Body Dysphoria in Anorexia and Transgenderism

Body Dysphoria in Anorexia and Transgenderism

Body dysphoria is a killer but my daughter survived. She survived anorexia.

On New Year’s Eve four years ago, my fifteen year old sat beside me as I sipped champagne, and casually dropped the sentence: “I think I have anorexia”. To say it put a dampener on the celebrations would be to underestimate that moment so significantly that I might throw back my head and laugh out loud …… now.

As soon as humanly possible I marched her into the doctor’s surgery and said she needed to be assessed. The doctor, fortunately, took me seriously and fast tracked her into the Paediatric Outpatient Clinic. There she began three years of evidence based care. Incredible care that supported not just my daughter but our family too.

The next three years were a rollercoaster ride. There were suicide threats, acts of self harm, acts of violence against me, and terror on both of our parts. I was afraid she’d die, she was afraid I’d make her eat.

It was agony for me as a mother, to watch my previously happy, healthy, teenager spiral out of control with whacko diets and unbending rules around food. Her social life was obliterated because her friends weren’t interested in shopping for broccoli by the kilo (yes, really!)

One day she announced that she needed a breast reduction. She fully intended to save money and go to Thailand. She knew our universal healthcare would never provide that sort of service. Of course her perception of it was that they were failing her, because it was a genuine medical need, not body dysphoria. But I don’t believe they were failing her.

The frightening reality for me, and it’s one I often think about, is that had she announced on that fateful New Year’s Eve that she was in fact a boy? That she was trapped in a girl’s body, but she was really a boy? Things might have been terribly different. It’s entirely possible that they would have completely removed her breasts.

At first, with an eating disorder, the priority is to get the body healthy and fully nourished, but after we completed that stage in treatment we were sent, as a family, to therapy. It’s vital when a child is so distressed that the entire family work together. During therapy, and at home as well, she talked at length about how unhappy she was in her body, how this part, or that part was wrong.

To my eyes, and to the eyes of anyone we might have walked by, she was a perfectly healthy, fortunately attractive young woman. But when she looked in the mirror she must have seen some kind of demon gazing back at her. She literally couldn’t see herself there. Her response to photographs where she thought she saw a thin woman ….. and then realised it was her, spoke volumes about how the dysphoria was manifesting. It was distorting her self perception in such a way that it made her want to take drastic measures to “fix it”.

No amount of logic, of talking (or shouting) could help her see. She wasn’t a hideous, obese oaf,  she was fine just the way she was. She just couldn’t see that. She couldn’t see it to the degree that there were tears and panic attacks and horrendous anxiety, not to mention the suicidal thoughts and self harm attempts. Dysphoria, at its pinnacle, was unimaginable. But never once did anyone do anything to reaffirm her dysphoria.

I simply can’t imagine being the mother of a physically healthy child with dysphoria about their sex. I can’t imagine facing that without the full backing of an entire medical team, both physical and mental. And yet that’s what many mothers are facing with their children who, after an afternoon on BuzzFeed, believe that they are actually the opposite sex. I know this trivialises it, but the impact of the internet really isn’t a trivial matter. (see here ) (or here )

One thing I can imagine though, is how easy it would have been for me to simply pretend that she was right, that she was a boy. Dangerous, yes, but easy. There would have been no fighting or raging. There would have been life altering surgery, and a lifetime of hormones that potentially destroyed her hopes of childbearing. Therapy that never challenged the belief that her body was wrong. Therapy that never told her that, in fact, her body was RIGHT, but her feelings were mixed up. It eats me alive to think of a child with suicidal thoughts, in therapy that confirms for them, that their body is the problem. And it doesn’t surprise me in the least that the suicide and self-harm rates are high in these transgender teens. The suicide and self-harm rates  are high in the eating disordered youth as well, but people are at least, working with them to help them accept their bodies.

My opposition to the permanent surgical and synthetic hormonal treatment of young children has brought a storm of hatred to my doorstep. People have said things like “You have no idea what it is to have a suicidal teen” despite the fact they usually only have very young children themselves, if any at all. Despite the fact that I actually do know what it’s like …….

There’s a shockingly lackadaisical attitude to the dysphoria of a teen who believes they are transgender, compared with a teen that is in the grips of an eating disorder.

Dysphoria in an eating disorder is a mental illness, but dysphoria in transgenderism isn’t. It requires confirmation and challenging it is dangerous. It’s a strange, and baffling contradiction from my perspective. I put it to you that challenging the dysphoria of an anorexic isn’t a safe process by any stretch of the imagination. That’s because the dysphoria is actually dangerous.

I’ve seen people argue that transgenderism is body dysmorphia, which is separate to dysphoria, but the trans community does largely refer to it as dysphoria. The reason we now have “birthing people” instead of pregnant women is to avoid triggering dysphoria, so I’m calling that a moot argument.

