The Marketing of Dysphoria

I’m starting to think my struggle may be more related to my body than I wanted to believe.  My childhood is mostly a blur, but one of my earliest memories is of the relief I would feel when I tucked my penis behind my legs and imagined the image of myself in the mirror to be that of a girl.  When I was seven I performed “surgery” on my baby doll Charles Cherry Cherry Coquette by cutting out nir penis with a pair of scissors.  To this day, when my nail polish is looking good, I want to chop a finger off and put it in a jar of formaldehyde so it can be preserved in all its girlyness without the shame of being attached to me.  When I have sex sometimes having my chest touched feels wrong and awkward.  The other day I went against my own advice and wore a dress because it looked pretty good combined with pants and and a cardigan and a wide belt to give the illusion of a waist, and I definitely experienced having phantom breasts, which was strange.


If I were to drink the Trans-Aid, I would conclude that I have a female “subconscious sex.”  That my brain is wired in a “female” pattern and my suffering results from a “map” in the brain that does not match my body.  I haven’t ruled this out, but I think it’s much more likely that these bodily sensations are the result of psychogenic pain and misattribution of arousal. I propose that the indignities experienced by a gender-variant person in our society are so great that anger at society and anger at oneself is turned toward the body as a protective distraction to keep dangerous repressed emotions from being consciously experienced.  And I believe the anxiety brought on by the cognitive dissonance of gender-non-conforming presentations leads to perceptions such as phantom breasts because maintaining the conflicting beliefs “I am male” and “I am wearing women’s clothes in broad daylight” is so distressing.

I’ve definitely been convinced that there is some fundamental difference in the brains of transgender persons which manifests before birth.  But I reject the idea that the pain that results from this difference could possibly be best treated by modifying the body with surgery and hormones.

Excessive Humanity Disorder

Part of the reason I am so reluctant to try hormones is that I have an intense distrust of the medical industry.  I’m not sure how much that distrust is rational and how much is borne from being raised by an abusive psychiatrist who diagnosed me with Oppositional Defiant Disorder, physically abused me, and subjected me to cold showers and scorn to punish me every time I would engage in “anal expulsive” behavior when I failed (or refused, according to my father) to be potty trained at the age of four.  In any case I believe most doctors have their pocketbooks more than my well-being at heart.

Psychiatry especially has no idea what the fuck it is doing.  I mean, sure it has improved somewhat from last century’s shock therapies and lobotomies, but the change in its barbarism is not in quality and only in degree.

The reason psychiatry adopted a pharmaceutical model is not that it would cure mental “illness” but because of an embarrassing business problem.  Overcrowding in mental hospitals cages was reaching the proportions of an untenable crisis.  Meanwhile, Smith, Kline & French were using a shotgun approach to finding a market for the serendipitously “tranquilizing” Thorazine, which was discovered when trying to find a cure for malaria.  The pharmaceutical company marketed the powerful drug for a wide range of conditions from asthma to menopause before discovering that it was the perfect solution to the contemporary crisis in the business model of psychiatry.  Of course, the drug didn’t cure the patients.  It just disabled their brains to such an extent that they were no longer able to experience psychosis.  While the marketing said one thing, all the experts agreed it was just a “chemical lobotomy.”

The growth in the psychiatric drug industry since this watershed of deinstitutionalization is unfathomable.  The APA, FDA, and pharmaceutical companies formed an incestuous relationship with the intent of pathologizing humanity to the extent that over twenty percent of Amerikans now take psychiatric drugs.  Does one in five people really require psychiatric drugging?

Below are two advertisements for psychiatric drugs, one for Serentil from the 1960s, and one for Paxil from the 1990s.  Both of them position the drugs as solutions to wholly ordinary problems, whether “for the newcomer in town who can’t make friends,” or for the person who “would love to find someone special, only can’t.

Excessive Humanity Disorder: Then and Now

“Serene-til” was a potent “antipsychotic” with a high risk of permanent side effects such as tardive dyskenesia, cardiac arrhythmia, and sudden death.  It was finally withdrawn from the market more than forty years after release in 2004.  “Peace-il” is a supposedly safe “antidepressant” that allegedly functions by selectively inhibiting the reuptake of serotonin in the brain.  However, the evidence shows that SSRIs produce dependence and withdrawal just like an addictive drug, only the psychiatrists call this addiction “antidepressant discontinuation syndrome.” Cocaine happens to be another serotonin reuptake inhibitor.  I wonder if history’s greatest proponent Sigmund Freud had “cocaine discontinuation syndrome.”

