Abstract
A growing number of adolescents are seeking medical care to alleviate gender dysphoria (GD). This qualitative study explored the subjective experiences of GD among help-seeking transgender and gender nonconforming (TGNC) youth in order to develop a more nuanced conceptualization of the phenomenon. Fifteen life-mode interviews were conducted with newly referred youth between the ages of 13 and 19. All participants were assigned female at birth. The data were analyzed using thematic analysis. The participants targeted five major themes that characterize GD: (1) Bodily sensations were constant reminders of GD throughout the day, (2) emotional memories from the past of being different and outside triggered GD, (3) the process of coming out was a transformative experience that changed how the participants understood themselves, (4) GD both increased and decreased in relation to others, (5) everyday life required careful negotiation to feel whole without developing new forms of GD. Based on the results, we suggest a more conceptually nuanced model of GD, one which accounts for how bodily sensations and emotional memories from the past were sources that elicited GD. The sources were mediated through the process of coming out and relating to others, and this resulted in the negotiation of GD today. The conceptual model suggested in the present study could ideally shed light on preexisting knowledge on TGNC youth struggling with GD. In addition, an improved understanding of GD could ideally help clinicians when addressing individual treatment needs.
Highlights
Transgender and gender non-conforming (TGNC) refers to individuals that experience a degree of incongruence between their internal sense of gender and the sex assigned at birth (Winter et al, 2016)
We describe the five major themes that emerged in our interviews with TGNC adolescents experiencing gender dysphoria (GD)
The first major theme, (1) Bodily sensations, serves as the principal topic of the analysis, since descriptions of the body were connected to the five remaining major themes: (2) Emotional memories from the past, (3) The process of coming-out, (4) Understanding oneself through others, and (5) Negotiating GD in everyday life
Summary
Transgender and gender non-conforming (TGNC) refers to individuals that experience a degree of incongruence between their internal sense of gender (gender identity) and the sex assigned at birth (Winter et al, 2016). Archives of Sexual Behavior et al, 2018; Kaltiala et al, 2020a; Zucker et al, 2008) This has created increased attention both within clinics and in public debate regarding what constitutes best treatment for TGNC youth seeking such help (Bell, 2020; Saketopoulou, 2020; Wren, 2019). The first evaluative research of medical treatment for adolescents was promising It indicated that carefully selected youth without significant psychosocial challenges benefit from puberty suppression followed by hormonal treatment after age 16, in regard to alleviating psychological distress related to GD (Cohen-Kettenis & van Goozen, 1997; de Vries et al, 2014). In parallel with the increase in adolescent referrals over the past few years, there has been a shift in gender proportion—a majority of the youth referred to the gender clinics today are assigned female at birth (Arnoldussen et al, 2019)
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