What is Gender Dysphoria?

Here is a talk I gave at Q Denver titled, What is Gender Dysphoria?  It is being featured on Q Ideas. I try to explain the phenomenon, as well as provide a little background information on theories of etiology, prevalence, and management strategies. Also, check out the talk by Melinda Selmys, who shares about her own experiences with gender dyshporia.

After we both spoke, Gabe Lyons invited us to join him for a time to Q & A from the audience. This was a helpful opportunity to reflect further on gender dysphoria:

To give you a little background on Q Ideas, here is a description from their website:

Q was birthed out of Gabe Lyons’ vision to see Christians, especially leaders, recover a vision for their historic responsibility to renew and restore cultures. Inspired by Chuck Colson’s statement, “Christians are called to redeem entire cultures, not just individuals,” Gabe set out to reintroduce Christians to what had seemed missing in recent decades from an American expression of Christian faithfulness; valuing both personal and cultural renewal, not one over the other. Re-educating Christians to this orthodox and unifying concept has become central to the vision of Q.

Together, we explore topics that fall into four broad themes: culture, future, church, and gospel. Q facilitates the investigation of deeper engagement and responsibility in each of these areas. As we continue to work through these ideas on a deeper level, so grows our commitment to equipping innovators, social entrepreneurs, entertainers, artists, church-shapers, futurists, scientists, educators, historians, environmentalists, and everyday people to do extraordinary things. At Q Ideas, you’ll see a broad spectrum of content represented in our small group curriculum, essays, videos, blog articles, and podcasts. These are all contributed and commissioned to shed light on unique areas of culture and the church.

The Calvin College Talk on Gender Dysphoria

The AV staff at Calvin College have been working on a better quality video of the talk I gave titled Understanding Gender Dysphoria: Navigating Transgender Issues in a Changing Culture. Here is the video. It is about an hour with some Q&A from the audience:

Several transgender and gender variant people and families who have loved ones who are under the transgender umbrella have reached out to me following the talk. They are hungry for resources and for a way forward.  If I were to summarize the themes from those exchanges so far (and some are ongoing), I would say they are centered on (1) self understanding (How do I understand what I am going through?), (2) the faith community (How do I have more constructive discussions with pastors and others in my church?), and (3) How do I improve existing relationships with loved ones? In some ways these are similar to what we reported in our research with male-to-female transgender Christians a few years ago. I think these themes also line up with what I have seen in counseling individuals, couples, and families over the years.

These are important, significant discussions for every individual and family that is navigating this terrain. So many feel alone and unsure how to even begin a conversation. The section from the presentation on different “lenses” through which different stakeholders “see” the issues and people seemed especially promising to them. There is certainly much more that can be done to be a resource for responsible care in these three areas, and I hope that ongoing discussions and future discussions will be a part of seeing that come about.

 

 

 

Developmental Trajectories among Gender Dysphoric Children

sextherapytextInterVarsity Press Academic and the Christian Association for Psychological Studies are set to publish a new book I wrote with Erica S. N. Tan titled, Sexuality & Sex Therapy: A Comprehensive Christian Appraisal. I am hearing it will be out in April.

After four foundational chapters offering theological, sociocultural, biological, and clinical perspectives on sexuality, we discuss several sexual dysfunctions, the paraphilias, sexual addiction, and other clinical presentations. Here is an excerpt from the chapter on Gender Dysphoria.

What we are discussing is onset and course. Specifically, we are discussing a study of children who persist and desist in their experience of Gender Dysphoria:

Although there is relatively little research on gender dysphoria as compared to many other sexual concerns, there has been some preliminary research (Steensmaet et al., 2010) on possible developmental trajectories among those who persist (in their experience of gender dysphoria) and those who desist (or who do not continue to experience gender incongruence).

When these two groups are compared, it is interesting to note that there are apparent differences in underlying motives in cross-identification, as well as differences in responses to changes at puberty. In considering motives for cross-identification, one persister shared the following: “In childhood (and still), I had the feeling that I was born as a boy. I did not ‘want’ to be a girl. To myself I ‘was’ a boy, I felt insulted if people treated me as a girl. Of course I ‘knew’ I was a girl, but still, in my view I was not” (Steensmaet et al., 2010, p. 6). In contrast to this, a desister shared this: “I knew very well that I was a girl, but one who wished to be a boy. In childhood I liked the boys better, the girls were always niggling [petty, nagging]. I was tough and wanted to be as tough as the boys” (p. 6).

