Gender Identity Disorder and Gender Dysphoria

Spread the love

Originally posted 2017-09-15 21:03:33.

Gender Identity Disorder (GID) and Gender Dysphoria (GD) are the same thing. In the Diagnostic and Statistical Manual (DSM) of Mental Disorders, prepared by the American Psychiatric Association, the terms GID and GD apply to the same condition, depending on which edition of the DSM you look in.

Up to the fourth edition, DSM4, the condition appears as Gender Identity Disorder and in DSM5 it appears as Gender Dysphoria . There is a note in DSM5, which confirms that the name was changed to Gender Dysphoria because the word “Disorder” was seen as having negative connotations and was stigmatising to people suffering from it, not because it was no longer considered a mental disorder — as most trans-activists will tell you. GD still appears in the DSM5.

As someone who has suffered with Gender Identity Disorder my entire life I can assure the reader that it is in fact a mental disorder. I was born with a perfectly functional male body in all other respects, but from early childhood my innate behaviours and sense of myself were completely at odds with that fact.  The causes of this disorder may well be physiological in some patients and psychological in others and we will discuss that later in this article. The disorder though, is one which with proper medical and or psychiatric care can be managed and so allow the sufferers to live full and happy inclusive lives.


There are all kinds of self-penned pseudo explanations of Gender Dysphoria circulating on the internet, on social media sites by “transgender” people the vast majority of which are incorrect, misinformed or down right spurious.  These explanations confuse general discontent or unhappiness with one’s physical appearance, bodily functions or social roles with actual GD and, while these things can contribute to and exacerbate the anxiety caused by GD they are not themselves Gender Dysphoria .

What It Isn’t

Depending upon its severity a dissatisfaction with part or parts of one’s appearance, i.e. being too tall/short, nose too big, lips too thin, jaw too strong, too muscular, not muscular enough, breasts too small or too big are common complaints amongst many of the general population and are little more than mild body dysmorphia.

Where body dysmorphia is so strong it begins to effect a person’s moods or demeanour so much so that they seek surgery to change or as they see it correct, what they perceive to be a defect it still does not mean that this is Gender Dysphoria . Even where the perceived defect is considered a trait of the opposite sex or natal sex it is not GD. A woman with a strong jaw line or nose who seeks surgery to reshape it does not have GD and neither does a man with a receding hairline who seeks scalp surgery.  Those who do suffer GID often develop body dysmorphia for their primary sex organs and secondary sex characteristics, but those feelings of discomfort arise from the Gender Identity Disorder; they are not themselves GD. Body dysmorphia does not turn into Gender Identity Disorder; in other words, you don’t become transsexual because you don’t like your penis or flat chest, it is always, always the other way around.

In natal females, it is also very common for them to be uncomfortable, around the time of puberty, as their reproductive systems become active alongside the changes to their body shape, which attracts attention from the opposite sex. It is very easy for young women, especially lesbians or classic “tomboys” to confuse these feelings as being Gender Identity Disorder. They are not, and far too many young lesbian girls are being misled by their peers into believing they are “trans” and embarking on opposite sex hormone regimes and surgeries as a result of this misinformation, which they will doubtless later live to regret. In this article we will look only at Gender Identity Disorder in genetic males, I will leave GID in females to somebody who has sufficient experience of it and those who suffer it and so is better qualified.

Unlike the West, AGPs in southeast Asia can be very feminine. In this picture, the girl at  right is AGP; left and centre right are HSTS and centre left is a woman


There are two distinct types of transsexual, Homosexual Transsexual (HSTS) and non-homosexual transsexual or Autogynephile (AGP). The differences are best classified in the work of Dr Ray Blanchard as explained here . Both experience Gender Identity Disorder but in distinct and different ways.

Classic Western-profile middle-aged AGPs


These are usually able to fit into the masculine role expected of their birth sex and most but not all of them only seek transition later in life, having lived for years often decades as successful men, marrying women and having fathered and raised children. They are in almost every case sexually attracted to females and tend to develop an almost idol worship syndrome for women, which they at some point, usually during puberty, conceptualise into a female persona of their own.

As they age they continue to feed and get reward from secretly bringing this female persona to life. This causes them a great deal of distress as they hide this out of fear of how this will affect their lives and those around them. This results in years of them indulging this fantasised persona in secret causing them mounting depression until eventually they have a breakdown of sorts and the constructed female character takes over their identity and they come out as trans believing that they were in fact female all along just “trapped in the wrong body”. They do not suddenly wake up one day at 45 and decide to be a woman.  This created persona is usually nothing like an actual female but is often an exaggerated caricature of femininity. It is only after this second identity becomes dominant that AGPs usually begin to develop body dysmorphia.