SSRIs can also induce mania and akathisia, and have been implicated in many violent episodes including murder and suicide.  Of course, if an SSRI causes someone to have a manic episode, the psychiatrists say the “medication” “uncovered” the “patient’s” “underlying” “bipolar” “disorder.”  Not “Oops we poisoned this guy with powerfully toxic psychoactive chemicals and it caused nem to gun down forty people in a movie theater.  Sorry.”  How long will it be until Paxil is taken off the market just like Serentil?

Most psychological “disorders” and “syndromes” are just regurgitations and collations of the subjective experiences reported by patients themselves–fabricated pathologizations of natural human experience subjected to the inhumanity of modern society.  No one would prescribe Paxil for “major depressive disorder” because Prozac was generic and cost one-tenth as much.  Therefore Glaxo Smith Kline took ordinary shyness and invented a new illness “Social Anxiety Disorder” and got it into the DSM-IV.  Paxil became the only drug approved for use in this disorder, and so GSK could then market its patented drug and rake in the revenue.

Gender Dysphoria seems to be the one case where the psychiatric community has finally admitted that it is unable to diagnose someone with a disorder.  If you go to a psychiatrist and say “I think I have depression, what do you think?”the psychiatrist will conduct an interview and make an official diagnosis that you have “major depressive disorder” or not.  If you go to a psychiatrist and say “I think I have gender dysphoria, what do you think?” the psychiatrist will say no one can determine that but yourself.  So the sole diagnostic criterion for whether you have gender dysphoria is that you decide you have gender dysphoria.  I would call that simply no longer being blind to how gender is traumatizing to everyone.

The fact that transgender identities are no longer seen as pathological by psychiatry does not change the fact that the medical industry is still over-medicating the condition.  The psychiatrists are just passing on the business and referring it to more lucrative specialists in endocrinology and plastic surgery.  When all you have is a hammer, it’s irrelevant that every individual is a uniquely shaped peg and society contains only round and square holes.  You’re going to pound on the problem the only way you know how just the same.

About now is when the psychiatrists start to wonder whether I have “paranoid personality disorder.”  I guess it’s possible I am excessively distrustful.  I’ve never taken an SSRI.  If I were going to buy into the medical model of treating the individual traumas of a dysfunctional society, it would be crazy not to try an SSRI before I leaped to estrogen, don’t you think?  Unfortunately I believe an SSRI or estrogen have about as much potential to make me happy as a fuller head of hair or a new car for that matter.  My happiness is only going to come from within.

Dysphoria or Dissociation?

The author of ThirdWayTrans wrote an insightful post about how “dysphoria is very ordinary.”  On one level I agree.  The experience of a flat-chested person wanting breasts is not fundamentally different in a qualitative way from the experience of a bald-headed person wanting hair.  The problems only differ in the narratives that are used to understand the problems and the intensity with which the dissatisfaction is felt.  If society were arranged so that bald people shopped in different clothing departments, or were expected to paint their scalps to be beautiful, someone might very well feel like a full-haired person trapped in a bald-haired body.

On another level, I do think gender dysphoria is unique.  The ordinary parts of gender dysphoria discussed by ThirdWayTrans are its conscious manifestations, like the desire to wear different clothes, or be treated differently and be recognized as a different gender, or have different morphological characteristics.  To me the extraordinary parts of dysphoria are its unconscious manifestations.

It may be that, as an early transitioner, the author of ThirdWayTrans did not have the experience trans people who did not transition at an early age report, where gender dysphoria manifests as unconscious malaise, repression, and dissociation as described accurately by Anne Vitale and Jamie Veale.  I believe this experience is fundamentally different from ordinary dissatisfaction (or dukkha as the Buddha would call it).

To this day, the joy and sense of rightness that the idea of being female arouses within me occurs in fleeting moments before it is exiled from my consciousness by my psychological defenses.  It feels like a faint echo from another galaxy that somehow managed to reach me through the vacuum of space.  It feels like my life is a film in black and white, but someone who wants me to know I am more spliced in a disorienting frame of technicolor.  It feels like I’m in touch with a ghost from a past life.  It feels like I’ve yet to be born.  It feels like feeling it for more than a split second would warp the fabric of space-time and catapult me into another dimension I could never possibly have comprehended before.  It feels like everything else is just this strange nightmare that I’m too afraid to accept is not real.  I guess derealization and depersonalization such as this might be “ordinary,” and occur on a spectrum, and I’m just more dissociated than the average person, but it’s still terrifying.

