The phenomenology of gender dysphoria in adults: A systematic review and meta-synthesis

Abstract

Gender dysphoria is distress due to a discrepancy between one's assigned gender and gender identity. Adults who wish to access gender clinics are assessed to ensure they meet the diagnostic criteria for gender dysphoria. Therefore, the definition of gender dysphoria has a significant impact on the lives of individuals who wish to undergo physical gender transition. This systematic review aimed to identify and synthesize all existing qualitative research literature about the lived experience of gender dysphoria in adults. A pre-planned systematic search identified 1491 papers, with 20 of those meeting full inclusion criteria, and a quality assessment of each paper was conducted. Data pertaining to the lived experience of gender dysphoria were extracted from each paper and a meta-ethnographic synthesis was conducted. Four overarching concepts were identified; distress due to dissonance of assigned and experienced gender; interface of assigned gender, gender identity and society; social consequences of gender identity; internal processing of rejection, and transphobia. A key finding was the reciprocal relationship between an individual's feelings about their gender and societal responses to transgender people. Other subthemes contributing to distress were misgendering, mismatch between gender identity and societal expectations, and hypervigilance for transphobia.

Predicting outcomes of cross-sex hormone therapy in transgender individuals with gender incongruence based on pre-therapy resting-state brain connectivity

“…In a non-trivial proportion, therapy has had limited success as evidenced by the high heterogeneity in quality of life outcomes across studies ( Murad et al, 2010 , Nobili et al, 2018 ), as well as variable improvements in body image ( van de Grift et al, 2016b , van de Grift et al, 2017 ). This may be due to inter-individual biological variability, contributions from sociological or cultural factors, or a combination of these factors ( Cooper et al, 2020 ). The desired therapy outcome is improved congruence between one’s gender identify and the sex-related physical characteristics of one’s body.…”

Sexual Self-Concept Discrepancies Mediate the Relation between Gender Dysphoria Sexual Esteem and Sexual Attitudes in Binary Transgender Individuals

“…is likely to arise from gender dysphoria, given the gender-body incongruence that gets "in the way" during sex (Doorduin & van Berlo, 2014), and might affect components of the SSC such as anxiety and esteem. Indeed, it has been shown that transgender individuals reported disappointment and depressive feelings related to the mismatch between their body and gender identity (Cooper et al, 2020), as would be predicted by the theory about self-concept discrepancies (Higgins et al, 1994). This mismatch and the related distress become less prominent after transition (Cooper et al, 2020), indicating that the discrepancy between the actual and ideal self-concept might decrease as transgender individuals transition toward their experienced gender.…”

“…Body dysphoria and conflicting feelings between body and identity are central themes in transgender experiences (Cooper et al, 2020), although not in all (Fiani & Heather, 2019). Because being comfortable with one's own body is an important aspect of sexual wellbeing (e.g., Sanchez & Kiefer, 2007), and sexual wellbeing is related to general happiness (Rosen & Bachman, 2008), it is important to investigate bodily selfperceptions in transgender persons (or self-related body perceptions) in relation to their sexual experiences.…”

Gender dysphoria in the field of obstetrics and gynecology

“…However, it is crucial to underline that the size of the transgender population does not reflect the true number of people with GD, as these terms are not identical. 4 Hence, the transgender population can only vaguely hint at the true number of people with GD.…”

“…Recent data indicate a percentage as high as 1%. 4 Concerning GD, it is estimated that 1% of the population experiences some level of discomfort and/or incongruence regarding their gender (https://www. bma.org.uk/advice-and-support/gp-pra ctices/gp-service-provision/managingpatients-with-gender-dysphoria).…”