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I am Abra. I am a trans woman, and I live with gender dysphoria. In the past, the DSM (Diagnostic and Statistical Manual of Mental Disorders) listed it as gender identity disorder, a stigmatizing term for trans folk. In the DSM-5, it has been changed to gender dysphoria, which involves “significant distress or problems functioning” related to “a difference between one’s experienced/expressed gender and assigned gender.” In Canada and many other countries, an official diagnosis of gender dysphoria is required to get access to medical support for transition and to change government identification.


While being trans is not a mental disorder, which the previous DSM designation of gender identity disorder seemed to suggest, gender dysphoria can be every bit as debilitating and deadly as clinical depression. In fact, gender dysphoria, when untreated, can exhibit as depression and anxiety. While I had buried my gender issues so completely that it took me until I was 42 to break through, and I didn’t recognize the distress with which I lived as gender dysphoria, it was always a background noise in my life. 


In the spring of 2016, after my egg had cracked (an expression common among trans folk to describe the moment they began to realize that they are trans), my gender dysphoria got so bad that I began to have suicidal ideation. I knew then that I had to choose between death and treatment. And the only effective treatment for gender dysphoria is transition (social and/or medical). So I took the leap and made an appointment at a gender clinic and by October 12th, 2016, began HRT (hormone replacement therapy) and social transition. I had already begun laser hair removal and soon attended voice therapy and in the summer of 2018 had vaginoplasty (I got my vagina!).


It is important to recognize that, not unlike clinical depression, gender dysphoria can be treated, but will not necessarily ever go away entirely. I am fortunate that my transition has gone very well. I have a loving, supportive wife, a network of supportive friends, I live in a country where I could access medical help and change all my government identification, and I am able to live and work as the woman I am. I have some passing privilege, meaning I can move about the world being seen and treated as a woman. Yet still there are times when I have gender dysphoria after seeing myself in a reflection or photograph. But with treatment, and with societal change to accept trans people, living with gender dysphoria can be manageable. In order to help with the societal change and to inspire others, I choose to remain visible and to represent.