Dysphoria, Dysmorphia, and Girls' Socialized Self-hatred.

No one group has a lock on hating their bodies

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Twenty-one hairs. By eighth grade, that’s how many there were: six in a train below my belly-button, 11 between my breasts, and—worst of all—four on my actual breasts.

Most nights of my adolescence I cried. I thought I was a freak. I did not know other girls who’d grown body hair anywhere other than the places our sex ed teachers had told us females would sprout it: armpits and the public area. They didn’t say, “Hey, some men are hairless like dolphins and some women have full beards.” [We knew this latter fact from the woman we called the Bearded Lady, who sold metallic scarves and beaded earrings in downtown Amherst, MA, but we also thought she was a freak—now I see her as a hero for Not Giving a Fuck.] They didn’t say, “There are norms, and averages, but just because you’re female doesn’t mean you won’t have a treasure trail or a couple of stray boob hairs. It’s all normal.”

I didn’t tell anyone, not a parent, teacher or friend, about the sea of shame that I swam in. My breasts didn’t look like those in the Playboys we’d been sneaking since elementary school, either, and for that I cried, too, and could never take my shirt off in front of other people in the light. When, as a new mother, I couldn’t breastfeed, it confirmed my feelings of freakishness, though once again if doctors and educators were properly trained, they could have explained what was happening and even potentially found a solution for it.

I wish that my entire upbringing had been infused with the message that I should love and cherish my body, that its differences were its delights. I’ve been dieting since I was 10 years old, trying to conform to gender norms that I’ll never achieve, and I have hated my body since I was very, very small and noticed in gymnastics class how round my thighs were compared to the other little girls’ thighs. Up to 84% of women in the US are dissatisfied with their bodies. As many as 20 million women will have eating disorders in their lives (including yours truly).

When the dress reform movement took hold at the end of the 19th century, and women’s bodies could no longer be so easily controlled by corsets and bustles, those styles were replaced by the more masculine flapper looks. You know what happened? Dieting took hold, because those flapper dresses looked best on skinny bodies without breasts and hips. We found a subtler but foolproof way to control women’s bodies: shame. Make them feel terrible about their looks, and they will buy anything. They may be liberated on paper, but in reality they will still be caged.

But I noticed when I interviewed very masculine young girls that they seemed to have absorbed none of that shame. They felt really good about themselves, better than gender-conforming girls. They had no interest in perfecting feminine norms, in being pretty and thin, in having long, shining hair. And because they were often mistaken for boys, and thus treated as boys, adults did not concentrate on their appearances. When interacting with these masculine girls, adults focused on what they liked to do, what sports they played. Adults didn’t say, “I love your hair,” or “I love your basketball jersey.” And so that natural nonconformity, that resistance to societal messages about what girls should be like, was reinforced, over and over.

What happened at puberty? For the older generation, the great bulk of them, even those who grew up to continue their nonconformity or identified (or were identified by others) as butch grew to love their female bodies, but often after extended periods of what we now call gender dysphoria. Growing a woman’s body after having a boyhood can be very distressing. Growing a woman’s body after having a girlhood can be extremely distressing, too.

Several of the younger folks I talked to transitioned at or after puberty, because that technology was available to them. It allowed them to continue the boyhood they’d had, and to be seen the way they wanted to be seen, treated the way they wanted to be treated, and made them feel more comfortable walking around in the world.

Today, we’ve gone beyond educating kids about this technology, which allows for at least the illusion of changing sex, to actively marketing it to them. Over on TikTok, overwhelmingly perused by youngsters, Dr. Sibhbh Gallagher, aka GenderSurgeon, creates light-hearted videos about “yeeting the teets,” and then profiles her happy customers, young trans men who can now be shirtless in public. It’s just one small example of the pervasive narrative that medical transition is simple, mild, and a panacea for what ails young women. And it’s a narrative that the entire left and center media has decided not to question.

(By the way, women are legally allowed to be shirtless in NYC if it’s not for commercial purposes. But most of us don’t partake because we don’t want to be stared at, or we feel ashamed. It’s a lot easier to change your own body than it is change your culture. But I’m sure as hell trying.)

