Most people understand body dysphoria as a dissonance between sense of self and body. But what does that mean?
Is dysphoria the same as feeling uncomfortable after gaining weight? Is it the same as hating your big honking nose? Or is there a fundamental difference between dysphoria and other feelings of bodily discomfort? I think about this quite often. Am I dysphoric about my hips, or do I just feel inadequate in a world where femaleness is defined as possessing childbearing hips? Am I dysphoric about my facial hair, or am I self-conscious because the rest of the world judges hairy women? When is discomfort over my body a result of testosterone poisoning, and when is it a desire to be more attractive? Is it possible to tell the two apart?
This is not a philosophical question. Insurance companies categorize trans medical care as “cosmetic” and use this as a justification to deny coverage of trans-specific procedures. Psychologists write off body dysphoria as a delusional manifestation of body dysmorphic disorder. Friends and family dismiss the extreme pain caused by dysphoria and tell us to “just accept who we are”.
The difference between dysphoria and negative self-image is important for us as people, as well. The mystique surrounding dysphoria holds us back from living fuller, happier lives. Dysphoria is a vaguely-defined and poorly understood phenomenon. Most descriptions of dysphoria are intuitive, personal, and vague. How can we understand ourselves without the language to describe specifics? How can we develop useful coping strategies with such a limited understanding of the inner workings of dysphoria? How can we explain to the cisgender population–who often have the final say in whether or not we get to live happy, full lives–what dysphoria is and is not, unless we dig deeper?
One trans medical treatment that’s misunderstood is facial feminization surgery (FFS for short). Some people think the desire for FFS is rooted in the pathology of mainstream beauty standards. They think trans women get FFS to look like supermodels. These people are completely wrong.