Dysphoria defines or contributes to many ways of being trans. Gender dysphoria is a term borrow from the medical industry, specifically the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). For this reason, many trans people identify with the diagnosis for professional and personal reasons. It is an institutional marker which provides access to a variety of services. For the same reason, many trans people disidentify with dysphoria because they do not want to be associated publicly with a condition under medical management and with a book that has the term, "mental disorders," in the title. Yet gender dysphoria is an improvement, in many respects, over the now defunct diagnosis, "gender identity disorder" from the DSM-4. One of the key victories was the removal of "disorder" from the title, as the DSM-5 reflects a change in the medical field from considering transgender a disorder to considering it a condition. As part of this shift, gender dysphoria locates the primary distress and suffering of the condition in an external locus rather than an internal locus. The short definition of gender dysphoria reads, "there must be a marked difference between the individual’s expressed / experienced gender and the gender others would assign him or her, and it must continue for at least six months" (DSM-5). A careful read of this diagnosis will not that dysphoria occurs not because someone is born transgender. The cause of suffering is not internal. Rather, dysphoria arises because there is a conflict between their internal identity or mode of expression and the external environment that assigns another gender. The conflict is not between self and self, sane self and insane self. Rather, the conflict is between self and society. Thus, because it is based on social discourses and conflicts, dysphoria can become a way of reading and analyzing texts. How does the text embody or generate dysphoria? If one approaches texts from a dysphoric lens, one begins to see how countless texts and narratives depend on the tensions of the dysphoria it produces. These tensions and dysphoria may even affect people who are not transgender. In this case, the dysphoria is in the environment and not in the person.
Yet dysphoria is more than the sum of self and society. The longer definition of dysphoria from the DSM-5 does acknowledge a list of desires and disgusts that may rage within a transgender mind and body. For this reason, dysphoria does not represent the mere battle between a rigid social roles and a chaotic freedom that wants to go everywhere all at once. Usually, in the ocean of dysphoria there are tides and even whirlpools, where the dysphoric mind is drawn by larger forces (internal and external) towards specific loci of gender. These loci may be broad, such as womanhood. Or highly specific, such as pressed suits and short hair. As in the case of tides and whirlpools, there may be competing desires and disgusts that reflect ambivalence and gender fluidity. Other times, dysphoria is less like the ocean and more like a river, moving full force away from one place and towards another. Many trans men and women, especially those who live lives within traditional binaries, articulate their dysphoria in these terms. For instance, a trans man may have physical disgust at being made to embody or perform elements of femininity and may have an overwhelming need to embody or perform element of masculinity. In this respect, dysphoria is a conflict between self and non-self, one that does not necessarily extend very far into society. Non-self may be understood as those parts of one's body, genitals or hair style, that cause one great distress and disgust. Thus, dysphoria as an internal tension and trajectory of self and non-self often motivate transformation. Transformation is one of the visible functions of this aspect of dysphoria. In the first case, because change and transition mark the movement away from the non-self and toward the self. Or, in cases of oppressive social conditions or tidal backslides, from self to non-self. Additionally, transformation may also be read as trans-formation or the formation of the trans self. This may occur unencumbered as the formation of a self which happens to be trans. Or it may occur out of a rejection of the non-self. The trans formation arises out the failed and dysphoric cis formation. Thus, as a method of reading, readers can identify how texts reflect these competing tensions between self and non-self, between disgust and desire, whether the conflict is like a tide, whirlpool, or river. Because narratives frequently depend on tensions and conflict in order to motivate character change, the dysphoric reader begins to appreciate how closely tied storytelling and dysphoria may be.
Even in ideal conditions of access and acceptance, transitioning often takes time and may be incomplete in the mitigation of dysphoria. Most trans people and care givers are aware that transitioning can less dysphoria but will likely never may it totally go away. In part, this may be because dysphoria in society and the body cannot fully erase the affects and effects of the past. For instance, a trans woman who transitions in young adulthood still has the dysphoria caused by having to undergo a sort of imposed boyhood. When speaking about the past, this boyhood returns in the form of pictures, names, and memories even as they conflict with the current gender identity and presentation. This dysphoria across time may also be felt in the body, a body which may have had the marks of boyhood and adolescence which medical transitioning can mitigate but never fully remove. To use a metaphor from an article I've written on the dysphoria of medieval manuscripts: even after you turn the page, the writing and images from the other side can still bleed through to the present. Our experience of time is more fluid, non-linear and contested than we like the think. Thus, even the most directional river of dysphoria will find ways in which the tidal past causes momentary blocks, diversions, and backwash. Thus, as a method of reading one can analyze dysphoria in the way that time and narrative progression become jumbled by conflicting iterations of the self, whether the internal self of psychology and biology or the external self of identity and expression. Furthermore, one sees how narratives, especially about transgender, reflect and generate dysphoria through the difficulty they have in discussing the same person before and after transition. How do we talk about the non-self which was presented as the self for so long? Do we use deadnames and defunct pronouns or do we correct the past by naming the person more accurately? Often, texts don't have one way of answering these conflicts. The past affects the present and the present will affect our pasts. Recognizing and analyzing how this happens and how it is reflected in the text is another key element of reading dysphorically.