Before diagnosing someone with gender dysphoria, be sure that it is not a body dissociation disorder or a feeling of estrangement from their own body, which can be part of various other mental health conditions (e.g., DPDR, BDD, DID, PTSD, anxiety disorders, depression, schizophrenia or other psychotic disorders, substance use disorders, or other neurological conditions). Not all are transgender!

Today, on my way home, I encountered about ten transgender individuals, each more flamboyant than the last. Many of them exhibited clear signs and symptoms of mental health disorders.

This made me question whether society has perhaps made a significant error by normalizing transgenderism and promoting it in a manner similar to the decriminalization of drugs.

What if many of these transgender individuals were misdiagnosed based on what they said rather than on what their conditions actually are?

A poorly conducted differential diagnosis between a body dissociation disorder or a feeling of estrangement from one’s own body versus gender dysphoria could misguide a person with a primary medical condition onto the wrong path.

When I looked at the statistics, the percentage for gender dysphoria is low compared to all other mental health conditions where body dissociation could appear.

“Depersonalization-derealization disorder is a mental health condition where you feel disconnected from your body, your feelings, and your environment. It tends to come and go over a long period and causes distress and anxiety.”

When you feel disconnected from your own body, you might observe it from the outside and start having negative feelings towards it, usually hate. When you hate your body, you want to change it. Voilà! You want to become the opposite of what you are!

But this is not necessarily gender dysphoria. It could be anything and everything else but not gender dysphoria.

And your patient is NOT transgender!

Depersonalization-Derealization Disorder (DPDR)

Depersonalization presents as a sense of detachment or estrangement from one’s own body, thoughts, or feelings. People may feel like they are observing themselves from outside their body or feel like they are in a dream. Significant trauma and other factors can cause this!

Derealization is a sense of detachment from the surrounding environment, where the world feels unreal, distant, or distorted.

Body Dysmorphic Disorder (BDD)

This mental health condition involves a person being preoccupied with perceived flaws or defects in their physical appearance. They often look in the mirror for defects and may use masks and body coverage. They could use cross-dressing and disguises to hide the parts of their bodies they are concerned about, leading to a sense of disconnection or estrangement from those body parts.

Dissociative Identity Disorder (DID)

Previously known as multiple personality disorder, DID involves the presence of two or more distinct identities or personality states. Individuals with DID may experience dissociation and detachment from their body as they shift between different identities. They are not transgender; they have cross-dressing desires based on this diagnosis.

Post-Traumatic Stress Disorder (PTSD)

Individuals with PTSD, especially those with a history of severe or prolonged trauma, may experience dissociation as a coping mechanism. This can include a sense of detachment from their body or environment. For example, in the movie “Lady Valor,” an amazing Army officer and former transgender individual experienced a transgender episode, likely linked to PTSD.

Anxiety Disorders

Severe anxiety and panic attacks can lead to transient experiences of depersonalization and derealization, where individuals feel disconnected from their body or surroundings. One of my best friends, a woman, chose cross-dressing based on her high anxiety level and panic attacks stemming from a problematic family life.

Depression

In some cases of severe depression, individuals may experience depersonalization or a sense of disconnection from their body as part of their overall symptoms. Many depressed people hate their bodies either partially or entirely. They may cover themselves with large clothes, makeup, or choose cross-dressing.

Schizophrenia and Other Psychotic Disorders

Individuals with schizophrenia or related psychotic disorders may experience body dissociation or estrangement from their body as part of their delusions or hallucinations.

Substance Use Disorders

Certain substances, particularly hallucinogens or dissociative drugs (e.g., ketamine, PCP), can induce temporary experiences of depersonalization and body dissociation.

Neurological Conditions

Certain neurological conditions, such as epilepsy (particularly temporal lobe epilepsy), can include symptoms of depersonalization and body dissociation.

These conditions can vary widely in their presentation and severity, and the sense of disconnection from one’s body can manifest differently depending on the underlying cause.

A proper differential diagnosis could save many people from a poorly normalized transgender diagnosis and its severe consequences.

Be a good psychiatrist, psychologist, or nurse, and do not buy into what society tries to sell you.

People could be helped or destroyed! Be one to help people!