Gender Dysphoria is a condition in which people are uncomfortable with the gender to which they are assigned. In the extreme, this can lead to transsexualism, a desire to change gender. Gender dysphoria is more common in boys, but occurs across both sexes.
One psychological explanation is that gender dysphoria is caused by childhood trauma or a maladaptive upbringing. COATES ET AL studied one boy who developed gender dysphoria. They suggested that this may have been a defensive reaction to his mother’s depression following an abortion. The trauma may have led to a cross-gender fantasy as a means of resolving their anxiety.
A biological explanation of gender dysphoria is that is that it may be caused by abnormal prenatal exposure to androgens (male hormones). Some genetic conditions can cause discrepancy between hormones and genetic sex. For example congenital adrenal hyperplasia (CAH) occurs when genetic females have high levels of androgens which cause them to develop a small penis. The outcomes of such cases may be gender dysphoria for the affected individuals.
A further biological explanation is that some people have genes which cause gender dysphoria. HARE ET AL studied 112 male-to-female transsexuals and found a variant of the androgen receptor gene that causes reduced action of testosterone. This can affect gender development in the womb which could cause gender dysphoria.
Another biological explanation is the brain sex theory. A region of the brain known as the bed nucleus of the stria terminalis (BSTc) is twice as large in men that in women and contains twice the numbers of neurons. The number of neurons in the BSTc of male-to-female transsexuals is similar to that of the females, suggesting that the size of the BSTc correlates with preferred sex rather than biological sex.
Not all biological causes are internal. One external possibility is that environmental pollution may be causing problems. For example, the insecticide DDT contains oestrogens which may mean that males are prenatally exposed to unduly high levels of these females hormones causing a mismatch between genetic sex and hormone influences.
There is little research support for psychological explanations. Studies have found that in individuals experiencing gender dysphpria, the range of psychiatric conditions with no greater than that in the gender populations. This suggests that gender dysphoria is unrelated to mental illness, trauma or pathological families.
COLE ET AL studied 435 individuals experiencing gender dysphoria and reported that the range of psychiatric conditions displayed was no greater than found in a ‘normal’ population, which suggests that gender dysphoria is generally unrelated to trauma or pathological families.
STROLLER looked at individuals diagnosed with gender identity disorder and observed that many of the boys displayed overly close mother-son relationships. He explained that this would be likely to lead to greater female identification and confused gender identity, showing how a maladaptive upbringing could lead to cross gender fantasies.
ZUCKER ET AL studied 115 boys with concerns about their gender identity and their mothers. Of the boys who were eventually diagnosed with GID, 64% were also diagnosed with separation anxiety disorder, compared to only 38% of the boys who symptoms were subclinical. This points to some kind of disordered attachment to a mother as a factor in GID.
In some cases it has been suggested that persistently dressing a young boy in girl’s clothing or vice versa may cause transsexualism. DIAMOND claims that there is no evidence to support this.
There has also been inconsistent research support for abnormal exposure to androgens. For example, DESSENS ET AL studied 250 genetic females with CAH who were raised as females. Despite prenatal exposure to androgens, 95% were content with their female gender. This high rate suggests little relationship between androgen exposure and gender dysphoria.
The brain sex theory has been challenged by CHUNG ET AL who noted that the difference in BSTc volume between men and women does not develop until adulthood, whereas most transsexuals report that their feelings for gender dysphoria began in early childhood. This suggests that the difference found that in the BSTc could not be the cause of transsexualism but might perhaps be an effect. In addition POL ET AL found that transgender hormone therapy does influence the size of the BSTc. Therefore it may be the hormones that caused the difference in transsexuals such that their brain sex was more similar to their gender identity rather than their biological sex
However there is research to support the brain sex theory. RAMETTI ET AL studied the brains of female-to-male transsexuals and found that these individuals has a more similar pattern to those who share their gender identity ( males ) than those who share their biological sex. This suggests that abnormal development of the brain can lead to gender dysphoria.
A number of studies have produced supporting evidence for environmental effects. For example, a group of Dutch researches reported that boys born to mothers who were exposed to dioxins (which can promote oestrogen) displayed feminised play.- observer bias.
One problem with this area of research is that there are different kinds of gender dysphoria. Two distinct groups have been proposed: ‘homosexual transsexuals’ who which to change their sex because they are attracted to people of the same sex and ‘non-homosexuals’ who wish to change their sex because they are attracted to the idea of themselves as the opposite sex. Such differences suggest that there need to be distinct explanations for each group.
Another consideration is the social sensitive nature of this research. It may be good for transsexuals if a biological cause is identified as this may help people to be more accepting of their problems. Alternatively if a biological cause is identified this may harm individuals born with a related abnormality as it may be erroneously assumed that gender dysphoria is inevitable.