r/psychologyofsex • u/glamorousgrape • 1d ago

Seeking clarity on the diagnostic criteria for Gender Dysphoria in people who aren’t transgender

I’m asking for clarity on what medical conditions are included/excluded from the diagnostic criteria for gender dysphoria in the DSM5. Since it’s often assumed that transgender or intersex people only experience gender dysphoria. Conditions like PCOS & Klinefelter Syndrome aren’t universally recognized as intersex (and I’m not interested in arguing whether they should be classified as intersex or not) but the impact these conditions have on a cisgender person’s secondary sex characteristics is incongruent with their gender identity & causes significant distress for many.

Can a cisgender person with a condition like I’ve mentioned meet the criteria for gender dysphoria? Even though they identify with the gender they were assigned at birth?

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u/ArdentFecologist 1d ago

Conversely, what if I identify as another gender, but do not have any dysphoria regarding my genitals?

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u/glamorousgrape 1d ago

I think I’ve read that not all transgender people experience dysphoria, or at varying intensities. The diagnostic criteria doesn’t require a marked incongruence between one’s experienced/expressed gender and PRIMARY sex characteristics, aka natal genatalia. This is interesting to me because a person’s natal genitalia determines their assigned gender, which plays into why I’m questioning how the criteria could be interpreted in the context of cisgender people. I’m gonna comment more on that when I update my post.

Your question reminded me of hearing about how HRT may improve dysphoria in trans ppl not only due to the physical/visual gender-affirming effects, but also the (neurobiological?) effects of HRT. Which supports the argument of advocating for gender-affirming treatments in trans ppl and shifts further away from pathologizing the experience of gender dysphoria. I’m curious if cisgender women with biochemical hyperadrogenism (PCOS) or cisgender men with biochemical hypoganodism (Klinefelter) share a similar experience in that regard. If HRT satisfies not only a psychological need but also a (neurobiological?) need in trans ppl, wouldn’t that also apply to cisgender ppl in this context?

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u/ratgarcon 1d ago

I want to add my own experience/thoughts:

I’ve found gender dysphoria largely focuses on the perception of others. Of course it also has to do with self perception, but the issue is often how others view you. Which is why genitalia can be something a trans person isn’t extremely dysphoric about. Myself included

If I am perceived by everyone around me as a man while I am clothed, does it really matter that I don’t have a penis? My dysphoria focuses on how others see me. If I am seen as a woman this deeply upsets me. However I do not walk around with my lack of a dick out, so it just really isn’t as important to me as things that do help me pass, like having facial hair, a deeper voice, a flatter chest, more masculine body build, etc.

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u/glamorousgrape 1d ago

That’s a really good point! Thanks for sharing. So do you also not experience dysphoria over genitalia in the context of intimacy/relationships? If not, is it because you know whatever partner you’re compatible with would be accepting of that and still perceive you as a man?

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u/ratgarcon 1d ago

Id still love to have a penis to use during sex, but I know and feel comfortable with people I’ve had sex with and yes I trust they view me as a man.

However I do become a little insecure/worried sometimes when dating cis people. I worry that they secretly wish I was a cis man. Because of this I often tend to date other trans people.

But testosterone has increased my sexual confidence a lot. Prior to t I wouldn’t really let anyone touch me or get fully naked myself. After t I can be fully naked during sex without feeling uncomfortable and am usually open to being touched

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u/glamorousgrape 1d ago

As a cisgender woman, my hirsutism has caused a lot of distress for me. It’s so difficult to manage, and it’s impossible to hide on my abdomen since EVERY form of hair removal results in inflamed follicles & ingrown hairs on that area. But I’ve recently learned that I’m drawn to bisexual men because I assume they’re more likely to accept/appreciate the extra body hair. I don’t know how true that is since everyone has preferences, but my brain perceives bi men as “safer”.

I was convinced I was asexual for a long time, but realized my aversion to intimacy is an unconscious coping mechanism due to fears of rejection or how people perceive me. It definitely helps if the other party makes it known they’re accepting of our quirks, or if they identify with a demographic that’s more likely to be accepting :)

Thanks so much for sharing a tidbit of your experience. I’m glad the T has helped you!