Dysmorphia and Dysphoria – G.T.Health Newsletter 3

by | Newsletters




“Oh what we see when we finally stop looking.”


– Tyler Knott Gregson ?



October 2021, Volume 3 

The G.T.Health Letter

~Adding a dose of mental health awareness to our community~ 


What’s Inside: 

  • Mental Health Spotlight – Dysphoria and Dysmorphia 
  • Literature Spotlight 
  • Xtra Scoop of the Week – Dysmorphia and Plastic Surgery in East Asia
  • Weekly Testimonial – My Experience with Body Dysmorphia















Mental Health Spotlight – Dysphoria and Dysmorphia

What is gender dysphoria? 

Gender dysphoria describes a sense of unease or discomfort that arises because of a mismatch between biological sex and gender identity. For example, someone who was born male might feel wrong wearing pants and keeping their hair short, and only feel like themselves when they are in a dress and makeup. Gender dysphoria, especially if other people don’t understand it or are unsupportive, can lead to depression or even more harmful thoughts or behaviors, as it is essentially the feeling of being in the wrong body. When we dress ourselves, do our hair, even decorate our home, we are self-expressing, and telling others what they need to know about us. If a person has gender dysphoria, people will constantly misunderstand their identity because it is difficult to truly express the way they feel.


What is the difference between sex and gender? 

Although many people use them interchangeably, sex and gender are two very different things, which makes it possible for them to be unmatched. Sex refers to the organs and genes a person is born with: males have XY chromosomes, females have XX, and intersex people have characteristics of both. Sex determines how your body will look after puberty. Males have more of the hormone testosterone, which means more body hair, bigger proportions and muscles, and body fat stored in the stomach area, and females have more estrogen, which means a menstrual cycle, breasts and fertility, and fat stored in the hips and thighs. Gender, on the other hand, is a social construct; it is a set of norms and rules created within a society. Gender does not reflect biology, but rather social expectations. Traditionally, gender is thought of as a binary: there are men, who are assumed to be born male, and women are assumed to be born female. More recently, however, society has begun to acknowledge gender as a spectrum; some people are gender nonbinary or even agender, meaning they identify with all genders or none. Gender determines how we are expected to dress, what jobs we are expected to have, and how we are expected to act. Because of my sex, I have a female shape and I can have children, but because of my gender people will look at me strangely if I wear “men’s” clothing or work in construction.




How can you help someone with gender dysphoria?

Identifying with a gender that does not match your sex can be incredibly challenging, especially because many people cannot empathize with what you are going through. They might call it a phase and assume the feelings will go away, but of course this makes the suffering even worse because it robs you of validation. Our self-identity is made up of phases and is always changing; this is normal for humans, and should not be treated as an issue. If I put on my favorite shirt from three years ago, stop feeling like myself because it is no longer my style, and get very uncomfortable, I can simply take the shirt off. This is not so easy for someone with dysphoria, who can’t simply take off their skin. Sex changes or hormone treatments, where the sex organs are altered to resemble those of the desired sex or the hormones of the other sex are injected, are possible, but very expensive and hard to get for young people especially. It is believed there will be regret if somebody transitions and then decides to change their mind, but this is nobody’s decision to make but the dysphoric person themselves. The best thing that you can do to help someone with dysphoria is validate them: support changes in appearance, speak to them with the labels they desire for themselves. Therapy is also helpful if a person needs to come to terms with their new role in society, especially in a society that is still a long way away from fully accepting transgenderism.


What is body dysmorphia? 
Like gender dysphoria, body dysmorphia can only really be cured when what you see in the mirror matches what you see in your head, or when you learn to accept yourself exactly as you are. Body dysmorphia involves obsessive focus on a perceived or imagined flaw in appearance, and can actually be impairing enough to be diagnosed as Body Dysmorphic Disorder (BDD). This disorder can be confused with OCD because it involves a specific obsession, Social Anxiety Disorder because it makes people afraid of social interactions that confirm their fears about their body, Major Depression because of the way being dysmorphic can make you feel, and Eating Disorders because it might lead to unhelpful eating behaviors as an attempt to correct the perceived flaw. Clinically, body dysmorphia involves not only an obsession with body image but also repetitive, compulsive behaviors involving appearance like mirror checking or reassurance seeking. For example, I check my appearance in the mirror constantly and even talk at myself in the mirror because it comforts me to see what I actually look like, and when I was younger and very disturbed by my weight I used to punch my stomach. I do not have BDD, but dysmorphia can still be crippling even without a diagnosis. Much of the day can be spent on convincing yourself you look deformed, ugly, don’t have enough muscle, etc.

What are some ways to combat body dysmorphia? 
It is incredibly difficult to simply stop feeling like your body is flawed, especially when unrealistic beauty standards are plastered all over the internet. For example, if you identify as a man and see a Calvin Klein campaign featuring incredibly muscled men, it’s easy to convince yourself that your muscles are too small, especially in comparison to those men. Not to mention that the men might have had silicone injections to make their muscles look bigger and that it’s their entire job to have big muscles, so all they do is train. Women face even more extreme beauty standards, which are especially harmful because they change constantly. In the 1800s, you should be plump and bushy-browed and pale; in the 1920s you should have a boyish, youthful figure and short hair; in the 1950s you should be curvy and feminine; in the 1980s you should be athletic and lean; in the 1990s you should be deathly skinny; in the 2010s you should have a big bum and defined curves. Everywhere you turn, even if you try to keep up with beauty standards, there is someone saying that your body is not good enough. You are too skinny for Kim Kardashian, but too curvy for Kendall Jenner. Not to mention that it is, again, these people’s jobs to make their bodies look a certain way, that they edit their social media posts to make themselves look better because their body is their brand and income, and that they usually get plastic surgery and then say it’s “just puberty.” The best way to combat body dysmorphia, given all these factors, is to convince yourself, or be convinced by someone else, that your perceptions of your body are not true and that you are good enough the way you are. Affirmations can help with this, as well as talk therapy where a person can voice all their fears and be validated but disproven. I also find that mirror pictures help, because when I am feeling lost in my body I can look at them and be reminded of how I truly appear.





