Gender vs Body dysmorphia

[Kate T]

Can I please ask a question. Reading one of Helen Boyd's books recently I came across a comment that coalesced some concepts that I had been thinking over before hand. The comment / theory that Boyd quoted / proposed was that gender dysmorphia and body dysmorphia were separate though related elements. Her theory was that many (a majority??) of transexuals who seek SRS have body dysmorphia as well as gender dysmorphia. This theory would explain the strong need and feelings from an early age of being the classical "woman trapped in a mans body". Boyd proposed that other individuals, particularly "non op" transgendered individuals and perhaps also late onset transexuals, do not have a strong body dysmorphia but can still have quite a strong gender dysmorphia hence the need to live as the opposite gender.

My question then is what do you as a community feel about this idea of gender dysphoria being separate from body dysphoria. Boyd is a GG and only has her interpretation of stories she has been told to go on so maybe she has just missed the point? Or maybe it is an important theory and distinction and may help in the understanding of those who do not fit the classical "cross dresser" or "transexual" picture but have elements of both?

Thankyou

[Angela Campbell]

Maybe it is so different between people because there are just so many variables. I know several TS that seem to have a much bigger problem with their body than I seem to, but surprisingly I am doing more about changing it than they are. To me I would rather have the overall appearance so I can live as a woman than to have the genitals. For that reason I will have many procedures done before SRS. Mostly facial. SRS will come but it is not my biggest desire at the moment. I know some who focus on SRS and kind of pass by anything else.

Yes I do think that maybe the two are different aspects of the same thing. Perhaps a matter of severity than two different things.

[Rianna Humble]

I think that there is a bit of a confusion here about the terminology.

Transsexuals (whether "late onset" or not) suffer from acute Gender Dysphoria and also know that their natal sex is not right. This knowledge comes from a biological mismatch between the sex characteristics and the gender.

Gender Nonconforming individuals may suffer from a milder form of Gender Dysphoria but are quite content with their body matching their natal sex.

Neither group necessarily suffers from Body Dysmorphia which is a mental illness that causes people to have a distorted view of how they look. Although of course any person might suffer from an illness at some point in their life.

[Alex R]

I think they go hand in hand and could be seen as opposite sides of the same coin.

We all have our own take on each with respect to our own feelings and our realisation about the significance of each may occur at different times on our journey but I'm sure they exist for us all, but perhaps just not crystallised.

[I Am Paula]

My GD was absolutely debilitating. Whereas, knowing full well that starting HRT at 55, I was probably not going to turn into a thirty year old movie star. By nessesity, I have learned to overlook a lot of body dysmorphic issues, knowing I will always have to do the best I can with what I've been dealt (and some help from a good dose of estrogen).

[Rianna Humble]

I think I understand what members mean about having issues with our body, but that is not the same as the mental illness Body Dysmorphia which causes people to see defects which aren't there

[Barbara Ella]

I do now truly believe that I suffered from body dysphoria, not like Rianna describes, but similar enough. I now see that it focused my mind so much that it hid my gender dysphoria for many many years. I was born with a birth defect, club foot, that resulted in a leg that never fully developed, hence my two shoe sizes. I hated that so much i really let it dominate my thoughts, and force me to try so much harder to overcome the limitations that I could not see the feminine attractions i was involved with until now. I let it dominate my life, but there was nothing positive about it. It could/can not be changed with FFS, SRS, etc.

I live with it now, and look goofy in my skirts (would never wear shorts as a guy) which I love now, go figure.

So I do believe their is something to the two thoughts, but don't really know how individual the two are.

Barbara

[Ann Louise]

I am sick and tired of people trying to psychologically dissect me. No offence, but this BS is thoroughly unprovable, and yet anther journal publication for the edification of yet another "expert." IMHO only of course, Ann

[MysticLady]

My question then is what do you as a community feel about this idea of gender dysphoria being separate from body dysphoria.

I think......................she was stoned.

[Kate T]

If I can expand a little.

I believe that the work that Boyd and others are referring to relates more specifically to those who have very specific body dysphoria e.g. they believe they should have only 1 arm. The only reference that I can find is to some work published by Paul Mcgeoch and V.S. Ramachandran in 2008 that apparently found almost 60% of FTM TS individuals reported having sensations of a "phantom penis" from an early age. They also reported that a significantly higher proportion of males who had penile amputation not for the purpose of SRS (e.g. tumour removal, trauma) reported having a sensation of a "phantom penis" versus individuals who underwent penile amputation as a part of SRS procedure.

Please understand I am not about trying to pathologize transexualism / GID in any way by trying to "lump it in" with BDD. In fact I wonder whether some individuals with apparent body dysmorphia may in fact not have a mental disorder but like some with GID they have a physical mismatch with their mental body picture and the appropriate resolution is in fact surgery, not pyschiatry or medications. I mean until relatively recently GID and transexualism was treated in much the same way as those with BDD currently are i.e. misguided psychotherapy and aversion techniques, psychoactive medications.