When the researchers looked at the different responses to puberty, they noted the strong reaction against these changes among those who persisted with their gender incongruence. One persister shared the following: “It was terrible, I constantly wanted to know whether I was already in puberty or not. … I really did not want to have breasts, I felt like, if they would grow, I would remove them myself. I absolutely did not want them!” (Steensmaet et al., 2010, p. 8).

Again, in contrast, a desister shared this: “Before puberty, I disliked the thought of getting breasts. I did not want them to grow. But when they actually started to grow, I was glad they did. I really loved looking like a girl, so I was glad my body became more feminine” (Steensmaet et al., 2010, p. 12).

Keep in mind that both groups engaged in some cross-identification at a young age, about 6 or 7 years old. However, Steensma et al (2010) reported that for those who desisted—whose gender dysphoria abated over time—that change occurred at between 10-13 years of age, whereas the gender dysphoria seemed to increase for those who were called persisters.

The persisiters would go on to disclose and make a plan for some kind of transition between the ages of 10-13 years old, while those who desisted tended to identify with their birth sex at age 13 and older.

Although I have provided clinical services and consultations in the area of gender dysphoria and have conducted research involving transgender Christians, I have not written that much about it. I enjoyed the opportunity to work on this chapter with Erica and to reflect further on gender identity and gender dysphoria from a Christian worldview.

MtF Transgender Persons in Corrections

Here is part 1/7 of a documentary titled “Cruel and Unusual” on male to female transgender (MtF) persons in corrections:

The rest of the documentary is available via YouTube.

It is an interesting documentary that opens with the argument that the mistreatment of transgender individuals amounts to “cruel and unusual punishment” – hence the title of the documentary.

I am reviewing it as part of a consultation I’ve been doing for a couple of months now dealing with sexual minorities in corrections. You can see from watching the documentary that significant challenges arise in the juvenile justice system (which are not covered here) and in prisons in terms of responding to those who experience gender dysphoria.

The responses to these challenges can become polarizing, with one side charging the other with making demands for accommodations that smack of “political correctness” to them; the other side can run the risk of marginalizing the very staff that they are meant to train and educate.

In my work so far, I have found it helpful to note that those who are incarcerated are serving their sentence by virtue of being in corrections. They are not to be further punished through violence, sexual assault, or other forms of mistreatment. These forms of mistreatment – particularly sexual assault – are of significant concern especially to sexual minorities (those who experience their sexual identity or gender identity in ways that are different from those in the majority).

This has been an thought-provoking topic for me as a Christian who studies sexual identity and gender identity issues. If you are particularly interested in this topic, you might read this post in which I discuss T.J. Parsell’s experience as he shared in his book Fish.

Gender Identity Issues

Here is an interesting video we are viewing in preparation for a training on Gender Identity issues at the Institute for the Study of Sexual Identity:

If you are curious about how we approach training, let me begin by saying we follow many of the leading mainstream LGBT researchers and theorists; they are the one’s doing the majority (by far) of the research. There are few Christians doing serious scholarship in this area, and to limit our understanding of gender identity, for instance, to just what is produced by Christian psychologists (or Christians from other disciplines), would put us at a severe disadvantage.

Some of the strengths of this video include exposing the viewer to the ways in which the word “transgender” functions as an umbrella term. We may say this all the time, but it can be helpful to “meet” various people who prefer different ways of describing themselves and their experiences, such as transman or female-to-male transsexual. There is also some interesting perspective offered on key terms, such as biological sex, gender role, gender identity, and sexual orientation. Just the discussion of the common ways people think of differences and the ways in which the folks in the video think of differences is informative. There are also some helpful suggestions on how to approach a person – how to talk with them in a way that would be respectful given how they experience themselves.

It would have been helpful to have additional information on developmental perspectives on gender identity, as well as information on some of the issues that lead people to seek counseling/therapy services. But that was not the purpose of the video; the video was meant to be introductory and essentially a primer.

