Gender Analysis

I’m going to list some descriptions of certain feelings, and I’d like for any trans or gender-questioning readers to think about whether they’ve felt anything similar to this over the course of their lives.

• A sense of detachment or estrangement from your own thoughts, feelings, or body: “I know I have feelings but I don’t feel them”
• Feeling split into two parts, with one going through the motions of participating in the world and one observing quietly: “There is this body that walks around and somebody else just watches”
• Feeling as if you have an “unreal” or absent self: “I have no self”
• Experiencing the world as distant, dreamlike, foggy, lifeless, colorless, artificial, like a picture with no depth, or less than real
• Being absorbed in yourself and experiencing a compulsive self-scrutiny or extreme rumination
• Having an ongoing and coherent dialogue with yourself
• Feeling like a veil or glass wall separates you from the world
• Emotional or physical numbness, such as a feeling of having a head filled with cotton
• Lacking a sense of agency – feeling flat, robotic, dead, or like a “zombie”
• Inability to imagine things
• Being able to think clearly, but feeling as if some essential quality is lacking from your thoughts or experience of the world
• A sense of disconnectedness from life, impeding you from creative and open involvement with the world

These are taken directly from clinical descriptions of depersonalization and derealization, symptoms which are generally characterized as “feelings of unreality” (American Psychiatric Association, 2013; Sierra, 2009; Steinberg, Cicchetti, Buchanan, Hall, & Rounsaville, 1993; Medford, 2012). This is not a matter of “delusion” – while these are considered dissociative symptoms, individuals who experience them without other dissociative conditions typically have an intact grasp of reality. They’re able to recognize and understand the real world in a normal way, but their experience of life and of their own existence takes on an “unreal” sensation.

Despite the reduced emotionality of those with depersonalization, they often find these feelings to be deeply unpleasant and distressing, and can suffer “extreme emotional pain” as a result (Medford, 2012; American Psychiatric Association, 2013). An additional challenge is that the subjective experience of depersonalization can be “particularly difficult for patients to describe, and can sometimes go unnoticed or can be experienced by patients habituated to it as ‘normal’” (Steinberg et al., 1993).

Depersonalization symptoms can also occur in the context of untreated gender dysphoria, yet this is not widely recognized among the public or in most literature on transness and transitioning. Descriptions of depersonalization-like experiences feature prominently in many trans people’s recountings of their lives prior to transition, and these symptoms can heavily impact their general quality of life. But with very little attention given to depersonalization as a discrete symptom experienced by many with gender dysphoria, some trans people may struggle to recognize that this could be an indicator of dysphoria, and may not be aware that they could find relief via transitioning. Continue reading →