I believe that I suffer from gender dysphoria (you can find a fairly helpful definition of gender dysphoria on the NHS web pages). This is a condition in which there is a dissonance between the biological sex of an individual and their sense of gender. Ever since my youngest years I found myself wanting to do the things that girls do, and having very little idea how to behave like one of the other boys. As I grew older and entered adolescence, I learned to behave like other boys, but as soon as it became possible to drop the facade, I did so and all my adult life I have been conscious of not fitting masculine stereotypes.
I would always have said I was male. Every time I undress I am aware of my male body; every morning as I stand in front of the mirror shaving I am reminded of my masculinity. When I am out dressed as Karen, I do not believe that I have become a woman; I am a biological male with a brain that feels itself to be feminine whether I am dressed as a man or a woman. I have no illusions about what I am: I have often described myself as a bloke in a dress. And yet, when I’m out and about, people tend to treat me like a woman; they appear to be quite comfortable, by and large, acquiescing to my taking the role of a woman. I have in fact been quite touched at the degree of acceptance extended to me by many women. This peculiar half-world is a compromise that I am happy to live with. I do not demand that people believe that I actually am a woman. But it pleases me greatly if they choose to treat me as though I was one. One of the arguments raging between radical feminists and trans activists concerns what it is to be a “real” woman. I am quite content to be a “real transwoman”. It would be great to celebrate transwomen without arguing about what we mean by a “real” woman.
All my life I wondered what it would be like to lose my male genitalia and acquire a feminine form. I suspect many of us when we were younger stood in front of a mirror, as Eddie Redmayne did in The Danish Girl, and tucked out genitals between our legs and wondered what it would be like for them to disappear. But few of us take the step of surgical intervention. Some trans people experience such an intense dysphoria that they are unable to live happily in their biological gender. For them, surgery is not a choice, but a necessity that enables them to experience better mental health.
For the most part gender dysphoria remains a condition of unknown origin: it could lie in a stage in foetal development, but equally it could be attributable to experiences in early childhood. In many questions related to human behaviour, nature and nurture may play a role in development, but disentangling the two can be difficult or, indeed, impossible.
It is easiest for me to understand gender dysphoria in a negative sense: the feeling that one’s biological sex is in some way not the right one. It doesn’t really matter where that sense comes from – I don’t feel I have to be able to point to a biological cause to legitimate the way I feel. If gender dysphoria is simply a psychological condition, it does not in fact make it less real or less important than would be the case if it had a physiological origin, and professional psychiatrists are now agreed that it is neither a disorder nor a curable condition. That I “feel” dysphoria is as real a problem as “having” a feminine gender identity that somehow exists objectively apart from my feelings.