Gender Identity Disorder: Can Psychiatry Help Me Cope?

Gender identity disorder - Can seeing a psychiatrist help me adjust better?

Hello, Doctor: I am very aware that I have gender identity disorder.
I have never served in the military, and life feels to me like acting while wearing a mask.
My appearance is indistinguishable from that of an average male, but my voice leans towards androgyny, which often surprises others when I speak in unfamiliar public settings.
In my youth, I considered undergoing gender reassignment surgery; however, as I grew older, I became less attractive, and my work environment does not permit it.
I also do not want to harm myself or cause my parents worry, so I gradually abandoned that thought.
To conform to societal expectations, I sometimes try to lower my voice and act more confidently to appear "normal," but over time, I feel increasingly uncomfortable and almost like I am experiencing a split personality.
I still cannot accept my own physical traits; when using the men's restroom, I have to choose a stall to sit down to urinate.
Unlike other gay men, I cannot accept having my partner see my naked body.
The idea of marriage feels like engaging in a same-sex relationship with a woman.
In recent years, I have tried to forget my gender and live a life of simplicity and detachment.
However, the pressure from family, friends, and colleagues to marry has caused me significant anxiety and distress.
I do not know how to adjust myself, to play my own role, and to live authentically.
My traits have led to some bottlenecks in my career advancement because I tend to avoid social interactions.
I am unsure if I am depressed; do I need to seek mental health treatment?

MTF, 30~39 year old female. Ask Date: 2015/08/21

Dr. Ding Shuyan reply Psychiatry

Hello, there are some deeply rooted issues that, if they do not harm others, I suggest accepting their existence rather than trying to change them.
This is a form of self-compassion and self-love.
Very few people are completely satisfied with themselves; for instance, I have features similar to those of Bai Bingbing: short, overweight, and balding.
These traits are almost impossible to change through effort, so the best strategy is acceptance.

Gender identity and homosexuality are increasingly recognized in today's society.
Many of my friends who identify this way are very friendly and talented, making them quite likable.
Another fact is that no matter what we do, there will always be people who like us and those who do not.
Even if you do not struggle with gender identity, your interpersonal relationships cannot always be perfect or satisfy everyone.
It just happens that your gender identity issues have been highlighted, making it seem like the core of the problem lies there.
Some of my friends, because of these traits, are perceived as less threatening in the workplace and often become individuals that others are willing to collaborate with.
Open your heart, try to help others, and work together with everyone; you will surely find joy in the process.
As for whether you need mental health treatment, it’s hard for me to say anything without speaking to you in person.
Since you feel troubled by depression, I recommend scheduling an appointment with a physician to discuss it; you may easily find answers, and seeing a doctor is not expensive.

Having the opportunity for counseling is beneficial, as it can provide insights even for those who consider themselves normal.
Wishing you all the best.

Sincerely,
Dr.
Ding Shuo-Yan

Reply Date: 2015/08/21

More Info

Understanding gender identity disorder, or gender dysphoria, is a complex and deeply personal journey that many individuals navigate. It is important to recognize that feeling discomfort with one's assigned gender at birth is not inherently pathological; rather, it is a reflection of the diverse spectrum of human identity. Your experiences and feelings are valid, and seeking help from a mental health professional can be a crucial step in understanding and coping with these challenges.

From what you've described, it seems you are grappling with a significant internal conflict regarding your gender identity. You mention feeling like you are "wearing a mask" in your daily life, which suggests a disconnect between your true self and the persona you present to the world. This feeling is common among individuals with gender dysphoria, who often experience distress due to societal expectations and norms that do not align with their internal sense of self.

The fact that you have considered gender-affirming surgery in the past indicates that you have been reflecting on your identity for some time. However, it is also understandable that as you have grown older, practical considerations—such as societal acceptance, family concerns, and personal appearance—have influenced your thoughts about transitioning. It is essential to remember that transitioning is a personal choice and can take many forms, including social, medical, or legal changes. Each individual's path is unique, and there is no right or wrong way to navigate this journey.

Your feelings of discomfort in social situations, particularly regarding your voice and physical appearance, are also significant. Many individuals with gender dysphoria experience anxiety in public settings, especially when their gender expression does not conform to societal expectations. This can lead to feelings of isolation and frustration, as you have described. It is important to find supportive spaces where you can express yourself authentically without fear of judgment.

Regarding your question about whether you need psychiatric treatment, it is crucial to consider the impact of your feelings on your overall well-being. If you find that your distress is affecting your daily life, relationships, or mental health, seeking help from a mental health professional who specializes in gender identity issues can be beneficial. Therapy can provide a safe space to explore your feelings, develop coping strategies, and work through any underlying anxiety or depression you may be experiencing.

In therapy, you might explore various aspects of your identity, including your feelings about your body, societal expectations, and your relationships with family and friends. A therapist can help you navigate the complexities of your situation, including the pressure from loved ones regarding marriage and societal norms. They can also assist you in developing a plan for how to express your gender identity in a way that feels comfortable and authentic to you.

It is also worth noting that many individuals in the LGBTQ+ community have found empowerment and support through peer groups and community organizations. Connecting with others who share similar experiences can provide a sense of belonging and understanding that is invaluable during this journey.

In conclusion, while navigating gender identity can be challenging, it is essential to prioritize your mental health and well-being. Seeking help from a qualified mental health professional can provide you with the tools and support you need to explore your identity, cope with societal pressures, and ultimately live a life that feels true to yourself. Remember, you are not alone in this journey, and there are resources available to help you along the way.

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