Gender Dysphoria

Gender Dysphoria is the technical medical diagnosis for an individual who does not associate with their biological sex and gender. People with gender dysphoria are uncomfortable with the sex they were born as, making those with the condition distressed with their physical body in appearance and function.  People with gender dysphoria may often experience significant distress and/or problems functioning because of the way they feel and think of themselves (referred to as experienced or expressed gender) and their biological sex.

This conflict affects people in different ways. It can change the way a person wants to express their gender and can influence behaviour, dress and self-image. Some people may cross-dress, some may want to socially transition, others may want to medically ‘transition’ with sex-change surgery and/or hormone replacement treatment, as well as puberty blockers for youth. Socially transitioning involves transitioning into the opposite gender which involves taking on alternate pronouns, changing their attire, use of opposite sex bathrooms and change rooms, and participating in the sports, pagaents, and other activities.

The Diagnosis

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides for one overarching diagnosis of gender dysphoria with separate specific criteria for children, adolescents and adults. In adolescents and adults gender dysphoria diagnosis involves a difference between one’s experienced/expressed gender and their biological gender and involves significant distress or problems functioning. 

In Adults

Gender Dysphoria diagnosis for adults involves at least two of the following, lasting at least six months.

  •  A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics
  •  A strong desire to be rid of one’s primary and/or secondary sex characteristics
  •  A strong desire for the primary and/or secondary sex characteristics of the opposite gender
  •  A strong desire to be of the opposite gender
  •  A strong desire to be treated as the opposite gender
  •  A strong conviction that one has the typical feelings and reactions of the opposite gender

In Children

Gender Dysphoria diagnosis involves at least six of the following, lasting at least six months.

  •  A strong desire to be of the opposite gender or an insistence that one is the opposite gender
  •  A strong preference for wearing clothes typical of the opposite gender
  •  A strong preference for cross-gender roles in make-believe play or fantasy play
  •  A strong preference for the toys, games or activities stereotypically used or engaged in by the opposite gender
  •  A strong preference for playmates of the oppostie gender
  •  A strong rejection of the toys, games and activities typical of one’s assigned gender
  •  A strong dislike of one’s sexual anatomy
  •  A strong desire for the physical sex characteristics that match one’s preferred gender

All of these ‘distress and impairment signs’ of gender dysphoria are being promoted as acceptable behaviour and taught as normal throughout (K-12) in SOGI 123. Why are we allowing the indoctrination of a mental illness into the minds of our children!? 

Comorbid Disorders

In medicine, comorbidity describes the effect of all other diseases an individual patient might have other than the primary disease. The term can indicate either a condition existing simultaneously and or independently with another condition or a related medical condition. Mental disorders may exist simultaneously for a variety of reasons. On the DSM, Major Depressive Disorder is a very common comorbid disorder. The DSM personality disorders are often criticized because their comorbidity rates are excessively high, approaching 60% in some cases. 

Comorbidity is common in psychiatric disorders which increases the risk of suicide. Depression is the most common illness among those who die from suicide, with approximately 60% suffering from this condition.

A report finds that the majority of patients with gender dysphoria had at least one psychiatric Axis 1 comorbidity, the most common being major depressive disorder (33.7%), specific phobia (20.5%), and adjustment disorder (15.7%) 

In a study of adolescents with Gender Identity Disorder they found that 60% had a prior DSM diagnosis other than GID. Of the 30 clients 11 (37%) had one prior diagnosis, 14 (47%) had two, and 5 (17%) had three or more. This is the greatest explanation for the extreme increase in suicide rates from those struggling with Gender Dysphoria.

Suicide Rates

90%

of people who commit suicide have a mental disorder

41%

of transgenders have attempted suicide

vs

5%

of general population commit suicide

47%

of TRANS youth have thought about attempting suicide

vs

14%

of youth have thought about attempting suicide

Gender

Is it Biological or a Social Construct?

SOGI ideologies and the LGBTQ+  sex activists will try to have you believe that gender has no association to biological sex, and that gender expression, roles, and preferences are all a result of social engineering through an oppressive ‘patriarchy’. The idea of gender being a social construct is false, as we can see how typical gender preferences line up with their biological sex; in infants with no exposure to societal expectations, and  mirroring within the animal kingdom. Sex does to a large extent determine the typical gender expressions and roles that we see today, not society. This is because the idea of ‘gender’ is false. We should replace the term with ‘biological expression’.