But we do need to question this narrative, because in some cases it’s very hard to tell the difference between gender dysphoria and body dysmorphic disorder. Because more and more kids with eating disorders are being diagnosed with gender dysphoria, too, it’s really important to try to tell the difference, especially when you look at the treatment.

Here’s Mayo Clinic on dysmorphia:

Body dysmorphic disorder is a mental health disorder in which you can't stop thinking about one or more perceived defects or flaws in your appearance — a flaw that appears minor or can't be seen by others. But you may feel so embarrassed, ashamed and anxious that you may avoid many social situations.

When you have body dysmorphic disorder, you intensely focus on your appearance and body image, repeatedly checking the mirror, grooming or seeking reassurance, sometimes for many hours each day. Your perceived flaw and the repetitive behaviors cause you significant distress, and impact your ability to function in your daily life.

You may seek out numerous cosmetic procedures to try to "fix" your perceived flaw. Afterward, you may feel temporary satisfaction or a reduction in your distress, but often the anxiety returns and you may resume searching for other ways to fix your perceived flaw.

Treatment of body dysmorphic disorder may include cognitive behavioral therapy and medication.

Here’s the Mayo Clinic on some of the symptoms of gender dysphoria:

• A marked difference between your inner gender identity and primary and/or secondary sex characteristics, or anticipated secondary sex characteristics in young adolescents

• A strong desire to be rid of primary and/or secondary sex characteristics because of a marked difference with your inner gender identity, or a desire to prevent the development of anticipated secondary sex characteristics in young adolescents

• A strong desire for the primary and/or secondary sex characteristics of the other gender

Notice they’re doing a lot of work to assure you that the reason someone would want to change their body is because they’re transgender, not because they just hate their bodies like the rest of us. And they focus on secondary sex characteristics, even if gender-affirming surgeries include Brazilian butt-lifts and facial feminization or masculinization procedures.

If you’re deeply distressed about your butt and don’t identify as transgender, it may be seen as body dysmorphic disorder, and treated with therapy and anti-anxiety meds, encouraging a patient live with and love her body. If you’re very distressed about your butt and identify as trans, it may characterized as gender dysphoria, and perhaps treated with surgery to give you the body you want. Though, as the Mayo Clinic points out at the very end of its treatise on dysphoria, “Adolescents and adults with gender dysphoria before gender reassignment might be at risk of suicidal ideation, suicide attempts and suicide. After gender reassignment, suicide risk might continue.” [Emphasis mine. Also, many people within and outside of this industry question the suicide the statistics themselves, and the way they are wielded to promote medical transition.]

Because of the overlap, it’s crucial to perform proper assessments and ascertain the source of the distress, so the right treatment is possible.

Meanwhile, many within the medical and mental health fields have accepted that trying to get a distressed young person to feel comfortable in their own body is conversion therapy. So rather than teaching kids to be kind to their bodies, to keep them healthy, and to find a way to love and celebrate them, we teach them that they can change their bodies, and that this will lead to happiness.

I’m not saying that it doesn’t sometimes, maybe even often, lead to happiness. I was 33 when the boyfriend I thought I would marry and I broke up, and I was desperate to find a good partner in time to procreate. I went to a laser hair removal place on 57th Street and got those 21 hairs zapped off, and I felt a million times better. Cosmetic surgery is always a kind of gender-affirmation surgery (I said this in a class at NYU once and I deeply offended the students). It helps us feel better by changing our bodies to conform to societal gender norms, and it alleviates our distress at not looking how we want to look. I get it.

But I believe young people should not be taught that body parts are removable and which puberty they go through is optional, and that gender nonconforming kids who have a natural advantage—not feeling shame for their lack of conformity—should be supported and celebrated and emulated. I believe kids should learn that you get one vessel for your time on the planet, and that our society will try in many ways to shame you about it and tell you why it’s not good enough. Maybe you will grow up and decide that the physical, emotional and financial cost of transforming it is worth it, so you can feel more comfortable. And maybe you will decide that you feel comfortable with what you were given.

Pic: Pixabay, Creative Commons.