A beautiful Asian HSTS: Sam Villasencio.  Pic Rod Fleming


These are almost without exception very feminine in appearance, body type and in their innate behaviours from early childhood. They rarely fit in as boys or young men and avoid gendered pastimes and sports typically associated with their birth sex. They are exclusively sexually attracted to other males to whom they are submissive. They recognise their femininity from an early age and become comfortable with it but realise all too soon that this is incompatible with their lives as males.

The resultant depression this causes is usually compounded by the antagonistic reactions of other males around them. They begin very quickly to disassociate themselves with their physical masculinity and feel like their lives would have been better had they been born female and feeling that they should in fact have been born so. HSTS usually present as transsexual and seek treatment early in life, by their teens or early twenties.

It is usual for HSTS to develop body dysmorphia around the time of puberty. It is more than likely that this type of transsexualism is physiological in nature and MRI studies and genetic studies give indications that HSTS have different brain structures and Androgen Receptor polymorphism than other males. These are not found at all in AGPs .

Both types of transsexualism are equally distressing conditions causing considerable suffering to those who experience them.   

 What is Gender Dysphoria?

In both types of transsexual Gender Dysphoria manifests and is observable as severe anxiety and depression, which arises from the internalised feelings of guilt and profound and pronounced shame, they each feel from the effect that their disassociation with their birth sex has upon them, but in different ways.

AGPs feel guilt and shame for wanting to undertake the societal female role when they, their partner, family and children believe and often need them to be the male component of the family unit. Many  will delay announcing their condition until after their children have grown and left home. Once an AGP is “out” they then start to realise the gargantuan (often impossible) task they face in living and being accepted as women in society; this is when the secondary symptoms such as body dysmorphia set in.  They often believe themselves to actually be female and are devastated when this cannot be realised physically or socially. Once “out” they can live their constructed persona openly so the GD is effectively removed and it is only the failure to realise their goal of being accepted as female which causes them distress, not the Gender Identity Disorder.

Experience of Gender Identity Disorder

HSTS too feel guilt and extreme shame but for simply being male! This is because the target of their desires, heterosexual males are attracted to and desire females and it is for those partners that they experience the feelings of shame.  HSTS usually transition very easily and fit into society as women without experiencing any problems such as those experienced by AGPs. They may well have had Genital Reconstruction Surgery (GRS) to remove the male genitalia and create a vagina, but despite externally appearing female in every sense they are fully aware that they are not so. Sadly this means that while GID is greatly reduced following transition, HSTS will still experience it from time to time.

As a personal experience of Gender Identity Disorder post GRS, I can recount that this only happens very rarely and is a totally internalised experience. I might at some random fleeting occasion contemplate the fact that I am still genetically male and wonder at the totally imagined effect this fact might have on my male partner’s feelings about me. The feelings of crippling shame that this induces can be devastating, it is like trying to breath with somebody standing on your chest. Fortunately after transition these are very short lived and extremely rare relapses.

That “self-generated” anxiety and depression from the disassociation with one’s biological sex is Gender Dysphoria. It comes from within the psyche and not from external factors. Being “upset” because someone misgenders you or “clocks” you; looking in the mirror and not liking the look of a particular feature or body part; or you hating a bodily function are just that, being upset, nothing more. These are not Gender Dysphoria ! Such a person is upset or sad because they cannot have what they want or because somebody has been rude or mean to them; it is not Gender Dysphoria. However those things can lead the person to induce an attack of GD.


Gender Identity Disorder is a very debilitating condition and those who suffer it do deserve sympathy and help in treating it. Suffering it is not a choice and all attempts to treat it other than transitioning tend to fail miserably and perhaps with fatal consequences.

Those who claim to be “transgender” but say they do not suffer Gender Dysphoria are not transsexual at all but are simply making a nonconforming fashion statement for their own reasons.



7 Replies to “Gender Identity Disorder and Gender Dysphoria”

  1. You make some points in the article, but if you were to go by the true Blanchard research definition of a HSTS, it is a man who desires to attract and be fucked by a man and adapts his behavior to be more feminine and female to do so. This leads to early transition to the female role. The primary motive is sexual and to attract a man. Are you willing to admit that? Of course we can’t get AGPs to admit their erotic motivation? but many HSTS also don’t openly admit to desiring men as their motive.

    1. HSTS are male but not men. They don’t ‘adapt their behaviour’, the evidence — as noted by Blanchard, whom I think you should actually read before lecturing to others about it — suggests that some innate factor (ie not one under their control) causes them to be be fully and sometimes hardly at all, masculinised across a range of parameters, of which sexuality is only one. HSTS are not HSTS because they are homosexual, it is one in a range of factors that define HSTS. It is not the primary motive, that is a gross misrepresentation, although it is consistent and so diagnostically useful. I realise that you are hostile towards them but that does not excuse you blatantly misrepresenting the science, or the scientist. HSTS do not ‘admit’ that their desire for men motivates them any more than women do. I have let this comment through but in future I’ll require you to moderate your tone. I will let the author respond more fully if she wishes, this was an Editor’s growl of warning.

