Introduction
Have you ever found yourself confused over dysphoria and dysmorphia? Or have you used it interchangeably without realizing their different origins? Even if the words sound similar there is some clear distinction between the two. When we talk about mental health struggles and body image issues, these words come up quite often. While they share some similarities, such as being tied to emotional distress, they stem from different causes and affect people in distinct ways.
What is Dysphoria?
Dysphoria or Gender Dysphoria (GD) is a form of intense unease, dissatisfaction and psychological distress over one’s gender identity. Often resulting from incongruence between how one identifies their gender and the gender that was assigned to them at birth. Often experienced by Trans, Gender Fluid and Non-Binary individuals or even anyone who may struggle to accept their gender identity may face gender dysphoria. While there is a diagnosis for the same in the Diagnostic and Statistical Manual 5 or DSM-5, it is very important to note that it is not a form of mental illness or disorder. Those who struggle with gender dysphoria often struggle greatly in their perception of self and identity, these struggles are real however, having these struggles itself, or being Transgender, Gender Fluid, or Non-Binary does not mean that there is something psychologically wrong.
Symptoms of Dysphoria
One of the major symptoms faced by those who experience GD is immense and extreme dissatisfaction over one’s assigned gender identity, or the body one is in. Because of which people with GD may experience severe desires to lose/remove certain body parts, or physical attributes that exacerbate their GD.
According to the DSM-5 TR, In adolescents and adults, gender dysphoria is defined as a significant discrepancy between one's given gender and their experienced/expressed gender that lasts for at least six months and is exhibited by at least two of the following symptoms:
- - A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics)
- - A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics)
- - A strong desire for the primary and/or secondary sex characteristics of the other gender
- - A strong desire to be of the other gender (or some alternative gender different from one’s assigned gender)
- - A strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender)
- - A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender)
Other common symptoms experienced by those with GD are:
- - Low self-esteem and sadness or an inability to find fulfillment in everyday activities
- - Emotional distress (e.g., sadness, anxiety, or frustration) about one's physical body or societal expectations.
- - Difficulty functioning in daily life due to these feelings.
- - wishing to be seen as a different gender by others
- - and exhibiting emotions and behaviors that could be typical of a different gender
According to the DSM-5-TR, a child has gender dysphoria if there is a significant discrepancy between their given gender and their experienced/expressed gender that lasts for at least six months and is demonstrated by at least six of the following (one of which needs to be the first criterion):
- - A strong desire to be of the other gender or an insistence that one is the other gender (or some alternative gender different from one’s assigned gender)
- - In boys (assigned gender), a strong preference for cross-dressing or simulating female attire; or in girls (assigned gender), a strong preference for wearing only typical masculine clothing and a strong resistance to the wearing of typical feminine clothing
- - 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 other gender
- - A strong preference for playmates of the other gender
- - In boys (assigned gender), a strong rejection of typically masculine toys, games, and activities and a strong avoidance of rough-and-tumble play; or in girls (assigned gender), a strong rejection of typically feminine toys, games, and activities
- - A strong dislike of one’s sexual anatomy
- - A strong desire for the physical sex characteristics that match one’s experienced gender
Yes, children can also experience Gender Dysphoria, GD isn’t an experience that is locked behind age or wisdom. Children can understand the world that they live in and what expectations are placed upon them from a young age, however limited it might be. It does not take away from their experiences. A lot of young Queer/LGBTQIA+ individuals understand from a young age the difference between who they are and who the society wishes them to be. Sometimes people know it from a young age, and other times it might even take decades for them to fully grasp and accept their gender identity. As it is not easy to accept that one is different, or accept the severity of the complex emotions they experience if they have GD. That is to say, it is very important to remember that not every gender queer, or trans individual experiences GD.
What is Dysmorphia?
Dysmorphia however is significantly different from Dysphoria. While they share some similarities, dysmorphia occurs typically when someone has a distorted perception of one’s physical appearance. The term is most often linked to body dysmorphic disorder (BDD), a mental health condition characterized by an obsessive focus on perceived flaws in appearance, even if these flaws are minor or nonexistent.
Body Dysmorphic Disorder or BDD is a deeply distressing condition where one is obsessively focused on their perceived imperfections which may not even be visible or noticeable to others around them. These distortions are often found to be rooted in negative thought patterns and can lead to behaviors such as avoiding social situations, developing eating disorders, or pursuing unnecessary cosmetic procedures.
Symptoms of Dysmorphia
According to the DSM 5-TR the diagnostic criteria for BDD is
- - Preoccupation with 1 or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.
- - At some point during the course of the disorder, the individual has performed repetitive behaviors (e.g. - mirror checking, excessive grooming, skin picking, reassurance seeking) or mental acts (e.g. - comparing his or her appearance with that of others) in response to the appearance concerns.
- - The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- - The appearance preoccupation is not better explained by concerns with body fat or weight in an individual whose symptoms meet diagnostic criteria for an eating disorder.
Other symptoms may include:
- - Repetitive actions (such as obsessive grooming, mirror checking, skin picking, or reassurance seeking)
- - Mental activities (such as comparing one's looks to others).
- - Having low self esteem and being self conscious
- - Visiting a lot of dermatologists, plastic surgeons, or getting a lot of cosmetic procedures done.
- - Having their false view of self affecting other areas of their life
- - Seeking approval from others
- - Engaging in excessive grooming
Body Dysmorphic Disorder is one thing that can be highly triggered by the societal perceptions and depictions of beauty. From magazines to movie stars, from societal expectations of presentations to how one is supposed to look to seem desirable, it is very easy to fall prey to the systems that thrive on selling insecurities to individuals regardless of gender to make more money. However, with that said, women do tend to be far more vulnerable as they are often the target audience of a lot of beauty products that exist solely to fix ‘insecurities’ that do not actually exist. Not to mention, societal beauty standards for women are far more rigid and worse than they are for men. Men too can have BDD but how it manifests itself and the reason it may manifest may be completely different from women.
Overlaps and Misconceptions
Dysphoria and dysmorphia can at times coexist or even be mistaken for one another. For Example, a transgender person experiencing gender dysphoria may also develop body dysmorphia due to societal pressures or dissatisfaction with their physical transition progress. In such cases it is important to address each condition individually and at the same time be mindful of how they interact with one another.
Treatment
It can be difficult to talk about these things or open up to those around you in fear of being perceived differently and being misunderstood. If you or someone you know are facing such issues or experience GD or BDD you can talk to HEALO , your friendly mental health companion that is at your service 24/7.
If you are considering seeking help, Cognitive Behavioral Therapy or CBT is one of the best courses of action for BDD, or GD. An antidepressant class known as SSRIs may be able to lessen compulsive and obsessive thoughts and actions. SSRIs or other such medication which need to be taken only on prescription by a licensed psychiatrist or physician.
For GD, counseling is also a good option or other treatment option that focuses on anxiety or stress.
Conclusion
Broadly speaking, people experience a great deal of anxiety, stress, dissatisfaction and psychological distress in both GD and BDD. Understanding these differences and similarities between dysphoria and dysmorphia is vital for creating inclusive, compassionate spaces.