The psychotherapist Daniel Mackler produced a film called the Four Stages of Emotional Healing where ne outlines a path of 1) dissociation, 2) depression, 3) grieving, and 4) enlightenment.  In the film, ne astutely identifies that the modus operandi of most psychological practitioners is to bring clients backward from depression into the inferior state of dissociation.  It’s pretty obvious that the function of “transition” is to bring clients back from suffering into a dissociated state.  Anyone with a penis who says ne is a woman is in pretty much the epitome of a dissociated, or perhaps even delusional state.

As ThirdWayTrans wrote in October, “I think people really are letting go of a false self in the process of transition, the trick is not to just adopt a second one.”  I hope to master this trick.  However, if I know one thing it’s that I have to reunite myself with that fleeting joy.  I hope that reunion does not require me to pretend to be a woman, but if it does, so be it.  I can no longer stand feeling so utterly disconnected from myself.

Not to be Reproduced (La reproduction interdite), René Magritte, oil on canvas, 1937.

12 thoughts on “The Marketing of Dysphoria

  1. rimonim February 5, 2015 / 6:08 pm

    I’m sorry to hear about your horrifying early experiences with psychiatrists. Completely with you on the psychiatric/medical establishment. It’s a deeply creepy tool of social control.

    At the same time, if certain treatments will improve a person’s life and they are able to give informed consent, whatever, go for it, life is short.

    “I think people really are letting go of a false self in the process of transition, the trick is not to just adopt a second one.”

    YES. This has been on my mind a lot lately–I have a big writing project in the works on avoiding the trap of the 2nd false self. Transition is a powerful opportunity for awakening; it can also be an excuse to fall asleep again, trading a delusion for a more pleasant delusion.

    However, if I know one thing it’s that I have to reunite myself with that fleeting joy. I hope that reunion does not require me to pretend to be a woman, but if it does, so be it. I can no longer stand feeling so utterly disconnected from myself.

    Joy requires no pretension. If joy requires you to look and behave such that you are called a woman, you could view that as pretending…or it could simply mean that “woman” isn’t such a stable concept after all. Is it possible to pretend and become more authentic at the same time?

    Liked by 1 person

    • pasunhomme February 5, 2015 / 8:00 pm

      I suppose once I acknowledge that living in any gender, man, woman, neither, or both is in some sense pretending, then I suppose living as woman could be more authentic than living as any other gender, if that gender resonated the most with me.


  2. thirdwaytrans February 5, 2015 / 6:44 pm

    I did not mean to say that dysphoria was not its own unique experience also. I think all sufferings are universal in some ways and unique in other ways. I was focusing on the commonalities because I think they are getting lost in a lot of the discourse around dysphoria. Also focusing on the commonalities can bring more empathy and compassion.

    I did not experience much repression but a lot of dissociation. I would say I spent most of my time when transitioned in a dissociated state with some breaks of non-dissociation. Now I am rarely dissociated which is a blessing. I don’t think it was detransition that led to my non-dissociation but rather the letting go of “gender fakery” We all engage in a little gender fakery, trans or cis or anywhere in between, but focusing energy on passing was very destructive.

    It is certainly possible to transition and minimize gender fakery. I recommend to you the site of Pace Smith She is a transitioned trans woman and authentic, open, and real. Also has some good wisdom on following your heart.

    I definitely think you are on the right track in following your joy and not letting go of that. Repressing leads to all sorts of problems.

    Liked by 1 person

    • pasunhomme February 5, 2015 / 11:29 pm

      Thanks for the link. Thank god someone else admits “gender fakery” is a real thing. Trans gospel would call that “transphobic.” Having been engaging in gender fakery for 31 years that is precisely my struggle. I can’t imagine how one could transition to the opposite binary gender and not amplify their gender fakery. But I guess you carefully and accurately said “minimize” rather than eliminate gender fakery. I’m trying to follow my own gender fakery minimization gradient, and I feel like I’m lost at a singularity.


  3. Jonathan February 7, 2015 / 10:40 am

    If I were to drink the Trans-Aid, I would conclude that I have a female “subconscious sex.” That my brain is wired in a “female” pattern and my suffering results from a “map” in the brain that does not match my body.

    It’s perhaps a small point, but you’re conflating two separate ideas there.

    Julia Serano’s concept of “subconscious sex” was an attempt to describe a transsexual person’s certainty about who they are sex-wise, contrary to other morphological indications; e.g. a trans man’s knowledge that he’s a man, despite his apparently “female” body. And she framed it in terms of subconscious sex in order to separate it from analysis of gender. Thus feminist critique of gender and gendered power structures stand up without impinging on – or being impinged upon – by trans realities. But really it’s just a theoretical hypothesis to explain (some) trans natures. Serano doesn’t try to fix “subconscious sex” concretely; i.e. she doesn’t tie it to notions of brain sex or anything.

