Tuesday, September 23, 2025

Gender Dysphoria 9-23-25

Gender dysphoria is classified as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 

According to the DSM-5, gender dysphoria is defined as a marked and persistent incongruence between one's experienced or expressed gender and their assigned sex, accompanied by significant distress or impairment in functioning.  

Criteria for diagnosis

For an adolescent or adult to be diagnosed with gender dysphoria, they must experience clinically significant distress or impairment along with at least two specific criteria for a minimum of six months. These criteria relate to a marked incongruence between one's experienced gender and primary/secondary sex characteristics, including strong desires related to being of another gender, being rid of one's current sex characteristics, acquiring the characteristics of another gender, being treated as another gender, and a conviction of having the typical feelings and reactions of another gender. 

Why is the diagnosis important?

The diagnosis of gender dysphoria is important because it provides a clinical pathway for individuals to access necessary medical treatments, such as hormone therapy or gender-affirming surgery, which often require a formal diagnosis for insurance purposes. Treatment for gender dysphoria can help alleviate distress and improve mental health. 

This is for informational purposes only. For medical advice or diagnosis, consult a professional. 

https://www.google.com/search?q=is+gender+dysphoria+a+mental+disorder+dsm-5

Gender-affirming treatments have associated risks and side effects that vary depending on the specific medical intervention, such as puberty blockers, hormone therapy, or surgery. Before beginning treatment, patients are advised to discuss these potential ill effects with a healthcare provider. 

Puberty blockers (GnRH analogues)

Used to delay puberty, blockers suppress sex hormones but are generally considered reversible. The full long-term effects on fertility and bone density are still under investigation. 

·       Reduced bone density: Puberty blockers can decrease bone mineral density during treatment. This may be reversible after stopping the medication or beginning hormone therapy.

·       Impact on fertility: The blockers can prevent the development of reproductive organs. Their effect on a person's ability to have biological children is a significant concern, though studies on rats showed normal reproductive function resumed after stopping treatment.

·       Brain development: Researchers are still studying the impact of delaying puberty on cognitive development, though studies on precocious puberty have not shown long-term effects.

·       Pseudotumor cerebri: In July 2022, the FDA issued a warning about a rare but serious risk of intracranial pressure causing headaches, vision changes, and nausea.

·       Other side effects: Common, less severe side effects can include headaches, hot flashes, fatigue, mood swings, and swelling at the injection site. 

Masculinizing hormone therapy (Testosterone)

Testosterone therapy for transgender men can cause permanent and irreversible changes, as well as a number of reversible and health-related side effects. 

·       Permanent physical changes: Deepening of the voice, growth of facial and body hair, male-pattern baldness, and clitoral enlargement are irreversible.

·       Cardiovascular risks: A person's risk for stroke and heart attack can increase. This is elevated for those with pre-existing conditions, who are overweight, or who smoke.

·       Erythrocytosis (thickened blood): Testosterone can cause an increase in red blood cell count, which raises the risk of blood clots, heart attack, and stroke. Blood tests are used to monitor this.

·       Changes in cholesterol and blood pressure: Increases in "bad" LDL cholesterol and blood pressure, along with decreases in "good" HDL cholesterol, are possible.

·       Liver damage: In rare cases, testosterone therapy can lead to liver damage. Regular blood tests are needed to monitor liver function.

·       Reproductive health and infertility: The therapy can lead to irreversible infertility, and patients are advised to discuss fertility preservation options before beginning treatment.

·       Emotional and sexual health: Mood swings, increased sex drive, and vaginal dryness are common side effects. 

Feminizing hormone therapy (Estrogen and anti-androgens)

Estrogen therapy for transgender women involves both permanent and health-related risks, particularly cardiovascular problems. 

·       Permanent physical changes: Breast development is not reversible. Some fat redistribution will reverse if hormones are stopped, but long-term effects on fertility may be permanent.

·       Cardiovascular risks: The risk of blood clots (venous thromboembolism), stroke, and heart problems is increased, particularly for those who smoke. Studies suggest that risk is higher than for cisgender women but potentially similar to cisgender men.

·       Cancer risks: The risk of breast cancer appears to increase but remains similar to the risk for cisgender women. More research is needed to understand the effect on prostate cancer risk.

·       Metabolic and other health changes: Higher blood pressure, weight gain, high triglyceride levels, high potassium, and an increased risk of Type 2 diabetes are potential side effects.

·       Reproductive health and infertility: Estrogen therapy can cause infertility, and long-term use increases the risk of it being permanent. Sperm cryopreservation is an option to preserve fertility.

·       Emotional and sexual health: Decreased sex drive, mood swings, and increased emotional vulnerability can occur during the "second puberty" experienced during hormone therapy. 

Gender-affirming surgeries

As with any major medical procedure, gender-affirming surgeries have potential risks, which differ depending on the specific procedure performed.

·       Risks for any major surgery: All surgeries carry risks of bleeding, infection, and negative reactions to anesthesia.

·       Feminizing surgeries (e.g., vaginoplasty):

o   Infection: Infection is a risk for any surgery, including vaginoplasty.

o   Tissue necrosis: Damage or death of tissue used to create the vagina or labia is possible.

o   Fistula: Abnormal connections between the vagina and the bladder or rectum can form.

o   Vaginal complications: The new vagina may narrow, close, or not be deep enough for intercourse.

·       Masculinizing surgeries (e.g., phalloplasty, metoidioplasty):

o   Urethral and urinary complications: Issues with the new urethra, including strictures or fistulas, can lead to urinary problems.

o   Wound healing issues: Poor wound healing or complications at the donor site (where tissue is taken) can occur.

o   Implant complications: For phalloplasty with prosthetics, infection or erosion of the implant can happen.

·       Top surgeries (e.g., mastectomy or breast augmentation):

o   Top surgery (mastectomy): Risks include scar tissue, changes in nipple sensation, and the need for corrective surgery.

o   Breast augmentation: Risks for implants include rupture or leaking, infection, and changes in nipple sensation. 

Social, emotional, and psychological effects

Receiving gender-affirming care can affect a person's mental and emotional state, influenced by both internal and external factors.

·       Mental health fluctuations: During hormone therapy, many people experience a "second puberty" that can cause temporary mood swings, anxiety, and depression. However, some studies indicate that treatment can mitigate long-term mental health risks associated with untreated gender dysphoria.

·       Long-term regret or detransition: Some studies, particularly those using older or self-reported data, suggest an elevated risk of suicide, self-harm, and PTSD after gender-affirming surgery. However, these findings face methodological criticism. A major concern is the high percentage of people lost to follow-up, which can skew the results to show higher regret or negative outcomes than may actually exist.

·       Challenges and discrimination: Transgender people often face societal stigma, discrimination, harassment, and violence. These external factors are a primary contributor to poorer mental health outcomes in the LGBTQIA+ population and can compound the emotional challenges of transitioning. 

·       Gender-Affirming Hormone Therapy (GAHT)

https://www.google.com/search?q=what+are+the+ill+effects+from+receiving+gender+affirming+treatment

Comments

The angry reaction of Trans Supporters to their “lost cause” is motive for violence.

Norb Leahy, Dunwoody GA Tea Party Leader

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