By Stephanie Popovich
The Chicago School of Professional Psychology
Gender dysphoria has been defined as a condition in which there is a marked incongruence between an individual’s expressed/experienced gender and their sex assigned at birth (American Psychiatric Association, 2013). Individuals with gender dysphoria can experience a strong desire to change primary or secondary sex characteristics, the desire to be accepted as their identified gender, which is different than the one they were assigned at birth, and experience of societally perceived feelings or reactions of a gender other than that which was assigned at birth, which in general impedes their overall quality of life (Lawrence, 2014). Therefore, many individuals seek out support to cope with these difficult experiences with the goal of living a more fulfilling life and finding comfort in their own skin and in the world in which they live.
Individuals experiencing gender dysphoria may pursue gender-affirming hormonal and surgical options to change their bodies to fit their personal gender identity (Cole, O’Boyle, Emory, & Meyer III, 1997). These treatments, although effective, are very costly and are not feasible for all individuals. Additionally, not all individuals experiencing gender dysphoria plan on medically transitioning, but most do experience the negative thoughts and feelings that equate to overall depression and life struggles.
Gender dysphoria is not only a physically-based experience, but an experience influenced by physical, social, and covert variables as well. Therefore, it is important to consider the individual’s thoughts and other verbal behaviors in addition to biological and physical variables.
Behavior therapy and psychotherapy have shown to have some immediate effect on “sextyped” behavior of individuals with gender dysphoria, but there is little evidence in regards to their long-term effects (Wren, 2000). As an alternate approach, mindfulness and mindfulness-based cognitive behavior therapy have been used to treat a variety of psychological issues, especially in the realm of depressive and anxiety disorders. Mindfulness techniques can be used to help the individual view these feelings as merely personal thoughts and stress that these thoughts do not define the individual as a whole, enabling the individual to still engage in a valued action (e.g., going out in public to have meaningful interactions with others).
In addition, Acceptance and Commitment Therapy (ACT), a “third-wave” behavior change method based on principles of Relational Frame Theory (RFT; Pellowe, 2006), can be used to emphasize the value of accepting behaviors rather than judging or altering the context of inner experiences such as feelings and sensations (Juarascio, Shaw, Forman, & Timko, 2013). There currently are no published research studies that have implemented an ACT procedure for individuals with gender dysphoria, although such a procedure has potential for effective treatment outcomes. Through an ACT procedure, individuals still may experience unpleasant symptoms, but the procedure may help decrease the severity of the symptoms as well as the overall negative impact on day-to-day functioning.
The purpose of an ongoing line of research conducted by Popovich and Stockwell at The Chicago School of Professional Psychology is to evaluate the effects of mindfulness as an affordable, user-friendly intervention for individuals experiencing gender dysphoria. Through the principles of ACT, the study involves a tailored mindfulness procedure to potentially provide relief and increase valuesbased behavior for individuals experiencing gender dysphoria. Due to the fact that there is not any research that integrates the use of mindfulness for treatment of gender dysphoric symptoms, this study seeks to open new doors to a different and affordable treatment increasing values-based behaviors and establishing positive coping skills.
Cole, C. M., O’Boyle, M., Emory, L. E., & Meyer III, W. J. (1997). Comorbidity of gender dysphoria and other major psychiatric diagnoses. Archives of Sexual Behavior, 26(1), 13-26.
Juarascio, A., Shaw, J., Forman, E., Timko, C. A., Herbert, J., Butryn, M., & Lowe, M. (2013). Acceptance and commitment therapy as a novel treatment for eating disorders: An initial test of efficacy and mediation. Behavior Modification, 34(175), 459-489.
Lawrence, A. A. (2014). Gender dysphoria. Gabbard’s Treatments of Psychiatric Disorders, (299-315). Retrieved from http://dx.doi.org.tcsedsystem.idm.oclc.org/10.1176/a
Pellowe, M. E. (2006). Acceptance and commitment therapy as a treatment for dysphoria (Doctoral Dissertation). Retrieved from ProQuest.
Starcevic, V. (2007). Dysphoric about dysphoria: Towards a greater conceptual clarity of the term. Australiasian Psychiatry, 15, 9–13.
Wren, B. (2000). Early physical intervention for young people with atypical gender identity development. Clinical Child Psychology and Psychiatry, 5(2), 220-231.
This piece was originally published as a part of the Summer 2016 SBRP SIG Newsletter.