's say you know from day one that your gender is female but you have been born male, is that still GD or is it another form of dysphoria? You're not questioning your gender, you're questioning your body.

I'm just playing with the meaning, I've always took GD to mean an issue with mind and body being different genders.
It is interesting to look further into it though, is the congruence worse if you are binary?

Sorry for the very late reply!

I'm trying to clearly distinguish between several different concepts.

Dysphoria first. There is dysphoria and then there is dysphoria. … Meaning dysphoria in the general use sense versus dysphoria in the clinical sense. People toss lots of things into the category of gender dysphoria. That's OK if you're using "dysphoria" in the general sense. In the clinical sense – and as it relates to a diagnosis of gender dysphoria – it refers solely to distress rising to the level of impairment (itself a medical definition) OVER the conflict between assigned sex and gender.

A few things to keep in mind: As applied to the *diagnosis* of GD, general psychological issues triggered by GD are plunked into the category of co-morbid conditions. Second, that gender issues and conflicts (dysphoric or not) pop up in connection with all kinds of conditions not associated with either transsexuality or gender variance. Third, that anyone with virtually ANY kind of gender conflict CAN be termed dysphoric in the non-medical/non-diagnosis sense.

The second is distinguishing between different types of sex and gender conflicts. Generally speaking, current thinking is that sex and gender are distinct. BUT! - the terms are used differently in different fields. Those engaged in physical medical research, for example, tend to view physical sex as an amorphous idea, subject to many, many exceptions, much complexity and they may view gender AS an expression of physical sex in one of many ways. In a psychological context, physical sex tends to be viewed more conventionally from the standpoint of external genitalia. In philosophy, feminist thinking, religion, metaphysics, and other fields, there are yet more variations in the concepts, none of which I will broach! I'll also leave out intersex conditions as currently defined for now. Perception of gender, however, is critically important, and by that I'm not referring to the concept of socially CREATED gender (nor excluding it, for that matter), but to social context.

Now, start to run combinations of these:

1) Clinically dysphoric over seeing my body because it doesn't square with what I AM.
2) Clinically dysphoric over seeing my body because it doesn't fit with what I would like to be.
3) NON-clinical dysphoria over the above.
4) NO dysphoria, clinical or otherwise, but my body doesn't square with what I am.
5) No dysphoria, no conflict - yet manifesting cross-gender behavior.
6) Assigned sex is irrelevant, I'm male (MTF context here) by that standard, but that's incorrect even if I don't meet the conventional intersex definition. All the various dysphoria possibilities apply.
7) I'm psychotic and think I'm a female alien.
8) I'm a kid and gender confused. (Here's a minefield! ... But most of these resolve to cis and are rooted in other issues.)
9) I'm severely dysphoric and KNOW I am my assigned birth sex.

Etc. Etc. Etc. You can come up with hundreds of them. That you can is apparently red meat to people who like to view that as evidence of various ideas and phenomena like spectra and umbrellas. I view it as a mess. Part of that is naturally due to language lagging science. Part of it is field and context collision. There are pure social aspects in play, not just from things like politics, but because the milieu drives things like the severity - or even the existence - dysphoria.

In answer to your questions, I apply the following:

"Sex" - There is no one determinant of binary sex nor any definitive combination of factors that constitute physical binary sex. I don't believe we've discovered all the ways that humans can be sexually dimorphic. We *certainly* don't understand them all. That said, I acknowledge (or would guess) that were such an exhaustive list available, most would still be cissexual, that every factor would be uniformly male or female. That's my view of the facts and what is considered normal or not is a perspective judgement.

"Gender" - My belief is that gender is the social expression and recognition of SEX. Further, that for both cis people as well as transsexuals, it is rooted in physical sex. I.e., that transsexualism is a currently unrecognized (widely, anyway) type of intersexuality. Physical aspects of sex, however, only inform expression and role, they do not provide finality. And the reality of the visible aspects of one's "birth sex" drive social recognition more than any other factor.

My view is that transsexuals are physically intersex AND recognize the gender (so-called) difference vs their assigned sex (they may or may not perceive their own physical intersexuality in any way apart from gender recognition). This is a baseline, and whether or not they are dysphoric is another question entirely. Is it possible that an individual who is entirely cissexual is still gender conflicted, perhaps dysphoric? Absolutely. They may even transition. I think them gender variant, though, not transsexual per se. Take this as an expression of condition distinction, though, not a semantic distinction. In fact, they are different. The resolution may be the same - just as you may take an antibiotic for different illnesses - but the conditions are not.

Does the difference MATTER? Yes. The proper, and for some, the only effective treatment for transsexuals is physical change (here taken as anything from hormones to SRS). For someone who is truly gender variant, whose "issues" are not rooted in or informed by their physical sex, physical change is not only inappropriate treatment, it may introduce a sex/gender conflict!

Now you can add to this all the discussion over what (or whether) you know the root causes of your conflict, if you can sort out expression and sex, whether or to what degree you align and conflict in different ways, whether genitalia conflict is determinant (vs other physical aspects of sex), etc.

