Dominion Hospital - October 10, 2019
2019 LGBTQ Healthcare Equality Top Performer logo

It’s a struggle for many people to talk about gender. Too often the topic is confused or combined with sexuality. Old stereotypes kick in when education and understanding is what’s needed. One of the prevailing myths that exists, even within the medical community, is that gender identity is a mental disorder. In fact, it is not.

Gender identity conflict is called gender dysphoria, a term that mean dissatisfaction. It involves a conflict between a person's physical or assigned gender and the gender they identify. People with gender dysphoria feel distress over this conflict, often at an early age but sometimes not until puberty or later. This distress stems from way they feel and think of themselves being in contrast to their physical gender. Another term for gender dysphoria is being transgender.

Gender dysphoria is not the same as homosexuality or being gay. Being gay means that a person is attracted to others of the same sex, physically, emotionally and sexually. It is sometimes seen as being more common than gender dysphoria and is more often depicted in movies or on television than transgender people, so it’s more familiar.

Children who experience gender dysphoria may insist that they will grow up to be a man or a woman despite physically being the opposite. They may refuse to wear the clothing typical of their sex, play with the typical toys and even resist being called their given name. Puberty brings extreme anxiety and frustration and a desire to rid themselves of parts of their body that feel wrong.

The internal conflict going on is made worse by stigma, discrimination and bullying from others or denial from close family and friends. Historically the medical community classified gender dysphoria as a mental disorder. Research and compassion led the World Health Organization to removed gender nonconformity from its list of mental disorders in its global manual of diagnoses in 2019. This move should prompt governments to reform national medical systems and laws in light of the outdated diagnosis.

But change is slow. And the daily distress for those suffering takes a toll. Some estimates say as many as 71 percent of those with gender dysphoria will also have a mental health diagnosis in their lifetime. That includes mood disorders, anxiety disorders, schizophrenia, depression, substance abuse, eating disorders, and suicide attempts. Treatments available, therefore, are not focused on changing the person but lessening their distress.

Some teens and adults may have mixed feelings about their physical gender. They often find it useful to talk with a counselor to determine who they feel they truly are. Finding a trusted resource for help and guidance isn’t always easy. In northern Virginia, Dominion Hospital has been designated as a Top Performer on the Healthcare Equality Index (HEI), the national benchmarking tool that evaluates healthcare facilities' policies and practices related to the equity and inclusion of lesbian, gay, bisexual, transgender and queer (LGBTQ) patients, visitors and employees. Learn more about gender identity and expression.