Gender identity as a multidimensional measure: the new Genderqueer Identity Scale

Clinical instruments evaluating patients for possible gender dysphoria have historically followed a relatively basic structure. Inventories like the Utrecht Gender Dysphoria Scale (UGDS) (Schneider et al., 2016) and Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ-AA) (Deogracias et al., 2007) ask questions that are straightforwardly related to gender identity, bodily dysphoria, and social gender roles, such as (paraphrased):

• “Have you felt, given who you really are, that it would be better for you to live as a woman rather than as a man?”
• “Have you felt unhappy about being a man?”
• “I feel unhappy because I have a male body.”
• “Have you had the wish or desire to be a woman?”
• “Have you disliked your body because it is male?”
• “I dislike having erections.”
• “Have you wished to have hormone treatment to change your body into a woman’s?”
• “I feel unhappy if someone calls me a boy.”
• “My life would be meaningless if I would have to live as a boy.”

(These items are reworded as appropriate in versions given to AMAB and AFAB patients.)

While these inventories serve the narrower purpose of determining whether a person likely meets the criteria for a diagnosis of gender dysphoria and whether they may be likely to benefit from transition and gender-affirming treatment, they do suffer from certain shortcomings. The questionnaires construe gender dysphoria and gender identification as a matter of finding a better fit with either one binary gender or the other, and their usefulness and applicability to nonbinary people is almost certainly limited by this. They also sample an individual’s gender identity and dysphoric symptoms at only one point in time, leaving them unable to capture fluid experiences of gender over time.

The recently developed Genderqueer Identity Scale (GQI) aims to remedy these insufficiencies, offering a clinically validated instrument that can capture the diverse and complex aspects of gender experienced by genderqueer, nonbinary, and genderfluid people (McGuire et al., 2018). While previous gender identity and gender dysphoria questionnaires aim to provide information to facilitate a yes-or-no answer – does this individual have clinically significant gender dysphoria? – the GQI encompasses four measures: challenging the binary, socially constructed gender, theoretical awareness, and fluidity.

• Challenging the binary includes question items regarding an individual’s identification with a nonbinary gender, their desire to be seen as nonbinary, and the extent to which they consider this a deliberate act of challenging society’s perceptions of binary gender. Respondents are asked to rate their agreement (from “strongly disagree” to “strongly disagree”) with statements such as “I don’t want to be seen in the gender binary”, “I try to deliberately confuse people about whether I am male or female”, and “I enjoy it when people are not sure if I am male or female”.
• Social construction describes the extent to which social influences have played a role in a person’s understanding of their gender identity. This includes items such as “The way I think about my gender has always been the same”, “My gender is something I have spent a lot of time figuring out”, and “The way I think about my gender will probably continue to change further as I age”.
• Theoretical awareness describes how one’s identity can inform one’s political views and activism in interaction with society – as the authors note, “making space for gender diversity among others is one way to make personal identity political, to embody gender.” This group includes question items such as “I have done research about gender theory and gender roles”, “The way I show my gender is important because I push society to question traditional gender roles”, and “I encourage others to be more open minded about gender and gender roles”.
• Fluidity contains items regarding anticipation of how one’s gender identity and expression may change in the future – rather than being limited to the form one’s gender may take at the present time, these questions are forward-looking and capture how fluid a person considers their gender to be. This includes question items like “In the future, it will upset me if people misgender me”, “In the future, I think my gender will be fluid or change over time”, and “I will have a non-traditional gender role (be gender non-conforming)”.

These four measures are each distinct and largely independent: “A person scoring high on challenging the binary, may not necessarily score high on the other subscales, suggesting that expression may or may not feel socially constructed, theoretically grounded, or variable from day to day.” The GQI thus accounts for the possibility that a person may be, for instance, nonbinary but not genderfluid, politically informed in their understanding of gender identity but not genderqueer in their identity or expression, or nonbinary and genderfluid while also uninterested in pushing for gender openness in society.

Neither the GQI nor earlier inventories of gender identity and dysphoria are substitutes for one another – each fulfills a distinct function. The value the GQI adds is in explicitly accounting for nonbinary and genderqueer identities, and providing a structured method of capturing many of the experiences shared by genderqueer trans people. In doing so, it opens the door to future studies examining how genderqueer identity and its numerous factors interact with other gender-related phenomena and experiences in society. ■