Dysphoria in the Treatment Room

Practical information for health and medical providers

Dysphoria is discomfort and distress related to the incongruence between a person’s gender identity and the sex they were assigned at birth.

Dysphoria can be:

  • Mild, such as feeling uncomfortable in gendered clothing or gendered environments
  • Moderate, such as social anxiety or persistent depression that impacts daily life
  • Severe, such as the inability to leave the house or complete activities of daily living
  • Suicidality among transgender people frequently stems from severe dysphoria.

Dysphoria becomes a form of sustained trauma (plus trauma occurs at higher rates to gender non-conforming people) so your patient/client may be scared of touch, need extra care to not feel trapped/cornered, and/or need informed consent (to know everything that is going to happen before it happens).

How Dysphoria Shows Up in the Treatment Room:

Disconnected from their bodies, sometimes profoundly. Often can’t tell you detailed information about their pain or how stress is manifesting in their bodies

  • Collapsed, sunken-in and trying to disappear- hard to connect with
  • Fatigued
  • Higher than average depression & anxiety
  • Higher than average trauma and survivorship
  • Substance use disorder
  • Extreme sensitivity to language about their bodies
  • Discomfort removing articles of their clothing for exam or treatment

Concerning behaviors associated with Dysphoria that affect the body & might be present for your patient/client:

Note: every person is different and reactions to dysphoria can present in many different behaviors

  • Binding/Restrictive shaping garments worn in risky ways
  • Disordered eating
  • Compulsive workouts/exercise
  • Use of body-building supplements
  • Dieting and use of extreme weight loss products
  • Self-harming behaviors
  • Isolation (sometimes severe)
  • High cortisol levels and adrenal fatigue
  • Intimate partner violence

 

Guide to dysphoria in the treatment room

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