Gender Dysphoria: A Personal Perspective

Background Paper 8.0 May 1995, from the Renaissance Education Association, Inc.

By Lee Etscovitz, Ed.D.

What is involved in the gender dysphoria which leads to transvestism, transgenderism, and transsexualism? Gender dysphoria is as much an inner as it is an outer, experience, if not more so. To be dysphoric is, by definition, to be uncomfortable. To be gender dysphoric is to be uncomfortable with one’s assigned gender. Gender dysphoria, then, is a precondition for gender transformation.  The nature and extent of the discomfort which characterizes gender dysphoria varies from person to person, depending upon a multitude of factors, such as family situation, personality, the extent of the dysphoria, availability of outside help, and so forth. But every transgendered person has experienced his or her dysphoria one way or another at some point in life.

Moreover, no one yet knows for sure in each case why gender dysphoria occurs. Explanations range from the personal to the cultural, from the biological to the psychological, from nature to nurture. Whatever the cause or causes, whether prenatal or postnatal, influence or neglect, parental closeness or distance, the fact remains that each gender dysphoric person has a gender story. That story, regardless of whether it is a trip, a journey, or a quest, or a combination of these, involves a period of gender discomfort followed, hopefully, by a period—by a life—of gender renewal. Let us examine some of the characteristics of gender discomfort, for it is out of such discomfort that gender renewal takes place.

Gender discomfort can be examined both developmentally and thematically. From a developmental point of view, discomfort with one’s assigned gender can be experienced in childhood, adolescence, and adulthood. Many, but not all, gender dysphorics experience their gender discomfort during childhood. Of course, what may be gender discomfort during childhood may not be recognized as such at the time. Only the discomfort, the unhappiness with oneself, perhaps an inability to play happily with other children, is felt. By adolescence, with the onset of puberty and sexual awakenings, gender dysphoria is often felt more acutely, even if not labeled. In fact, labeling it can be the beginning of gender renewal, so the failure to recognize gender discomfort beyond acting on it may actually add to the dysphoria and the discomfort it creates. One gets caught up in it, blindly, so to speak.

During adolescence, with the more clearly defined lines of sexual and gender identity (the two are not the same), shame and confusion can become a personal plague. Loneliness, even if self-created by personal withdrawal from life, can be excruciatingly painful. The sense of secrecy only adds to the loneliness. All of this discomfort may increase as the adolescent progresses into adulthood. Adult responsibilities, both vocational and familial, may simply add to the confusion and even to a sense of guilt. The inner conflict can become extreme, sometimes resulting in suicidal thoughts and even suicide itself. There is no real escape from the inner demands of gender dysphoria. The feelings persist and go with the dysphoric wherever he or she travels. There is no hiding place. Developmentally, therefore, gender dysphoria follows the individual from childhood through adolescence and into adulthood. The condition, if you will, only worsens if it is not handled positively. Denial does not help. It only increases the inner pressures. Academic achievement, job performance, marital happiness, and personal satisfaction can all suffer markedly from severe gender discomfort.

From a thematic, as opposed to a developmental, point of view, gender-related inner unhappiness is reflected in a variety of human situations and experiences, some of which I have already suggested. Several different words help to capture the inner unrest and struggle which, in varying degrees, can plague a gender dysphoric: turmoil, pain, loneliness, demons, grief, tears, unhappiness, confusion, shame, and guilt. Words like these have found their way into many of the poems which I myself have written over the years, poems which reflect my own gender dysphoria and my struggle with it. A few of those poems might help to convey what I, as one gender dysphoric person, have experienced.

When I was a seventeen year old high school senior, I was very depressed. The following poem, called The Leaf, grew out of that depression:

I looked through the window

and saw a leaf,

blown through the air

and affixed to a limb,

unable to free itself

from its grief.

Thank God

I was created Man

by Him.

My feeling of grief at the time I wrote this simple, yet deeply felt, poem was accompanied by a feeling of hope. But the grief itself was very large, a grief based more on a deep sense of inner confusion than on anything specific.

A sense of torment and struggle, yet still accompanied by hope, is reflected in another poem written, as all of the remaining ones were, as an adult. This poem is called Demons:


earthquakes of my soul,

throw me off balance

and tumble me into a chasm

of longing and fear,

where falling from pressure

of present and past

I lunge for release,

till twisted and torn

beyond recognition

I grasp the living ledge

of hope

and climb upward

once again.

Another poem captures the extreme loneliness which accompanied my gender discomfort. The poem is called, appropriately, Loneliness:

Loneliness stalks me

in the darkness of my bed,

in the crowdedness of a bar,

and when I walk the fields.

It presses in upon me

when I wish to be alone,

smashing my solitude,

drowning my days,

wrecking my weeks,

and punching me

in the stomach of my existence.

The pain and sense of struggle which these poems suggest have become an indelible part of my soul’s memory, at times filling me with a great  sadness, as reflected in the poem, Every Time I Swat a Fly:

Every time I swat a fly

I cry.

Oh not for smears

of black and red

that buzz into view

to be suddenly dead.


I cry for crashes

inside and out,

the dust and ashes

of stolen years.


every time I swat a fly

and wipe away

the smeared remains

I hear

a silent scream

and shed

and inward tear.

In another poem which speaks to the despair which has accompanied my gender dysphoria, I struggle with thoughts of suicide. This poem is called “Instead:”

I know I’m not supposed to say

that I would rather pass away,

and yet in moments of despair

it is as if I just don’t care.

There is so much to fill my heart,

and yet I still would soon depart.

But somehow after all is said

I find myself alive, not dead.

Perhaps I do not have to be

what everybody wants to see.

Instead, I’ll try to live the goal

of being faithful to my soul.

Again, the despair is accompanied by hope. In spite of a great deal of inner discomfort over the years, it is this persistent sense of hope which, at least in my situation, has contributed to my own gender renewal.

Gender dysphoria does not have to end in despair, even though it can cause pain. There is always hope, for out of the pain can emerge a vision of oneself as being entitled to a life of personal fulfillment. If there is a price to be paid for this fulfillment, it is in the form of courage, a courage based on faith in oneself and in the mysterious power of the human will. It was in the light of this need for such a faith that I wrote “A Prayer:”

This is a prayer

to the Unseen Powers

that move over and above us,

through and amidst us:

Grant us the strength

to see in our struggles

the emergence of a special wisdom,

a wisdom

born of pain and suffering,

of risk and trust,

of courage and persistence,

of caring and reaching out,

a wisdom

that yields a deeper knowledge

of who we are

in all our manifestations,

a wisdom

that helps us to handle

the forces of darkness

that sharpen our view

of reality.

May we learn in our lifetime

the meaning of existence,


and communally.

Let us reach down

into the depths of our souls

to do the soul work

our lives demand of us.

And let us remember

that the journey

into the fullness of life

begins with every sunrise,

with every awakening of the soul,

and with every step into the