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pages/gdb/_pager.hbs

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+
+<div class="pager">
+  {{#is step 0 1 }}<span class="filler"></span>{{/is}}
+  {{#is step 2}}<a href="/gdb/what-is-gender" class="btn btn-primary">{{icon 'chevron-left'}} What Is Gender?</a>{{/is}}
+  {{#is step 3}}<a href="/gdb/gd-history" class="btn btn-primary">{{icon 'chevron-left'}} The History of Gender Dysphoria</a>{{/is}}
+  {{#is step 4}}<a href="/gdb/euphoria" class="btn btn-primary">{{icon 'chevron-left'}} Gender Euphoria</a>{{/is}}
+  {{#is step 5}}<a href="/gdb/physical-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Physical Dysphoria</a>{{/is}}
+  {{#is step 6}}<a href="/gdb/biochemical-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Biochemical Dysphoria</a>{{/is}}
+  {{#is step 7}}<a href="/gdb/social-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Social Dysphoria</a>{{/is}}
+  {{#is step 8}}<a href="/gdb/societal-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Societal Dysphoria</a>{{/is}}
+  {{#is step 9}}<a href="/gdb/sexual-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Sexual Dysphoria</a>{{/is}}
+  {{#is step 10}}<a href="/gdb/presentational-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Presentational Dysphoria</a>{{/is}}
+  {{#is step 11}}<a href="/gdb/historical-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Historical Dysphoria</a>{{/is}}
+  {{#is step 12}}<a href="/gdb/managed-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Managed Dysphoria</a>{{/is}}
+  {{#is step 13}}<a href="/gdb/impostor-syndrome" class="btn btn-primary">{{icon 'chevron-left'}} Impostor Syndrome</a>{{/is}}
+  {{#is step 14}}<a href="/gdb/diagnoses" class="btn btn-primary">{{icon 'chevron-left'}} Clinical Diagnoses</a>{{/is}}
+  {{#is step 15}}<a href="/gdb/treatment" class="btn btn-primary">{{icon 'chevron-left'}} Treating Gender Dysphoria</a>{{/is}}
+  {{#is step 16}}<a href="/gdb/causes" class="btn btn-primary">{{icon 'chevron-left'}} Causes of Gender Dysphoria</a>{{/is}}
+  {{#is step 17}}<a href="/gdb/chromosomes" class="btn btn-primary">{{icon 'chevron-left'}} Disorders of Sexual Development</a>{{/is}}
+
+  {{#is step  0}}<a href="/gdb/what-is-gender" class="btn btn-primary">Continue Reading {{icon 'chevron-right'}}</a>{{/is}}
+  {{#is step  1}}<a href="/gdb/gd-history" class="btn btn-primary">{{icon 'chevron-left'}} The History of Gender Dysphoria</a>{{/is}}
+  {{#is step  2}}<a href="/gdb/euphoria" class="btn btn-primary">{{icon 'chevron-left'}} Gender Euphoria</a>{{/is}}
+  {{#is step  3}}<a href="/gdb/physical-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Physical Dysphoria</a>{{/is}}
+  {{#is step  4}}<a href="/gdb/biochemical-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Biochemical Dysphoria</a>{{/is}}
+  {{#is step  5}}<a href="/gdb/social-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Social Dysphoria</a>{{/is}}
+  {{#is step  6}}<a href="/gdb/societal-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Societal Dysphoria</a>{{/is}}
+  {{#is step  7}}<a href="/gdb/sexual-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Sexual Dysphoria</a>{{/is}}
+  {{#is step  8}}<a href="/gdb/presentational-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Presentational Dysphoria</a>{{/is}}
+  {{#is step  9}}<a href="/gdb/historical-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Historical Dysphoria</a>{{/is}}
+  {{#is step 10}}<a href="/gdb/managed-dysphoria" class="btn btn-primary">{{icon 'chevron-left'}} Managed Dysphoria</a>{{/is}}
+  {{#is step 11}}<a href="/gdb/impostor-syndrome" class="btn btn-primary">{{icon 'chevron-left'}} Impostor Syndrome</a>{{/is}}
+  {{#is step 12}}<a href="/gdb/diagnoses" class="btn btn-primary">{{icon 'chevron-left'}} Clinical Diagnoses</a>{{/is}}
+  {{#is step 13}}<a href="/gdb/treatment" class="btn btn-primary">{{icon 'chevron-left'}} Treating Gender Dysphoria</a>{{/is}}
+  {{#is step 14}}<a href="/gdb/causes" class="btn btn-primary">{{icon 'chevron-left'}} Causes of Gender Dysphoria</a>{{/is}}
+  {{#is step 15}}<a href="/gdb/chromosomes" class="btn btn-primary">{{icon 'chevron-left'}} Disorders of Sexual Development</a>{{/is}}
+</div>

pages/gdb/gd-history.md

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+---
+date: "2020-01-26T20:41:55.827Z"
+title: "The Gender Dysphoria Bible"
+subtitle: "A Brief History of Gender Dysphoria"
+description: "The origins of Gender Dysphoria and the current meaning today."
