A Problem of Gender Dysphoria

The purpose of Yildizhan et al.'s (2018) article was to examine transgender individuals who had gone through Sex Reassignment Surgery (SRS) and sex reassignment with those who had not yet gone through those procedures and compare their lifestyles, personal and social relationships, adjustments to society and quality of life. Previous research has gained some insight into the aftermath of a transgender persons full transition, but it has been hard as when a person fully transitions they tend to try and hide as much of their past as possible. Participants in this study consisted of 70 transgender men and women who were either just starting their transition or had already fully transitioned in terms of surgery and medication (estrogen and testosterone). The participants ranged from the ages 16 and up. 50 of the participants were new referrals (NR) meaning that they had yet not gone SRS and the other 20 were gender reassigned transsexuals (GRT) meaning they were individuals who had made the transition, made the necessary changes and had gone through the gender reassignment procedure of changing their sex in documents. Of the NR 60% (n=30) were transmen and 40% (n=20) were transwomen. Of the GRT group, 45% (n=9) were transmen and 55% (n=11) were transwomen.

The participants from each group were evaluated in an interview for about 90-120 minutes and then asked to fill out survey like forms. These forms assessed the patient's sociodemographic background, gender dysphoria, housing difficulties, physical violence and discrimination due to their gender, anxiety, and how well the patient's family functioned. The results of this study indicated that the biggest improvements were interpersonal relationships, acceptance by themselves and others, and better quality of life overall than those in the NR group. Although this study offers useful ness, it is not without limitations. For example, many of the people who fully transition move away and hide their past which makes it harder for studies like these to recruit. This means that there is underrepresentation and a possible bias in the study. Future studies should aim to define the area were participant come from as too know if it will be representative of the whole country. The purpose of Austin and Goodman's (2017) article was to understand and examine how internalized transphobia and social connectedness among transgender and gender non-conforming adults (TGNC) affected their self-esteem and well-being. Previous studies have demonstrated how internalized transphobia affects TGNC but this is the first study to specifically show how social connectedness affects the self-esteem.

Participants of this study included 65 TGNC adults from the age range of 18-73, with it not being ethnically diverse as 74% of the participants were non-Hispanic Whites. Although ethnicity wise it was not diverse, the gender identities were as they included bigender, genderfluid, man, man of trans experience, transgender, transman, transwoman, transsexual, two-spirit, and woman. These participants (n=65) were asked to fill out a paper-and-pencil survey which assessed the relationship between transphobia for one's self, social connectedness and how that affected self-esteem. The results of the study indicated that TGNC adults with internalized transphobia tend to have a lower self-esteem, while those who feel more socially connected to others have a higher self-esteem. In addition, it was found that social connectedness does go hand-in-hand with self-esteem but, it does not implicate the effects it has on internalized transphobia. Despite the usefulness of this study, there is some limitations to be aware of. One of the main limitations would be that the sample used in the study is limited as it not representative of TGNC people. The sample size was small (n=65), social connectedness with the TGNC community might have been different for each participant, and the majority was non-Hispanic White. Race and ethnicity play a huge factor as they make up a person's background and way they view things, and in this study it was scarce. Future studies should use not only a larger sample but a diverse one as well.

Incorporating diversity lets you have a better study. The purpose of DuBois et al.'s (2017) article was to examine stigma and diurnal cortisol levels among transgender men who were transitioning and receiving testosterone therapy. Participants included 65 healthy transgender men who were not taking medication for cardiovascular or immune related conditions. Medication was excluded as to eliminate the chances of the diurnal levels being a certain way because of medication. Participants ranged in age from 18 years or older, were assigned female at birth but identified with the male gender, and were undergoing testosterone therapy. Race and ethnicity was not mentioned in the study but it was mentioned that participants were from western Massachusetts, Boston and southern Vermont. Participants were then intensively interviewed, asked to provide health exams, saliva samples, testosterone therapy information, and stress evaluations pertaining to 3 major categories: transitioning-identity stress, coming out stress, and gender-specific public bathroom stress. The results of this study indicated that stress among transgender men who are transitioning amplify cortisol levels, with stigma having to play a role.

In addition, the saliva samples that were collected, consisted of samples from different times of the day, a majority of the samples indicated that stress levels and cortisol levels were higher during waking periods. These results are important because they show how stigma for the transgender community negatively affects the person transitioning. Although this study is useful, it does not come without limitations. For example, this study focuses on the stress transitioning transgender men experience while excluding transitioning transgender women. Apart from this, the sample size is too small as it only contains 65 participants. Future research should aim to include transitioning transgender women. The sample size could also be bigger as it did limit the amount of diversity. The purpose of Basar's (2016) article was to evaluate whether there was a relationship between the quality of life of a transgender individual experiencing gender dysphoria and the levels of discrimination and social support they receive.

Previous research has only focused on a transgender person's quality of life following their full transition. Participants included 94 individuals from the Hacettepe University Hospital in Turkey. Race and ethnicity were not established but it is inferred that participants were Turkish as the study recruited participants from a Turkish clinic. Age of the participants was not disclosed but it was said that the median age was 26 years including transgender men and transgender women. Participants were asked to fill out forms that assessed quality of life, transitioning experience, discrimination, and social support from friends and family. The results of this study indicated that discrimination affected a transgender person's quality of life including social. The more discrimination a transgender person with gender dysphoria experiences the more dysphoric and poorer they feel about themselves causing poor social relationships.

It was also found that hormone treatment such as testosterone and estrogen predicted a better quality of life rather than surgery such as genital re-assignment. Despite the usefulness of this study, it is not without limitations. For example, individuals who applied to be in the study were not given equal chances of being selected as there was some restrictions. Another limitation present was that sample size could have been larger. Furthermore, the study relied solely on one population and race which happened to be discriminatory towards the transgender community which could have affected the outcome of this study. Future studies should plan to incorporate many backgrounds as to see if the way transgender communities are seen affects someone's gender dysphoria, social support, and overall quality of life.

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