Beyond the Binary: Question Twenty-Two

July 5, 2013 § 1 Comment

Last question(s) before the weekend – panel bios here.


Question Twenty-Two:

This is probably logically following on from the question about separating dysmorphia from Morscerta, and I know I’ve spoken to CN along these lines on Twitter already, but…
How do you go about dealing with issues in relation to body image, diet, and exercise? Do any such issues go beyond the obvious issues relating to gender dysphoria?


Has anyone written about the difficulties of separating body dysmorphic disorder from gender identity disorder if you have both?



Nat: I don’t have much insight to add here as the majority of the physical discomfort I had for my body was resolved by treatment of my gender dysphoria. I think I’m very lucky in this respect as I’m certain that long term dysphoria, both social and physical, and misgendering are unlikely to have a positive effect on body image.

Regarding diet and exercise, I mainly focus on trying to keep myself from being underweight due to help problems while still eating healthily. This seems to override any lingering body image issues I might have.

The DSM (Diagnostic and Statistical Manual of Mental Disorders) itself might offer more insight into this as the brand new edition, the DSM-5, has radically redefined ‘Gender Identity Disorder’ so that it’s now been replaced by the much more progressive and nonbinary-inclusive ‘Gender Dysphoria’ classification.

Thanks to the changes in the DSM-5, Gender Dysphoria can now be defined in terms of feelings towards “some alternative gender different from one’s assigned gender” or can defined solely due to feelings of incongruence from ones assigned gender and the associated primary and/or secondary sexual characteristics. So this may (or may not) be a helpful way to distinguish this from Body Dysmorphic Disorder (which I understand has much less significant changes).

I understand that the changes in the new edition of the DSM are such that nonbinary people, including agender and neuter people, are much more likely to be given recognition of having gender dysphoria and access to transgender healthcare (especially given the similar changes to the WPATH Standards Of Care) and less likely to diagnosed with additional disorders to account for the lack of binary identification previously required to access the now obsolete ‘Gender Identity Disorder’ label.

However if you feel that your BDD (self?) diagnosis is accurate then I have little personal experience or insight to offer I’m afraid (see my answer to the question on body image, diet and exercise).



GrrlAlex: I like to keep myself slim as it helps me feel more female identified and since weight would go on my waist its better to keep thin.  I remove body-hair from my arms and legs and do some exercises to help tone my legs to a better female shape.



Hel: I’m afraid this is something I don’t feel able to comment on helpfully, except to say that I agree it can be very hard to untangle where various feelings about one’s body may have come from.



Jennie: Losing my muscle (to the point where I can barely walk at all) has made me pretty body dysmorphic, but it’s complicated as it also ties into the loss of my ability to physically express my masculinity, so yes, these things can be linked. I hate the way my body has become soft and weak in large part because it looks more feminine. There’s nothing I can do about it, though.



CN: It must be admitted that I’ve been googling ‘Morscerta’ to no avail, but hopefully I’m getting the correct read on this question. I think first I’d say that, though some people will obviously cross over, and lines of diagnoses are rarely all that strict, it’s important to remember that bodily dysphoria relating to sex/gender doesn’t appear to be the same as body dysmorphic disorder – they don’t present in the same way, and they can’t be treated in the same way. I just want to put that out there because I know that many people have tried to challenge or soothe my dysphoria as though it were me ‘just’ have body image problems: “oh, but you’re so beautiful/lovely/thin” etc. (which would also be a bullshit way of approaching BDD, for the record). I’m afraid I haven’t been able to find any pieces on the intersection of BDD and being trans that aren’t either grossly transphobic or questions for resources themselves – if someone knows of any could you please leave a link in the comments? I don’t have BDD, so this may be useless – but I did write a piece awhile ago about body image/beauty myth issues (which have affected me a great deal) – here if it helps.

For me, my biggest issue is not being able to be on hormones, and trying to work around/with the dysphoria that that induces. I can’t do anything about the lack of facial hair, alas, but I do work out quite intensely/try to eat a protein rich diet to up my muscle mass and lower my body fat. As many people have pointed out, bodies can be harder to ‘sex’ when hormonally-influenced patterns of fat distribution are disrupted – either through low or high amounts of body fat. I find having any kind of curves extremely distressing, so the likelihood that I would be able to gain enough weight to get to that level of high body fat is (forgive the pun) slim – and, to be brutally honest, it would damage my career prospects (again – total bullshit, but I can’t pretend that I’m not aware of that). I definitely get misgendered less when my face is thinner. But there is always this fear that, in trying to take care of my body/mental health in this way, I’m just playing into some really toxic discourses around size and gender – I know that I love a whole range of body shapes on other people (and why not?), but is that ‘okay for others but not for me?’ part of my dysphoria or part of the fatphobic message I’ve grown up with? I guess the best I can do is to keep trying to unpack received cultural messages, educate myself and challenge my own perceptions.

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