+
+---
+
+In 1948 noted sexologist Dr. Alfred Kinsey (yes, [*that* Kinsey](https://en.wikipedia.org/wiki/Alfred_Kinsey)) was contacted by a woman whose male child adamantly insisted that they were in fact a girl, and that something had gone very wrong. The mother, rather than trying to suppress her daughter, wished to help her become who she knew herself to be. Kinsey reached out to a German endocrinologist named [Dr. Harry Benjamin](https://en.wikipedia.org/wiki/Harry_Benjamin) to see if he could help the child. Dr. Benjamin then developed a protocol of estrogen therapy for the teen, and worked with the family to find surgical help.
+
+Benjamin then went on to refine his protocol and treated thousands of patients with similar feelings over the course of his career. He refused to take payment for his work, instead taking satisfaction from the relief he granted these patients, and using their treatment to further his understanding of the condition. He coined a term for this feeling of incongruence in 1973: Gender Dysphoria. Unfortunately, this term would not be used in the United States until 2013, the American Psychiatric Association opting for the term Gender Identity Disorder instead.
+
+{!{ {{inject '~/img' images.hbscale className="card sideline" caption="Harry Benjamin Diagnostic Scale"}} }!}
+
+If you are a trans person reading this, you may have heard the name Harry Benjamin before, but probably not in a favorable context. In 1979 his name was used (with permission) in the forming of the Harry Benjamin International Gender Dysphoria Association (HBIGDA), which released a Standards of Care (SoC) for transgender people. This SoC came to be known as the Harry Benjamin Rules, and were infamously limiting in regards to how Gender Dysphoria could be diagnosed. Patients were placed within a six tier scale based upon their level of misery and sexual dysfunction. If you did not land at Tier 5 or higher, classified as a "True Transexual", you were usually rejected for treatment.
+
+The problem was, Tier 5 and 6 required that you had to be exclusively attracted to your own birth sex. Transition *had* to be making you straight, not gay, and bisexuals were not allowed. You also had to be experiencing severe distress with your body and genitals, and already be living as your true gender without treatment. Many trans people got around these limitations through community coaching and performative presentations, but for many people (myself included) it was believed that if you did not fit all the criteria, then you were not trans enough to transition.
+
+In 2011 the HBIGDA reorganized itself to respond to mounting pressures in trans understanding and acceptance, taking on the new name World Professional Association for Transgender Health (WPATH). Under guidance by actual transgender people (a first for the organization), WPATH then proceeded to release an entirely new Standards of Care (version 7, the first in ten years) which abandoned the Benjamin Scale, focusing on specific individual symptoms and disconnecting gender from sexuality entirely. Two years later, in 2013, the American Psychiatric Association changed their diagnostic criteria to match the WPATH SoC in their Diagnostic and Statistical Manual of Mental Disorders (DSM) version 5, replacing Gender Identity Disorder with Gender Dysphoria. With this change, medical transition became available to all trans people in the United States.
+
+This is why trans presence across the world has suddenly exploded in the last decade. With easier access comes larger numbers, with larger numbers comes more visibility, with more visibility comes more awareness, and with more awareness comes more people accessing treatment. [A study conducted in 2014](https://williamsinstitute.law.ucla.edu/wp-content/uploads/TransAgeReport.pdf) showed 0.6% of adults and 0.7% of youth in the United States identified as transgender, [a study conducted in 2016](https://www.cdc.gov/mmwr/volumes/68/wr/mm6803a3.htm) showed 1.8% of high school age students identified as transgender, and [a survey conducted by GLAAD in 2017](https://www.glaad.org/files/aa/2017_GLAAD_Accelerating_Acceptance.pdf) showed a whopping 12% of respondents 18 to 34 did not identify as cisgender.
+
+Transgender people are coming out of the woodwork, we are everywhere.
+
+#### So What Is Gender Dysphoria?
+
+> **Dys·pho·ri·a** - *Noun*   
+> A state of unease or generalized dissatisfaction with life. The opposite of euphoria.