You can imagine that there are many issues that arise for those interested in integration of a Christian worldview with the study of gender identity. I won’t be able to do them justice here, but there are important questions about the relationship between biological sex and gender identity, the nature of the Fall, and how best to respond to such concerns from either a mental health or pastoral care perspective.

Update: Transgender Christians’ Experiences

The paper presentation on “Transgender Christians’ Experiences: A Qualitative Study” was earlier today. It went well. Trista and I went back and forth and discussed the various responses we received to questions about personal faith, relationship with God, religious coping activities, issues that arise in marriage, employment, etc. The day before the session, we were able to arrange to have a person in as a discussant who is transgender and Christian. She shared some of her own story and the challenges she has faced and choices she has made in response to gender dysphoria. Of course, these choices are not without consequences, and she was also able to share how some of her decisions had an impact on family members, local church experiences, and so on.

Although the audience was not large, those in attendance showed a genuine interest in the topic, and some had provided clinical services to this population. Most of the questions actually went to our discussant, which made a lot of sense, as she was quite open and transparent in sharing from her experience, and many in attendance probably have had few opportunities to interact with and ask questions of someone who has been sorting out gender identity questions and conflicts.

I also appreciated the opportunity to present at the Virginia Psychological Association. I have tended to gravitate toward the national organization, and this was my first foray into the state association. The audience was great, and the people there were quite receptive to the presentation and seemed quite appreciative that the topic was covered the way it was.

Transgender Christians’ Experiences

This Thursday I’ll be co-presenting an interesting study I conducted with Trista Carr, a student in the Doctoral Program in Clinical Psychology at Regent. The study is interesting to me in part because it is the first one we’ve undertaken that has addressed the relationship between gender identity and religious identity. Specifically, it is a study of 32 self-identified Christians who also self-identified as biologically male but transgender. They provided information on their experiences with local churches, their relationship with God, their spouses, employers, and so on. They also shared ways in which religion was a coping resource. Some even shared how their struggle with gender identity concerns led to a strengthening of their personal faith as Christians.

Here is the abstract from the paper we’ll be presenting:

Though the experiences of transgender persons have been explored to some extent, very few scholars have delved into the relationship between gender identity as a trangender person and religious identity as a Christian. Therefore, the qualitative data described herein reflects the narratives of 32 transgender individuals who are biological males and identify as Christians. The study sought to bring some understanding of the events and processes that occur for this specific population. Although some participants indicated that their gender identity conflict led to a strengthening of their personal faith, others reported a past struggle – often with specific persons or church leadership – and some indicated that they moved away from organized religion in light of their conflict. Many participants in this study still identified religious coping activities tied to their faith tradition as sources of support during present difficulties. Participants also shared experiences with conflicts in their marriages and places of employment.

The study came about through a number of developments over the past several years. Some of those developments included providing consultations to families who were worried that their child might be gay. The children were often presenting with symptoms of Gender Identity Disorder, and some met criteria, while others had symptoms but were sub-threshold for the diagnosis. I’ve also worked with older adolescents and adults who identified as transgender and Christian and were asking for assistance with possible ways to manage their dysphoria and/or conflict with their religious beliefs and values. If you know someone who is transgender or if you’ve worked with this population, you may have a sense for how challenging it can be to fully understand the issues that are involved.

A few years ago I was also introduced by someone who identified as transgender and Christian to an online group of people with similar experiences. This led to the idea of possibly furthering my own understanding of their experiences (and the experiences of adults I’d worked with) by conducting an initial study of some of what they had been dealing with. I brought this idea to the Institute for the Study of Sexual Identity (ISSI), the research institute I work with at Regent, and Trista expressed interest in working on it, as did some of our other team members. So we got to work on developing a questionnaire, and we ran it by various members of the community for help with wording, etc. We announced the study through various avenues, and people were able to access it online and provide us with some of their experience with gender and religious identity issues. So the study is a first step, and I hope we are able to follow it up with additional studies that delve into other related areas, but it is a start.

The paper we’ll be presenting is titled, “Transgender Christians’ Experiences: A Qualitative Study.” It will be presented at the Virginia Psychological Association’s (VPA’s) spring convention this Thursday, April 22, from 4-5pm at the Norfolk Waterside Marriott.