Many believe that transgender tendencies are a result of the amount of grey or white matter present within the brain. Yet these are simply observable structural differences and not diagnostic differences between male and female brains.  The President of the American College of Pediatricians, Dr Michelle Cretella, has explained how it is impossible for children to be born as transgender through the observation of identical twins. Dr. Michelle Cretella explains that if transgenderism is solely biological (born that way) through brain differences, we would see identical twins presenting the same expressions of transgenderism 100% of the time because they have the same DNA and biological make-up. However, we do not see this in identical twins, while one of the twins displays transgender ‘traits’ and lives as the opposite sex, the other associates with their biological sex. This leads us back to the psychological explanation through the  DSM-5 medical diagnosis that gender dysphoria is indeed a mental disorder, and should be treated as such.

Harald Eia - Hjernevask - The Equality Paradox

In this video, comedian Harald Eia is looking for a gender answer. He speaks to well-known people who have already dealt with this topic. Trond Diseth (child psychiatrist)

BBC - Is your Brain Male or Female?

Michael Mosley stages an experiment to investigate monkeys’ toy preferences. Their discovery showed a great similarity to human  biological preferences than previously realized.

The Transition Conveyer Belt

Social Transition

Changing name, pronouns, and dress,
into ‘new’ gender

Greatly reduces desistance

(Steensma, 2013)

Difficult to Detransition

(Steensma, 2013)

Socially Contagious

Puberty Suppression

Luppron, made by Abbvie used off-label

Puberty affects
brain development

Reduces desistance of Gender Dysphoria, even further

Cross - Sex Hormones

Some changes permanent. Sterilization likely

No long term data on effects…

Reduces desistance of Gender Dysphoria, event further

Surgical Transition

Permanent removal of healthy
body parts.

No long term data on effects…

Reduces desistance of Gender Dysphoria, event further

The Transition Conveyer Belt

Social Transition

  • Changing name, pronouns, and dress into ‘new’ gender
  • Greatly reduces desistance (Steensma 2013)
  • Difficult to detransition (Steensma 2013)
  • Socially contagious

Puberty Suppression

  • Luppron, made by Abbvie used off-label
  • Puberty affects brain development
  • Reduces desistance of Gender Dysphoria even further

Cross-Sex Hormones

  • Some changes permanent. Sterilization likely
  • No long term data on effects…

Surgical Transition

  • Permanent removal of healthy body parts.
  • And the harmful addition of surgical implants.

Transgender - Detransitioning

Please watch these short testimonies of those who were effected by transgenderism. They eventually desisted and expressed the negative affects that it had on their physical and mental health…

(The videos are all under 10 minutes)

Social Transitioning

Social transitioning is the first and possibly only step that many transgender people take. This is when they begin to act on or display the ‘gender’ that they feel they identify with. They begin to display these feelings socially to people around them through their appearance, hairstyles, clothing, makeup, interests, activities, and choice of facilities. They can also take on a new name and new pronouns which they expect others to refer to them by (see Bill C-16). These social transitioning signs are typical identifiers of gender dysphoria which need to be met before a formal diagnosis of Gender Dysphoria.

Social transition is currently controversial within clinical psychology and psychiatry, however it is increasingly being pursued by parents. Regardless more paediatricians, therapists and teachers are supporting these transitions. Schools are encouraging the social transition of students through name changes, clothing and use of facilities. There are some examples of social transitions occurring in children as young as 2-3 years old. It is unknown how many children have already socially transitioned. It is uncertain if these children are doing so independently or under the guidance of gender specialists.

It may appear harmless, and is easily welcomed as a beneficial approach that can relieve gender dysphoria symptoms in children. However, it is currently unclear what the long-term psychological effects will be for children who undergo social transitions and how this impacts their development and sense of self

The Threat of Social Transitioning

If they do NOT socially transition

84%

of adolescence desist from Gender Dysphoria after puberty

We need to protect our children and not promote them to socially transition. This statistic shows that dysphoric feelings that those in adolescence have will desist when they reach puberty, IF they do not socially transition. When we reaffirm the dressing up, new gender name, pronouns, and activities of the opposite gender in youth it causes more confusion for them once they begin to grow into their bodies and transition through puberty into adulthood. 

We should not put them on a path of doubting, suicidal tendencies, a lifetime of hormone replacement therapy and sex change operations. We need to encourage them that they are perfectly and wonderfully made. Through this truth they will find peace in who they are as they learn more about themselves, not by altering their bodies, possible sterilization and hormonally handicapping them.