+
+{!{ {{inject '~/img' images.glue className="card sideline" caption="What Dysphoria Feels Like"}} }!}
+
+There is a common misconception among both cisgender and transgender people that Gender Dysphoria refers exclusively to a physical discomfort with ones own body. Consequently, proponents of SoC 7 and DSM-5 have taken to a habit of saying that you do not have to have dysphoria to be transgender. This statement is often repeated like a mantra, as it informs people who do not feel significant body discomfort that they may also be transgender.
+
+However, this belief that body discomfort is central to Gender Dysphoria is in fact a misconception, and is not even a majority component of a Gender Dysphoria diagnosis. Gender Dysphoria crosses a large number of all aspects of life, including how you interact with others, how others interact with you, how you dress, how you behave, how you fit into society, how you perceive the world around you, and yes, how you relate to your own body.
+
+In principle, Gender Dysphoria is a feeling of wrongness intrinsic to the self. There is no logical backing to this wrongness, there is nothing which explains it, you can not describe why you feel this way, it is just there. Things in your existence are incorrect, and even knowing which things *are* incorrect can be hard to properly identify.
+
+Evey Winters described it extremely aptly [in her Dysphoria post](https://eveywinters.com/2019/10/14/on-dysphoria-before-enduring-and-after/).
+
+> Have you ever been sitting somewhere in a public or a formal place and all of a sudden the bottom of your foot itches? It’s not like you can remove your shoes right there and scratch it, so you endure the feeling of dying inside while this itch grows and grows until you are ready to murder the next person that speaks to you.
+>
+> Or when I was younger I used to watch cable TV in the mornings before school. Because it was cable TV in rural WV in the early 90’s, every so often I’d turn on my favorite channel to watch my shows while I ate my maple oatmeal and I’d be seeing Power Rangers — but the audio would be from another station (usually the weather channel). The video was fine. The audio was fine. But the mismatch between them? That’s the kind of frustration that sits with you all day as a child.
+>
+> It’s the feeling you get when you ask for a crisp refreshing Diet Coke and the server says, “Is Pepsi ok?”
+>
+> It is knowing that something is wrong and not being able to do a damn thing about it.
+
+The way I used to describe it is like wearing an adult's glove when you are a child. You can put your hand into the glove, and your fingers feed into the digits of the glove, but your dexterity with the glove is severely hindered. You might be able to pick something up, but you can not manipulate it like an adult could. Things just aren't quite right.
+
+Gender Dysphoria is at it's core simply emotional reactions to the brain knowing that something does not fit. This incongruence is so deep inside the brain's subsystems that there is no obvious message of what the problem is. The only way we have to identify it is via the emotions that it triggers. Our consciousness receives either positive (euphoria) or negative (dysphoria) feedback according to how well our current environment aligns with our internal sense of self. Part of transition is learning to recognize those signals.
+
+Cisgender people receive them as well, but since the signals usually align with their environment, they take them for granted. There have been a few notable occasions, however, when a cisgender person has been [put into a situation](https://www.teenvogue.com/story/maisie-williams-arya-stark-game-of-thrones-affected-her-body-image) where they experience gender dysphoria. Attempts to raise cisgender children [as the opposite sex](https://www.nytimes.com/2004/05/12/us/david-reimer-38-subject-of-the-john-joan-case.html) (Content warning suicide) have always met with failure when the child inevitably declares themselves differently.
+
+These impulses of euphoria and dysphoria, arousal and aversion, they all manifest in many different ways, some obvious, some much more subtle. Dysphoria changes over time, as well, taking on new shapes as one moves from pre-awareness into understanding and through transition. The goal of this essay is to break down these manifestations into their distinct categories and describe them so that others may learn to recognize them. This is a very lengthy post, so I have separated it into multiple pages.
+
+However, first I must stress something very important. So important that I am putting it into big bold letters.
+
+**EVERY SINGLE TRANS PERSON EXPERIENCES A DIFFERENT SET OF DYSPHORIA SOURCES AND INTENSITIES**
+
+There is no one single trans experience, there is no standard set of feelings and discomforts, there *is no one true trans narrative*. Every trans person experiences dysphoria in their own way to their own degree, and what bothers one person may not bother another.
+
+Ok, that disclaimer out of the way, lets get to the meat and potatoes.
+
+{{inject '_pager' step=2}}

pages/gdb/what-is-gender.md

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+---
+date: "2020-01-26T20:41:55.827Z"
+title: "The Gender Dysphoria Bible"
+subtitle: "What is Gender?"
+description: "A dive into the multitude of ways that gender dysphoria manifests and what it means to be transgender."