    2. Pri, I make no secret of my attraction to men. If you read some of my other articles you will note I refer to this throughout. That though while a minor factor was not my motivation for early transition, other than as a wistful fantasy. What prompted my transition early was my inability to adapt to the male role as a direct result of my disconnect to my natal sex.
      I was always attracted to men from being very young, developing crushes on my friends and losing my virginity to a boy at 15. However when I finally gave in and transitioned I was convinced no man would ever want me sexually again, but I could not go on any longer with the misery my condition caused me. The men with whom I had sex back then wanted me because I was a feminine male, they didn’t want a woman. I never envisaged a straight male desiring me once I revealed I was transsexual. Luckily I was very wrong on that count.
      I don’t believe that sex is the only motivator in either type of transsexual but it has factored heavily in all the APG transsexuals I have ever met. If Rod is happy for me to do so I will try to expand on the differences in the approach to sex and sexuality in another contribution.

      1. Hi Amanda: on the article, you bet! Your contributions are extremely valuable and I much appreciate them. I am up to the eyes in typesetting just now and struggling to keep up my own contributions!

    3. Pri:

      That’s actually Baileys theory, not Blanchards. Some autogynephilic transactivists like misrepresenting Blanchard, Blanchard does not think homosexual transsexuals are only driven by sexuality.

      “Blanchard and his colleague Ken Zucker both are advocates of HSTS and of course AGPS to remain male and not go through any sort of transition. Zucker was fired from the Clark Institute for such views. ”

      They both actually support it, they also support screening though and therapy.

  2. I’m well Versed in Blanchard’s work as well as read Bailey’s book. I’m not hostile and I am agnostic about all this stuff. I actually get hostile whenever I read about an AGP who used his Penis to father several children and used male privelleage to gain money and status and then all of a sudden claims he is a true woman and was a lesbian all along. That’s when I tend to attack and there are many of those cases. The author here is not that.

    Blanchard and his colleague Ken Zucker both are advocates of HSTS and of course AGPS to remain male and not go through any sort of transition. Zucker was fired from the Clark Institute for such views.

    The Man who would be Queen by Bailey also clearly indicates that extreme effeminate homosexuality or erotic motivation for attraction to self as a woman are the motivators for transition to woman. I can post a quote from the book.

    But Most true elite HSTS are very stealth under the radar and aren’t really paying attention to any trans related stuff.

    1. Pri. Maybe I came down on you too hard but you are making stereotypical, unsupported assumptions. I am not a supporter of identity politics or ‘intersectionality’ but the fact is that HSTS are abused by just about everyone. Conservative straight men hate them for not being heterosexual (and for tempting them,) homosexual men hate them for doing exactly what so many gays most want to do but are either scared to or they missed boat (I’m not saying that all gays are actually HSTS, although a good few are; but pretty much all gays wish they were HSTS). Feminists hate them because a) they conflate them with AGP, who are actually a menace to woman and b) feminists want to be in control of all male access to sex and well, HSTS kinda break that, and how. I men, goodness, what would happen if men just decided to take up with HSTS? All that social control would be out the window. (It amazes me that Feminists can spend so much time telling us all that women and men are just the same, and then not accept HSTS…)

      Blanchard is clear and so are Zucker and Bailey: homosexuality is not a determinant factor in whether a person transitions. It is a diagnostic consistency in determining whether a person might be HSTS. These are very different things. I do know many HSTS who are extremely sexually motivated (!), but consider this: in the Philippines and most of SE Asia, South America and I’ll warrant the West too, it is enormously easier for a gay guy to get sex than an HSTS transwoman. But does that deter HSTS from transitioning? Nope, there are squillions of them. They would rather go without sex than have to pretend to be what they are not. So I am afraid your proposition, which boils down to: they just do it for the sex, is not only nonsensical, it does show a misinterpretation of the science.

      FWIW while I respect both Zucker and Bailey greatly, I disagree with them on the former’s assertion, which the latter at least used to agree with, that it is better for a GNC child to grow up as a gay guy than HSTS. There’s no justification for that; HSTS can have full and rewarding lives as women. They just need to be allowed to do so without hindrance.

      Further, Bailey is not a primary source on HSTS, TMWWBQ (review here) only popularises Blanchard’s work. I support Mike but he’s not always right and does have a certain way of putting things.

      I’m not sure what a ‘true elite HSTS’ actually might be, but yes, most HSTS do stay away from anything that might out them. I don’t blame them either. They also tend to be very charming and unassuming people who are not given to public life.

Leave a Reply