What I am asking / trying to understand is why some individuals seem apparently happy with expressing gender variation without any apparent interest or ambition for physical alterations to their body yet others have a strong requirement for surgery and physical body adjustment. Again, I am not passing judgement on any individual however they feel, I am just interested in trying to understand.

[bas1985]

I think that the question is also economical - practical. surgeries cost and their effect, nowadays, is not 100% sure.

I think that many TS (including myself) would do greater body modifications IF the outcome WERE certain AND if it did not cost too much. So we pass from a psychological position to a practical one. Not all TS are equal also because there are social classes, norms, ages (a TS in her 20s will be more inclined to make more surgeries because the body can heal better AND the time to ENJOY the effects of the surgeries are greater).

Suppose, at limit, a TS at 70... things like FFS or simply HRT would mean little, if any.

just my 2c

[Rianna Humble]

What I am asking / trying to understand is why some individuals seem apparently happy with expressing gender variation without any apparent interest or ambition for physical alterations to their body yet others have a strong requirement for surgery and physical body adjustment. Again, I am not passing judgement on any individual however they feel, I am just interested in trying to understand.

For me, the difference is in the level of Gender Dysphoria. Although if you are transsexual it is a biological condition that dates from before birth, some people born with that condition manage to live out their life with a manageable level of Gender Dysphoria and so never need to transition. When the GD becomes intolerable, we transition and desire to become wholly congruent (although health or finance may put roadblocks up on the way).

People who are Gender Non Conforming may also suffer from a mild form of Gender Dysphoria that responds to appropriate Hormone Therapy, but they will not normally need surgery as they are content with a Gender Identity that is neither completely male nor completely female.

[Angela Campbell]

There is no amputation of the penis with SRS. It is mostly inverted and fileted. A phantom sensation would be unusual as most of the nerves and skin are still there.

[noeleena]

Hi,

This here is only one part of whats being talked about or seen. to get a better idear you need to talk with those of us who are interesexed, & youll be surprised at the results from us, & even then youll find many differentences ,
to divide Psychologically Mentalatly & Emotionally from our bodys , how do i explain that, i cant its all wraped up together,

Dysphoria has no meaning to or for myself, so i cant answer as to what that is for myself, a non event & hormones - synthic did not do any thing again for myself, they are only to maintain my body as i need them as a menopusal women my own hormones did more for myself,

...noeleena...

[Kaitlyn Michele]

Who cares what Helen Boyd thinks?

Who knows whether there is some kind of tie between body dyspmorphic disorders and gender identity issues? Who cares. Not me

[LeaP]

I guess the only reason to care is that its used as a sensationalist argument to ban SRS. You've seen it - the comparisons between transsexuals and people wanting to amputate limbs. People can't wrap their heads around transsexuality, but they sure latch onto BS like this.

[Andinera]

On that note, I think I could make it through life thoroughly happy with nothing more than a change in genital organs. The fact that I would have to go through a huge process of therapy, living as the opposite gender for X amount of time irritates me. Don't get me wrong, I would love to have been born a female, but I probably don't need it. Just give me the vagina, Ill be happy. More importantly, remove what I have right now because I can't stand it. One of these days Im probably going to cut it off myself through its annoyance.

[Angela Campbell]

The fact that I would have to go through a huge process of therapy, living as the opposite gender for X amount of time irritates me. ,One of these days Im probably going to cut it off myself through its annoyance..

The biggest reason that therapy would be a good thing to pursue.

[Rianna Humble]

Andinera, there is no gentle way to say this. Your words demonstrate that you would in no way be a good candidate for SRS. If you are not prepared to live as a woman then any surgeon who agreed to sell you a designer vagina would be committing malpractice.

This is not something to be done on a whim like some latter-day Charles Kane.

Those of us who are transitioning transsexuals have had to go through hell and high water to get where we are, people who just want the surgery without the rest do more damage to our cause than the outright haters.

[Marleena]

Boyd writes books she has no credibility. It was a stupid and careless thing to put in print.

[Kate T]

A few people have asked who cares what these particular authors think. For yourselves it may make little or no difference indeed. I would put forward the argument that such a theory MAY be worth persuing on the following grounds:
1. Ramachandran and Mcgeoch appear to be reasonably good researchers, they have done significant research in body image generally (NOT just in TS) and would appear to have some influence on medical opinion.
2. IF their theories on body image are correct (that body image is an innate characteristic "hard wired" into the brain) then the extension of this theory is that any attempt to "treat" the incongruency of body image with aversion or any other psychotherapy treatment is doomed to failure.
3. Therefore, given the unlikelihood of being able to alter the hard wiring of the body image in the brain the best option for treatment is to attempt to surgically match the individuals physical appearance to match their innate body image, i.e. in the case of TS to perform the various gender reassignment surgeries.
It seems to me what is important about this work is that it can "prove" to the medical community what we already know, that GRS is not only the preferred but the only option for gender dysphoria i.e. it proves the need for surgery and transition.

Boyd's books merely drew my attention to the theory. It is true that she is not a doctor, or psychiatrist. Whether you like her style of writing or agree with her opinions or not is up to you. However I have read nothing from her that does anything other than advocate for tolerance, acceptance, and understanding for transexuals and various other gender diverse individuals.