Changing Legal Documents

Legal sex refers to a person’s sex as it is recognized in legal contexts in their country of residence. This may include how their biological sex is recorded on identification, such as birth certificates, passports and drivers licenses. A person’s legal sex is normally initially recorded as their sex from  birth. 

For transgender people, legally changing “sex” on documentation is often a part of transitioning. It may be necessary to legally change one’s sex before being able to change name or title. It is also necessary to acquire an ID which reflects current gender identity, which is normally needed to gain employment or housing without revealing transgender status. Many countries have pre-requisites before a legal change of gender can be recognized. This may include having medically transitioned, or having been diagnosed with Gender Dysphoria. 

Testing the System

Yet, changing the documented sex identification on some legal documents has been surprisingly easy. An experiment was done by a Canadian journalist who wanted to test how easy it was to get new government documentation stating that she was a male. She started by going to a clinic in a ball cap and a sports shirt claiming she felt like a man for her whole life and received a medical note ‘confirming’ that she was a male. She then went to Ontario Services dressed as a female in high heels and showed the ‘medical’ note claiming she was a man to a clerk who promptly made a new ID card for her with the new sex identification. She was startled at the lack of questioning and investigation into her claims. 

Another story claims that an Alberta man legally changed his documented sex in order to pay less in car insurance and he got away with it. He did not show any difference in his gender expression but was granted his request in the name of tolerance. 

Importance of Puberty

Puberty is the sign that the human body has reached its natural age of maturation and fertility, on average occurs in girls from ages 10-14 years old, and in boys from 12 – 16 years old. Puberty involves a series of physical stages or steps that lead to the achievement of fertility and the development of the secondary sex characteristics. These are the physical features associated with adult males and females and tends to be accompanied by changes in the individuals mood and behaviour. Scientists distinguish three main biological processes involved in puberty: adrenal maturation, gonadal maturation, and somatic growth acceleration.

“Adrenarche”—the beginning of adrenal maturation—begins between ages 6 and 9 in girls, and ages 7 and 10 in boys. The hormones produced by the adrenal glands during adrenarche are relatively weak forms of androgens (masculinizing hormones) known as dehydroepiandrosterone and dehydroepiandrosterone sulfate. These hormones are responsible for signs of puberty shared by both sexes: oily skin, acne, body odor, and the growth of axillary (underarm) and pubic hair.

“Gonadarche”—the beginning of the process of gonadal maturation— normally occurs in girls between ages 8 and 13 and in boys between ages 9 and 14. The process begins in the brain, where specialized neurons in the hypothalamus secrete gonadotropin-releasing hormone (GnRH). As the gonadal cells mature under the influence of LH and FSH, they begin to secrete androgens (masculinizing sex hormones like testosterone) and estrogens (feminizing sex hormones).  These hormones contribute to the further development of the primary sex characteristics (the uterus in girls and the penis and scrotum in boys) and to the development of secondary sex characteristics (including breasts and wider hips in girls, and wider shoulders, breaking voices, and increased muscle mass in boys). The ovaries and testes both secrete androgens as well as estrogens, however the testes secrete more androgens and the ovaries more estrogens.

The third significant process that occurs with puberty, the somatic growth spurt, is mediated by increased production and secretion of human growth hormone, which is influenced by sex hormones secreted by the gonads (both testosterone and estrogen). Similar to the way that the secretion of GnRH by the hypothalamus provokes the pituitary gland to secrete FSH and LH, in this case short pulses of a hormone released by the hypothalamus cause the pituitary gland to release human growth hormone. This process is augmented by testosterone and estrogen. Growth hormone acts directly to stimulate growth in certain tissues, and also stimulates the liver to produce a substance called “insulin-like growth factor 1,” which has growth-stimulating effects on muscle.

The neurological and psychological changes occurring in puberty are less well understood than are the physiological changes. Men and women have distinct neurological features that may account for some of the psychological differences between the sexes, though the extent to which neurological differences account for psychological differences, and the extent to which neurological differences are caused by biological factors like hormones and genes (as opposed to environmental factors like social conditioning), are all matters of debate.

Puberty Suppression

For children under 16 years of age who are displaying the signs of gender dysphoria the only medical treatment that is recommended by the National Health Service (NHS) is puberty blockers. The drugs used are a class of synthetic gonadotrophin-releasing hormone (GnRH) analogues. By acting on the pituitary gland, these puberty blockers prevent the release of chemical signals which stimulate the production of estrogen and testosterone, thus halting the changes of puberty caused by these sex hormones.