I’ve been told that body dysphoria in eating disorders is different to body dysphoria in the trans community. I don’t believe that it is. A spade is a spade in my book, a rose by any other name etc blah etc. I do believe that the way it’s viewed socially,  is different though. Having read multiple stories of teens with body dysphoria, who believe they are trapped in the wrong sexed body though? The parallels are striking, and not in short supply. Incredibly, if  you removed the topic matter from some blogs about the various types of dysphoria, so that only the symptoms and discomfort of the dysphoria remain, you wouldn’t know whether the writer was referring to transgenderism, or anorexia.

I’ve thought long and hard about writing this. I know the precarious position of a parent with a teen in the grip of body dysphoria. I know how many random strangers think they can “fix it for good”. I know how you hold yourself responsible for it all, and how you’d do anything to end the pain your child is expressing. I don’t claim to have the answers for mothers of trans teens. I simply don’t, but I do have a lot of questions, that I have attempted to weave in amongst my own story of mothering up against the wall.

I understand the pull towards not fighting your teen who hates themselves, because to do so feels unsupportive. It feels as if you might push them into the abyss and they might never return. For a mother who has worked incredibly hard to forge a strong and healthy relationship with her child, it feels combative, and bellicose. It feels, quite frankly, terrifying. The kind of terror that you feel when you wake in a cold sweat from a nightmare, but you live with it day in and day out.

One difference I can see with transgenderism and eating disorders, is that the need to fight against the dysphoria is urgent. A teen who is starving is on perilous footing, even when they may appear to be healthy. My daughter’s heart was skipping beats by the time she told me she had anorexia. If I’d nodded and hugged her, and said “I’m sorry you’re so fat, let’s skip dessert” it wouldn’t have been helping.

My daughter thought I was so screwed up I could never understand her abject misery. Furthermore as her mother, she informed me that I am ultimately obliged to pat her head and tell her she’s thin and pretty.  That’s what she wanted to be, and my job as a mother was to affirm that. I would lie if necessary to fulfil my duty as a mother.

Teens are biologically driven to fight us, and they’ll go out of their way to find a platform on which to do so – even if we don’t fight back. As mothers we literally can’t even “not fight back” in a way that doesn’t antagonise them. It’s about brain development, and the biological urge to separate from care givers  to become independent. Unfortunately because they are the same size as us it’s easy to forget that they are still children in many ways. As such, I can well imagine being consumed by the desperate hope that by confirming dysphoria, rather than questioning it, you could preserve the relationship you have with your teen. Possibly even their life.

But why? Why would we treat the same condition, dysphoria, so differently simply because it manifests differently? We could even argue that the manifestation of my daughter’s body dysphoria, and her desire to have a mastectomy, matches perfectly with a transgender girl’s wishes to have her own breasts removed, so she can live as a male.

There’s no question that some adults live happily and peacefully as transgender people. It is their right to do so, and to be supported and accepted as such. I will never argue against that. What I argue against is the different ways that children are supported when they experience body dysphoria. I believe that we should challenge all dysphoria in a supportive environment. In a context that discusses THE SELF rather than the social construct of the body, or gender assignment.

Whether your son wears a dress, or your daughter wants a mastectomy is irrelevant if we simply create an environment in which they can question who they truly are. Wanting a mastectomy is harmless, as is wearing a dress …… in theory. In practice we can create trouble if we aren’t savvy in our management of the presentation of body dysphoria.

It is the nature of teens to want to experiment with their appearance in the community, because they are preparing to fly the roost. If they were to forever see themselves as a part of their nuclear family, they would never be ready to live independently. It’s why they often go all out to differentiate themselves from their parents as teens, then when they settle down to raise a family, they emulate many of the same patterns of their childhood.

All mothers want what is best for their children, and no phase of mothering presents more challenges than the teenage years (although they don’t call them threenagers for nothing …….)  Therapy was a huge success for my daughter’s body dysphoria. It was a time consuming process, gut-wrenching at times, but the results speak for themselves.

From the ashes that were anorexia, something special rose. My daughter is stronger, surer, and more salient in her own person than she might have been, had she not stared down the monster that fed her desire to mutilate whilst simultaneously starving herself. The work of challenging body dysphoria, and the success was ultimately hers. I was merely a support person, but the memories are ever-present. I know in my heart, that had the medical community not opposed her dysphoria, even though they did it gently, we wouldn’t be living as we are today. From reading some rarely published experiences of mothering through dysphoria and transgenderism, I know other mothers see similar results.


body dysphoria
The Ugly Duckling and Body Dysphoria
License: Creative Commons CC0.

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