The antecedents of gender dysphoria and the associated thoughts, emotions, and ways of coping: a qualitative analysis and clinical implications

ABSTRACT Despite recent trans-affirming research centering experiences of gender dysphoria and its relation to psychological outcomes, there is a dearth of research studying the components of experiences of gender dysphoria. This has limited the ability of clinicians to intervene and reduce the distress caused by gender dysphoria. The current study utilized an online qualitative approach based on cognitive-behavioral therapy thought trackers to ask 108 transgender and nonbinary participants four prompts: a) antecedents of gender dysphoria, b) associated thoughts, c) emotions, and e) ways of coping. Analyses of these prompts revealed that gender dysphoria is frequently triggered by body, social, and intrapersonal experiences and is associated with a range of thoughts (e.g. body, gender presentation, medical transition, and self-harm focused) and emotions (e.g. anger, sadness, fear, and suppression) related to experiences of gender dysphoria. Participants noted engaging in both facilitative coping strategies (e.g. mindfulness, gender affirmation, medical transition, social interactions, and cognitive reframes) as well as avoidant strategies (e.g. distraction; suppression; avoid viewing body/self, social interactions, and voice; and identity concealment) to deal with gender dysphoria. Considering the lack of published therapeutic interventions targeting gender dysphoria, the discussion focuses on the ways the current findings can inform clinical practice with TNB individuals.