Discuss research on gender dysphoria. (8 marks + 16 marks)

In this question you are required to discuss gender dysphoria and the reasons (psychological and/or biological) for it.


One psychological explanation is that gender dysphoria is caused by childhood trauma or a maladaptive upbringing. Coates et al. studied one boy who developed gender dysphoria. They suggested that this may have been a defensive reaction to his mother’s depression following an abortion. The trauma may have led to a cross-gender fantasy as a means of resolving this anxiety.

A biological explanation of gender dysphoria is that it may be caused by abnormal prenatal exposure to androgens (male hormones). Some genetic conditions can cause discrepancy between hormones and genetic sex. For example, congenital adrenal hyperplasia (CAH) occurs when genetic females have high levels of androgens which cause them to develop a small penis. The outcomes of such cases may be gender dysphoria for the affected individuals.

A further biological explanation is that some people have genes which cause gender dysphoria. Hare et al. studied 112 male-to-female transsexuals and found a variant of the androgen receptor gene that causes reduced action of testosterone. This can affect gender development in the womb (e.g. by under-masculinising the brain) which could cause gender dysphoria.

A third biological explanation is the brain sex theory. A region of the brain known as the bed nucleus of the stria terminalis (BSTc) is twice as large in men than in women and contains twice the number of neurons. The number of neurons in the BSTc of male-to-female transsexuals is similar to that of the females, suggesting that the size of the BSTc correlates with preferred sex rather than biological sex.

There is little research support for psychological explanations. Studies have found that in individuals experiencing gender dysphoria, the range of psychiatric conditions was no greater than that in the general population. This suggests that gender dysphoria is unrelated to mental illness, trauma or pathological families.

There has also been inconsistent research support for abnormal exposure to androgens. For example, Dessens et al. studies 250 genetic females with CAH who were raised as females. Despite prenatal exposure to androgens, 95% were content with their female gender. This high rate suggests little relationship between androgen exposure and gender dysphoria.

The brain sex theory has been challenged by the more recent finding that differences in BCTc volume between men and women do not become apparent until adulthood, while most transsexuals report feelings of gender dysphoria as beginning in early childhood. This suggests that the differences in BSTc volume do not cause gender dysphoria, but may be an effect.

However, there is research to support the brain sex theory. Rametti et al. studied the brains of female-to-male transsexuals and found that these individuals had a more similar pattern to those who share their gender identity (males) than those who share their biological sex (females). This suggests that abnormal development of the brain can lead to gender dysphoria.

Although most biological explanations involve genetics, some do not. For example, the insecticide DDT contains oestrogen which means that males can be prenatally exposed to abnormally high levels of oestrogen. This could cause these males to have a more female gender identity and thus have gender dysphoria.

Research into gender dysphoria has real-world applications. It is very important in providing information about the effects of erroneous sex assignments and determining the best solutions to such problems. Various organisations campaigning for the rights of intersex individuals rely on research evidence to show both biological and social influences on gender self-concepts.

One problem with this area of research is that there are different kinds of gender dysphoria. Two distinct groups have been proposed: ‘homosexual transsexuals’ who which to change their sex because they are attracted to people of the same sex and ‘non-homosexual transsexuals’ who wish to change their sex because they are attracted to the idea of themselves as the opposite sex. Such differences suggest that there need to be distinct explanations for each group.

Another consideration is the socially sensitive nature of this research. It may be good for transsexuals if a biological cause is identified as this may help people to be more accepting of their problems (i.e. it is not a ‘choice’). Alternatively, if a biological cause is identified this may harm individuals born with a related abnormality as it may be erroneously assumed that gender dysphoria is inevitable.