GnRH analogues were first licensed for use as end-stage prostate cancer drugs in 1985 and are still in widespread use today. They have since been used in other indications and are most recently being used ‘off-label’ to delay puberty in children with gender dysphoria. They are also used by transgender adults on cross-sex hormone therapy to suppress the production of their natural sex hormones.

The epidemiologically low persistence rates suggest that puberty suppression would not be wise for any child who experiences gender dysphoria. It would be an unnecessary treatment for those children whose gender dysphoria would not persist had they received no intervention. It is generally considered best in clinical practice to avoid unnecessary medical interventions. These interventions could, in some cases be harmful if they lead children whose gender dysphoria may have ceased during adolescence. The risks of puberty suppression are; adverse effects on bone mineralization, compromised fertility, unknown effects on brain development, and personality.

Jazz is a well known transgender individual who took puberty suppression from a young age. The puberty suppression had halted the growth of Jazz’s penis so much that they question if they can properly do the sex reassignment surgery.

Medical Costs of Puberty Suppression

0 $
Monthly Injection
0 $
Surgical Implant (Year)

Hormone Replacement Therapy

Hormone Replacement Therapy is a lifelong commitment for those who are transitioning. They are expensive and can cause many adverse health effects by altering the bodies natural hormone production. Healthy hormone production is crucial for proper brain function and the bodies general health. If a trans person stops taking their hormone treatments their bodies will revert back to their genetic instruction and the effects produced by the injected hormones will desist in some way. Although there are some permanent side effects such as fertility, hair growth, and more.

Trans Men

Trans men, who are transitioning from female to male take testosterone preparations which can be administered by injections, patches, or gels. The goal is to boost testosterone levels to a range that is typical for a man.

In Trans men, testosterone may cause the following effects:

  • It promotes beard and body hair growth
  • Male pattern baldness may develop
  • The clitoris increases slightly in size
  • Libido may be heightened
  • Muscle bulk increases
  • The voice deepens, but not to the pitch of a noraml man
  • Menstration will generally stop, may be some occasional bleeding
  • Develop acne

Masculinizing Medication (to reduce estrogen effects)

  • testosterone enanthate (injected)
  • testosterone undecanoate (injected or tablet form)
  • testosterone gels (applied to skin daily)
  • testosterone patches (applied to skin daily)
  • buccal testosterone (pill)
  • testosterone esters (injected)
  • testosterone is usually administered by way of intramuscular of subcutaneous injection every two to three weeks. 

The most serious risks of taking Testosterone is:

  • Polycythaemia (over-production of red blood cells)

Trans Women

Trans women, who are transitioning from male to female, usually take two types of hormones. An anti-androgen which is used to decrease testosterone levels to those of a typical woman. In addition, estrogen is taken to increase levels of that hormone. 

In Trans women, oestrogen has subtle feminizing effects:

  • Fat may be distributed on the hips
  • The size of the penis and testicles may be slightly reduced
  • Orgasm is harder to achieve
  • Muscle bulk and strength may be reduce
  • Breasts increase modestly in size
  • Slightly reduces facial hair growth

Feminizing Medication

  • Estrogen
  • oestradiol-based formulations are naturally occurring oestrogen 
  • oestradiol patches
  • oestradiol gel (applied to. skin)
  • oestradiol valerate (taken in pill form)
  • conjugated equine oestrogen (from mares urine; taken in pill form; more risk)
  • ethinylestradiol

The most serious risks of taking Estrogens are:

  • Deep vein Thrombosis (DVT)
  • Altered Liver Function

Medical Costs of Hormone Replacement Therapy

0 $
Monthly
0 $
Yearly

Sex Re-assignment Surgery

These surgeries are risky, intrusive, and have many dangerous complications!  The costs below do not include hospital stays and anesthesia. If you attain all of these procedures they can cost roughly $10,000 to $30,000. Below is a list of the most common surgeries and their costs. 

The 2011 National Transgender Discrimination Survey found 61% of trans and gender nonconforming respondents reported having medically transitioned, and 33% said that they had surgically transitioned. About 14% of trans women and 72% of trans men said they don’t ever want full genital reconstruction surgery.