    As for “maps of the brain” as evidence of trans, I think it’s like any “condition” which can’t be immediately seen: people want scientific (medical) proof, so that other people have to accept its validity. Here brain maps are one posited aetiology for (some) trans natures, though the evidence is far from conclusive. However, whatever the truth or otherwise of this particular idea, one thing should be made very clear: brain sex does not imply brain gender. Meta-analysis of scientific studies of gender difference (of which there are a great many) doesn’t indicate any significant correlation between binary sex difference in the brain and cultural notions of appropriate binary gender (masculinity, femininity and so forth). There’s no reason to suppose that a trans-sexed brain (if such a thing is shown to exist) would be any different in that regard.

    Liked by 1 person

    • Jonathan February 7, 2015 / 11:07 am

      Actually, quickly rereading the relevant chapter in Whipping Girl, it seems I’m wrong there. Serano does talk about brain wiring as a possible aetiology of subconscious sex. All the same, it’s unimportant – a possible aetiology, not a definite one. The rest of what I said stands, I think: e.g. her reasons for framing it in this way (sex not gender) and so on.


    • pasunhomme February 7, 2015 / 9:14 pm

      I greatly valued reading Serano’s description of what ne calls subconscious sex because it accounted for the fact that I have at all times a conscious identity as male, but at the same time an underlying central part of my psyche that feels whole when thinking of myself as female. This understanding allowed me to accept that I was trans despite having at all times accepted the conscious belief indoctrinated into me that I am “male.”

      I have a hard time interpreting the term “knowledge” in your phrase “a trans man’s knowledge that he’s a man.” I think boiling down the complex relationship of a trans person to their conscious and unconscious gender identities into such a phrase is reductive and meaningless. It could be that my experience is just different, but I suspect that people like to have simplifications of the matter in order to legitimize themselves in a world where gender identity is presumed to be obvious to everyone.

      Serano calls this unconscious gender inclination subconscious sex because, in retrospect, it seemed to be entirely about nir body, not behavior or presentation. But ne spent a decade focusing on behavior and presentation with little discussion of body dysphoria. It wasn’t until ne became absolutely miserable with being seen as male and therefore deciding to transition that ne decided it was about physical sexual characteristics. I must say, I’m skeptical. People adopt all sorts of theories and cognitions to align their thoughts with the actions they take in the world. I suggest it’s possible Serano had a great desire to be seen as female, could only achieve this in a satisfactory way through transition, transitioned, and then adopted a belief that nir unconscious gender inclination was specifically related to the body because it helped explain the decision to transition.

      be miserable without transition -> transition -> reduce cognitive dissonance inherent in transition by adopting beliefs that legitimize transition

      I bet you Kate Bornstein, who was a high ranking Scientology member before nir sex change would have a great deal to say about

      be miserable in current identity -> become a Scientologist -> reduce cognitive dissonance inherent in being a Scientologist by adopting beliefs that legitimize Scientology -> become disillusioned with Scientology -> reject beliefs that legitimize Scientology

      and how it relates to adopting and later rejecting the identity of woman.

      Do we need this “a trans man knows that he’s a man” simplification to legitimize trans? Maybe the trans man just has a very complicated relationship with gender that is best resolved for nir happiness through transition?

      Liked by 1 person

  4. Jonathan February 8, 2015 / 12:37 am

    What I meant by “knowledge” refers to the fact that (some) transsexual people just do know – in that they have a very deep feeling (knowledge) of being a certain sex, contrary to other aspects of morphology. Serano is attempting to theorize it, and I can relate to that – I try to theorize my identity as well – but for the less theoretically inclined, this “knowledge” is there anyway and can’t be simply dismissed. It’s not about trying to legitimize (this form of) trans. I don’t think that needs legitimizing – it just is. Or as the newly adapted Stonewall UK slogan goes: “Some people are trans. Get over it.”

    My own understanding of myself is as feminine (or, more exactly, femme) rather than female, but I just regard this as something different. It doesn’t mean that other people’s understanding (or knowledge) of themselves as female are therefore false. Okay, when it comes to my own community (MTF transvestite), yes, I think my theoretical model (femme) would be more applicable in a lot of cases – but even then I couldn’t apply it directly to anyone in particular; it’d still be up to them to understand it and accept it as correct for themselves.