Back to your post.

If we are sure of our internal gender despite it being biologically different is this in fact 'Sex Dysphoria'?

Not necessarily because you may not be dysphoric about it even in the most casual sense. But it also depends on what's driving your perception of the difference, I.e., whether or not you are actually intersexed (using "my" view of this). Assuming you are and are not conflicted, to twist a phrase from the past, "I'm Hans, I'm trans, get over it." It reduces what might otherwise be a conflict or clinical distress to a mere dichotomy. There might be external social conflict (I.e., alone), but that's another thing entirely.

Let's say you know from day one that your gender is female but you have been born male, is that still GD or is it another form of dysphoria?

Same answer.

is the congruence worse if you are binary?

You can be binary in either sex and/or gender (no matter how you define the latter). If you are really asking whether "the problem" is necessarily worse depending on how misaligned you are, I would say no. There's a correlation for transsexuals (intensity), but the degree of misalignment isn't determinant. Conversely, I'm disinclined to judge others' pain and I don't pretend to understand, much less compare the distress that people with other conditions experience.

While I hope all this helps, I think that it is unfortunately a better explication of the problem in understanding one another than a means to solving it.

[pamela7]

at the trans-awareness training event i attended yesterday, sex, gender and sexual orientation were presented as a Venn Diagram, overlapping eachother, with the "official" guideline that sex is the physically assigned-at-birth gender, gender is the self-assigned gender, and sexual orientation is just that: the preference for the "sex" of the other partner(s) in sexual relations.

Going back to my OP, I was thinking of body dysphoria in terms of: people who have the phantom-limb syndrome in the sense of requiring an amputation for psychological needs, or a CIS need for a boob-job (cosmetic) - and that GD is when the body does not accord with the assigned-at-birth sex. I wanted to hear other views before this, in order to avoid prejudicing the debate. It's been interesting, thank you.

Before I'd settled into my "knowing" my inner gender, it was possible that I might have had a body dysphoria needing the removal of testicles, but heck no, it all goes way deeper than that. :-)

[LeaP]

Such Venn diagrams, useful as they are, gloss the reality enormously. (I'm sure you recognize this.)

For a flavor of the complexity involved in the genetics alone, see the following article. The activity described is in getting to a better human genome map, how it was constructed, rationalized, error-corrected, and what it's limitations and uses are. That's interesting in its own right, of course, but reading between the lines will tell you a lot about the complexities of sexual dimorphism as well.

http://www.sciencedirect.com/science...02929707613895

[Wendy me]

gender or body or the two...???? at this time to become fully who i am first gender as i am now after a long road i am ok with the gender part i know that i am a woman in my heart and in my brain i am wired to be a woman..... the body part yes i have issues i am a woman from the top of my head to that thing between my legs .... i have 38c boobs i have had boobs from age 12 .... all thats left for me is to fix that but right now not happening ..... yes i think they can go together ... but if in your heart your not a woman changeing your body wont fix a thing.........

[Marcelle]

Hi Pam,

IMHO the answer is particular to each person.

We can throw out a litany of definitions on dysphoria (gender, body) but it will depend on how the person views it and what is required as part of their transition. It is almost a "chicken and the egg" debate. Did I have GD which lead to BD or do I have BD which is causing GD or as you asked (are they the same or different)? In my own case I would say definitely different. I have GD that was established early in my life and finally embraced a year ago . . . my gender is "female" but my body (genetics, bone structure, musculature) is "male". Now that I live as a woman, my GD is subsiding in that I don't feel out of sorts with life . . . to coin a phrase here . . . I feel authentic. I like who I am and am comfortable in my own skin. Would I like to look in the mirror and see a beautiful 20 something woman staring back with lush full hair, curves in all the right places and bits and pieces arranged as nature should have? Sure would. Does that mean I hate my body or that I can never feel like a woman? No.

While I look like a guy (and no amount of make-up is changing that ) and the best I can hope for when I am out and about is that Jane/John Q Public will see an aging Tranny, I consider myself a woman and that quells any internal angst my GD brings. For me (note I am saying me) my body is only a vessel that holds who I am. It is comfortable, I know it, I know how it responds to exercise, what works, what does not. Can I ever look like a genetic woman? Perhaps with chemical and surgical intervention . . . but I just don't feel the need. Now, going back to BD . . . in the sense that it could be associated with surgical and chemical change I don't have BD. However, I do take steps to present as a woman in a cosmetic sense which includes laser on my face and parts of my body so I guess in a sense there is some dislike of the visage in that if I truly had no body/image issues I could just done my everyday clothes, no make-up, no wig and walk out the door looking all guy but loudly proclaiming I am a woman. So there is a bit of comfort in that I have to align my outward appearance to the world as a woman. Is this BD? I am not 100 percent convinced it is. For me I think that is more aligned to a GD thing . . . feeling comfortable being a woman by being seen as a woman by others around me.

Just my take on things.

Cheers

Marcelle