General Costs for Surgeries

Female to Male

Facial Masculinization Surgery

$1,500 - $8,000

Mastectomy (Breast Removal)

$1,500 - $7,000

Body and Buttock Surgery

$6,200

Phallopasty (Creation of Penis)

$100,000

Hormone Therapy (Year)

$3,600

Male to Female

Facial Feminization Surgery

$1,500 - $8,000

Breast Augmentation (Implants)

$6,500

Orchietomy (Testical removal)

$3,500

Vaginoplasty (Creation of vagina)

$12,600

Hormone Therapy (Year)

$3,600

How does this effect average Canadians?

This effects Canadian because all of these expensive surgeries are being paid for with their tax dollars. This is unacceptable as there is no proof that receiving sex reassignment surgery improves the mental health of the individual. Below are the lists of sexual reassignment surgeries covered in each province. 

British Columbia

  • Pentectomy
  • Orchiectomy
  • Vaginoplasty
  • Breast Augmentation
  • Labiaplasty
  • Clitoroplasty
  • Vaginectomy
  • Hysterectomy
  • Salpingo – Oophorectomy
  • Metoidioplasty
  • Phalloplasty
  • Mastectomy
  • Scrotoplasty
  • Clitorial release
  • Chest contouring/Chest masculinization
  • erectile and testicular implant

Alberta

  • Pentectomy
  • Orchiectomy
  • Vaginoplasty
  • Labiaplasty
  • Clitoroplasty
  • Vaginectomy
  • Metoidioplasty
  • Phalloplasty
  • Mastectomy
  • Scrotoplasty
  • Clitorial release
  • Erectile and Testicular implant
  • Private clinic stay
  • Travel

Manitoba

  • Pentectomy
  • Orchiectomy
  • Vaginoplasty
  • Labiaplasty
  • Clitoroplasty
  • Vaginectomy
  • Hysterectomy
  • Salpingo – Oophorectomy
  • Metoidioplasty
  • Mastectomy
  • Clitorial release
  • Chest contouring/Chest masculinization
  • Private clinic stay
  • Travel

Saskatchewan

  • Orchiectomy
  • Breast Augmentation
  • Vaginectomy
  • Hysterectomy
  • Salpingo – Oophorectomy
  • Mastectomy

Ontario

  • Orchiectomy
  • Vaginoplasty
  • Labiaplasty
  • Clitoroplasty
  • Vaginectomy
  • Hysterectomy
  • Salpingo – Oophorectomy
  • Metoidioplasty
  • Phalloplasty
  • Mastectomy
  • Scrotoplasty
  • Clitorial release
  • erectile and testicular implant
  • Private clinic stay 
  • Services outside of Canada

Quebec

  • Pentectomy
  • Orchiectomy
  • Vaginoplasty
  • Labiaplasty
  • Clitoroplasty
  • Vaginectomy
  • Hysterectomy
  • Salpingo – Oophorectomy
  • Metoidioplasty
  • Phalloplasty
  • Mastectomy
  • Scrotoplasty
  • Clitorial release
  • Chest contouring/Chest masculinization
  • Erectile and testicular implant
  • Private clinic stay

Newfoundland
and Labrador

  • Pentectomy
  • Orchiectomy
  • Vaginoplasty
  • Labiaplasty
  • Clitoroplasty
  • Vaginectomy
  • Hysterectomy
  • Salpingo – Oophorectomy
  • Mastectomy
  • Scrotoplasty

Nova Scotia

  • Pentectomy
  • Orchiectomy
  • Vaginoplasty
  • Labiaplasty
  • Clitoroplasty
  • Vaginectomy
  • Hysterectomy
  • Salpingo – Oophorectomy
  • Metoidioplasty
  • Phalloplasty
  • Mastectomy
  • Clitorial release
  • Private clinic stay
  • Travel

PEI

  • Pentectomy
  • Orchiectomy
  • Hysterectomy
  • Salpingo – Oophorectomy
  • Mastectomy

Results After Surgery

Context

The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person’s body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment.

Objective

To estimate mortality, morbidity, and criminal rate after surgical sex reassignment of transsexual persons.

Participants

All 324 sex-reassigned persons (191 male-to-females, 133 female-to-males) in Sweden, 1973–2003. Random population controls (10∶1) were matched by birth year and birth sex or reassigned (final) sex, respectively.

Results

The overall mortality for sex-reassigned persons was higher during follow-up than for controls of the same birth sex, particularly death from suicide. Sex-reassigned persons also had an increased risk for suicide attempts and psychiatric inpatient care. Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls.

Conclusion

Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.

Sex Reassignment Surgery Animation

This may be graphic to some viewers,
viewer discretion is advised.

Male to Female Surgery Animation

Play Video

Female to Male Surgery Animation

Play Video

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