  5. UnknownJamie February 22, 2015 / 11:18 pm

    Yis, the mega-pharmaceutical machine is just another self dedicated rung of the larger machine making human cost decisions without apparent empathy.
    I despise SSRI’s, one month as a teenager and never again, it’s a racket and so is hormones if you wanna get all new world order about it.
    Still, the idea alone that hormones could stop me thinking about this mayhem from first thought in the morning to last thing at night is enough to go for it. Screw gender, honestly. Dysphoria seems to abate when one reaches the state their body seems to demand. There seems to be a clear difference in how much dysphoria juice one has in their brain.
    Hormones are a pretty luxury medicine and a life saver to many. Annoyingly SSRI’s have a record of truly working in some cases, even though they are pretty evil.

    Liked by 1 person

    • pasunhomme February 23, 2015 / 3:13 am

      I just can’t believe testosterone is “dysphoria juice.” I was born into this world the way I am. Why should I believe testosterone is some tragic biological error? There have been trans people for millennia, some of whom in some cultures lived happy, sometimes exalted lives. They didn’t need hormones. I believe the benefits of hormones can be attributed to (1) the placebo effect (2) empowering thoughts of affirmation that one is on the path toward expressing themselves authentically (3) reduction of fear of social repercussions from expressing one’s self authentically.

      In my opinion, the belief that one’s physiology is at odds with one’s innate behavioral inclinations, and the constant reinforcement of this belief by society is the source of dysphoria. Transition is one way to relax this belief, and is certainly better than trying to squash the behavioral inclinations, but I’m hoping it’s possible to unlearn the belief without transition. I’m lucky to live in a part of the world where I can express behaviors classified as feminine in a body classified as male with little threat of danger, and I owe a great debt to transsexuals for helping the transgender experience become known and accepted.

      You might want to see

      Liked by 1 person

      • UnknownJamie February 23, 2015 / 1:10 pm

        Just to clarify, I don’t mean ‘dysphoria juice’ to attribute as hormones, rather the varying levels of whatever chemical reactions in the body and mind that cause one to experience dysphoria. I don’t see testosterone as an error, it’s what a male body should have, it can just occur as an unfortunate concurrence with the traits of dysphoria.

        It is valid to ask about all those who have been able to integrate bigenderism before the inception of trans healthcare, but in the same way with all pre-medicinal ailments, these people had no choice but to deal with their lot, or had the fortune of living in a society where gender wasn’t so polarised, as opposed to the unhappy transfolk over the millenia living in violently oppressive patriarcal societies.

        Hormones definitely don’t seem to be a placebo, they can be quite powerful and pronounced drugs, as is evidenced by natural biology. The argument I’ve used for the other two points is that I spent a lot of time believing that in a perfect, tolerant world, all could express themselves freely in the role that they choose. In my personal revalation however, I realised that even in this utopia it wouldn’t be enough, even if the world saw me flawlessly as female with a male body, I would still know something was very wrong, and I would want to change it, it has nothing to do with presentation or expression. As such, a distinction opens between the medical needs of transsexuals and the socio-political demands of those who wish to challenge the binary. Both are valid, often they are mixed values within an individual.

        From this I have to disagree that transition is a roundabout way of skirting a societal error of self-belief, I believe it is irregardless of society. My ‘innate behavioural inclinations’ don’t demand I act like a female, it merely tells me that I am one, and would exist even if I were blind and deaf. For example, I could go back and call myself a man and socially transition, wear dresses and still shamelessly call myself a man. It would be preferable because I would maintain my physical strength and aggression to be able to defend myself. But I am not that, dysphoria hurts because of how it makes me feel, not because of how I want others to perceive me.

        Thanks for the reply, it is very thought provoking.

        Liked by 1 person

      • pasunhomme February 23, 2015 / 4:54 pm

        Thank you for your thoughtful reply, as well.

        There is an important difference between an ordinary placebo and an active placebo, which produces noticeable side effects that may convince the person being treated that they are receiving a legitimate treatment, rather than an ineffective placebo. For example, in antidepressant trials, the patients receiving the placebo can identify that they are not in the treatment group because the researchers tell them that the drug has common side effects such as dizziness, dry mouth, insomnia, and sexual dysfunction. When they experience none of these side effects, the effectiveness of the placebo is weakened compared to the drug. In clinical trials that use active placebos which are known to be ineffective for depression but produce similar side effects, the placebo effect is much stronger. It’s not that external hormones are not powerful drugs, but that their effects (other than 2 and 3) may be unrelated to the reason many transitioners feel relief from gender dysphoria.

        When you say that your brain tells you that you are female, I ask: what is a female? When you say it would not be satisfying to present femme and call yourself a man, I ask: what is a man? The categories of “female” and “man” are not ontologically valid truths, but rather subjective ideas within your mind, which have been manipulated through nefarious indoctrination from birth.

        Liked by 1 person

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