+tweets:
+  - https://twitter.com/CognitiveSoc/status/1228717614630940672
+---
+
+{!{ {{inject '~/tweet' ids=(array
+  '1228717614630940672'
+) tweets=meta.tweets className="sideline" }} }!}
+
+If you trace the etymology of the word to its Latin roots, gender simply means "type". Historically the word was used in literature to refer to masculine, feminine and neutral nouns. In 1955 psychologist John Money proposed using the term to differentiate mental sex from physical sex, but he was not the first to do so.
+
+Human Sex (the adjective, not the verb) is broken down into three categories:
+
+- **Genotype**: The genetically defined chromosomal kareotype of an organism (XX, XY, [and all variants there of](https://twitter.com/sciencevet2/status/1035250518870900737?lang=en))
+- **Phenotype**: The observable primary and secondary sexual characteristics (genitals, fat and muscle distribution, bone structure, etc)
+- **Gender**: The internal mental model of a person's own sex.
+
+Any of these three aspects can fall into a position on a range of values. Your elementary school health class probably taught you that Genotype is binary, either Female (XX) or Male (XY), when the reality is that there are a dozen other permutations that can occur within human beings.
+
+{!{ {{inject '~/img' images.bimodal className="card sideline"}} }!}
+
+Likewise, many people believe that Phenotype is also binary, but biology has recognized for hundreds of years that when you plot out all sexual characteristics across a population, you actually end up with a bimodal distribution where the majority of the population falls within a percentile of two groups. This means that some people will, simply by nature of how life works, fall outside of the typical two piles. Many people fall in the middle, with characteristics of both sexes.
+
+Gender, however, is a lot more... wibbly wobbly timey wimey type stuff. There are a lot of different ways that people have attempted to illustrate the gender spectrum, but none have quite thoroughly captured it, because the spectrum is itself a very abstract concept.
+
+{!{
+{{inject '~/img' images.spectrum className="sideline" link="https://bahamutzero.tumblr.com/post/56838411871/gender-a-visual-guide-when-most-people-think-of"}}
+{{inject '~/img' images.graph className="sideline" }}
+{{inject '~/img' images.gender_unicorn className="sideline" link="http://www.transstudent.org/gender"}}
+}!}
+
+The short of it is, some people are very male, some people are very female, some people feel no gender at all, some people feel both, some are smack in the middle, some land along the edges. Some people oscillate all over the spectrum in unpredictable ways, changing like the wind. Only an individual can identify their own gender, no one else can dictate it for them.
+
+Gender is part social constructs, part learned behaviors, and part biological processes which form very early in a person's life.
+
+Present evidence seems to suggest that a person's gender is established during gestation while the cerebral cortex of the brain is forming (more about that in the Causes of Gender Dysphoria section). This mental model then informs, at a subconscious level, what aspects of the gender spectrum a person will lean towards. It affects behavior, perceptions of the world, the way we experience attraction (separate from sexual orientation and hormonal influences) and how we bond with other people.
+
+Gender also affects the expectations that the brain has for the environment it resides in (your body), and when that environment does not meet those expectations, the brain sends up warning alarms in the form of depression, depersonalization, derealization, and dissociation. These are the brain's subconscious ways of informing us that something is very wrong.
+
+On the social side, gender involves presentation, how we communicate, what our expectations are from life, and the roles that we fulfill as we walk through life. These are all cultural factors, things which have developed within the population over time, but regardless of being essentially "made up", they are still connected to a gender identity. A person tends to connect to the social aspects of their internal gender, without even realizing they are doing it, and when they are denied access to those social aspects, this results in discomfort with their social position in life.
+
+John Money's experiments attempted to confirm his belief that gender is entirely a social construct, and that any child can be raised to believe themselves to be whatever they were taught to be. His experiment was a massive failure (see the Bio-Chemical Dysphoria section). Gender does not change, every human is the same gender at 40 that they were at 4. What changes is our own personal understanding of our gender as we mature as individuals.
+
+These negative symptoms (depression, derealization, social discomfort) are the symptoms of Gender Dysphoria.
+
+What **Gender is *not*** is sexual orientation. We describe orientation using terms relative to one's gender (homosexual/heterosexual/bisexual), but gender itself does not affect sexuality and sexuality has no role in gender.
+
+In generalist terms this essay will be describing gender in a sense of binary identities (male/female) vs non-binary identities (agender, bigender, genderqueer, etc), but this is purely for the sake of writing simplicity. Please know that the depth of gender experience and expression is far, far more complicated than this simple breakdown.
+
+{{inject '_pager' step=1}}