Navigating in the dark: Meta-synthesis of subjective experiences of gender dysphoria amongst transgender and gender non-conforming youth

Reidar Schei Jessen,Ira Ronit Hebold Haraldsen,Erik Stänicke

doi:10.1016/j.socscimed.2021.114094

Reidar Schei Jessen, Ira Ronit Hebold Haraldsen + Show 1 more

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https://doi.org/10.1016/j.socscimed.2021.114094

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Abstract

ObjectiveWe conducted a meta-synthesis of qualitative research on subjective experiences of gender dysphoria (GD) amongst transgender and gender non-conforming (TGNC) youth in order to improve clinical encounters, complement existing knowledge and potentially influence future research. MethodsWe systematically searched for qualitative studies on GD in English, German, Spanish and Scandinavian languages in seven databases. Starting with 2000 articles, we finally included 12 papers in the meta-synthesis, following Noblit and Hare's (1988) seven steps for qualitative meta-synthesis research. ResultsThrough the consistent comparison of key concepts, we were able to cluster the findings from the 12 included studies into four meta-themes: (1) the emerging understanding and awareness of GD was described as navigation in the dark, (2) the importance of relationships and societal norms, (3) the role of the body and the exploration of one's own body and (4) sexuality and sexual impulses. The young person's relation with his or her own body and sexuality influences subjective experiences of GD. The experiences are always mediated in relation with other people and societal norms, and they are both long-lasting and changing. ConclusionThe phenomenological analysis indicated that GD is a complex phenomenon involving manifold factors that changes across time and place for each individual. GD is not a static phenomenon but an expression of continuous negotiation amongst the body, its impulses, sexual desire and the relationships in which each person participates. Therefore, clinicians who treat TGNC youth should help them to reflect on this developmental process over time as a complement to medical approaches.

Highlights

The clinical management and care of transgender and gender nonconforming youth (TGNC) has received increased attention in both clinics and research over the last decades
The three remaining main themes refer to sources that elicit and mediate subjective experiences of gender dysphoria (GD): (2) relations to other people and available narratives and recognition, (3) body parts and the interpre tation of one’s own body and (4) sexuality, sexual impulses and sexual relation with others
The first meta-theme, navi gating in the dark, illuminates a dynamic where sources that elicit subjective experiences of GD work through relations of recognition that gradually develop from the increasing understanding and awareness throughout adolescence and into young adulthood

Summary

Introduction

The clinical management and care of transgender and gender nonconforming youth (TGNC) has received increased attention in both clinics and research over the last decades. TGNC is an umbrella term that refers to a diverse group of individuals with gender behaviours, ex pressions and identities that depart from the societal norms and expec tations associated with their assigned sex at birth (Olson-Kennedy et al, 2016; Stryker, 2017). Some TGNC individuals experience gender dysphoria (GD). This refers to the subjectively experienced distress that arises from the mismatch between gender identity, or internally felt sense of gender, and assigned sex at birth (Butler et al, 2018). Identifying as transgender does not automatically imply a need for medical treatment or meeting the diagnostic criteria for GD (Zucker, 2017)

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