Literature Spotlight 




Some Girls Want to be Princesses – Unknown

but I, I dream
of being a cantaloupe

in grade school I would fantasize about cutting myself
into bite-sized pieces
all I’ve ever wanted is to
feel palatable
oh how I wish I could simply
take a melon baller
and scoop myself out of me
leave little craters in my stomach
my thighs
my arms
man-made dimples sunken deep
into my moonlike skin
pale and cool and foreign

I don’t remember
the last time I ran my fingers
against my flesh
with some kindness
in my touch




Let’s talk about this poem. The narrator speaks as though she is trapped in a sinking ship and trying to break open a jammed door to escape. She wants to melon-ball out the little pieces of herself that she identifies with, and treat the rest coldly and without compassion.

She also mentions man-made dimples in the shell of her body. These make me think of plastic surgery, which is often used to erase a part of one’s body that is uncomfortable to them, but they also evoke self-harm. When your body is repulsive to you, altering it in damaging ways is less hard to imagine; if you don’t love something, you’re okay with it getting damaged.

We don’t all have to love or be obsessed with our bodies. Self-love is hard, since it might feel fake or vain; self-acceptance, on the other hand, is something we should all strive for. We don’t need to love our bodies, but let’s practice self-acceptance and be thankful for them, and take care of them because they take care of us. Let’s be blissfully neutral about our image until such time as we can look in the mirror and see what we feel being reflected back at us.

My body has lost weight when I asked it to, put on muscle when I asked it to. My body is able and strong; it allows me to ride horses and hike. My body digests the food I give it at its own pace. My body can go days without a good regime, if I’m stressed or stress eating or too busy to shower, and then bounce back afterwards with a bit of attention. My body has sat through countless exams and car rides and been flexible enough to get up and stretch after. My body is enough. 




Xtra Scoop of the Week – Dysmorphia and Plastic Surgery in East Asia

Body Dysmorphia in China 

Dysmorphia is a worldwide phenomenon, especially in regions where beauty standards are especially strict, like East Asia. Even buying clothes from East Asia is enough to worsen my own dysmorphia, since clothing sizes are so skewed; an American size 2 is considered a Large, and “one size fits all” clothing really only fits tiny people. In a self-report study of 487 first-year medical students in China, 32.5% (1/3 of participants) said they were concerned about some aspect of their body other than weight (shape, facial features, etc), and 1.3% of female participants were diagnosed with BDD. Those with higher levels of concern also had higher rates of depression and social anxiety (Liao et al. 2010). In Hong Kong, almost 5% of the population has body dysmorphia, which leads to low self-esteem and then plastic surgery addiction.

Plastic Surgery in East Asia

Plastic surgery is becoming excessively common in East Asia, and many people whose cosmetic surgery ideas have been rejected for safety go to Asia to have those procedures done. In South Korea, the country with the highest rate of cosmetic surgeries in the world (about 1 million procedures per year!), around one in three women (1/3 of the population) have had work done, and many are shocked by people who have not altered their bodies. Some of the most common procedures are skin whitening, because lighter skin is considered more attractive, nose jobs, where the nose bridge is enlarged, and double eyelid surgery, since monolids are considered unattractive. These beauty standards are as unrealistic as they are mentally harmful.




Weekly Testimonial – My Experience with Body Dysmorphia 




My body has changed many times since I was fourteen. I have gained weight, gained muscle, lost the weight too quickly, lost the muscle, gained definition in my stomach, gained less weight back, gained muscle, lost the weight, lost the muscle, gained definition in my stomach, gained some weight from binge snacking, and on and on. My body changes constantly; everybody’s does, and I can see that change in the mirror. I lost twenty-five pounds in four months during my last year of high school, and was unhealthily underfed. My weight has fluctuated since then, but only within 10 pounds, and I’ve been pretty healthy since I started college. But most days, despite looking in the mirror, I can still feel the weight from almost eight years ago.

Let me explain it this way. When I look at my stomach, I see that it is healthy; flat and covered with a very thin, very normal, and very healthy layer of fat. When I see my stomach in the mirror, it is the same. When I touch my own stomach, it is the same. But when someone else touches my stomach, I feel their hand at a distance, as if they are touching a thicker layer of fat that is no longer there. Logically, I know this is an illusion, but I have an intense emotional reaction to the added burden I still imagine myself carrying around.

Nobody is allowed to touch my stomach.

To some people, I probably seem pretty vain; I take lots of pictures of myself in the mirror and keep them on my phone, for example. But those pictures aren’t there to show off; they’re there for me to look at as affirmations when I forget the shape of my own body. Because of beauty standards for women that disgrace body fat and are completely unrealistic, I am haunted by my imagination and need to be comforted by reality almost every day.





That’s all for this week, folks!
Next week’s topic:
Attention-Deficit Hyperactivity Disorder




Any comments, questions, or concerns?
Want to share your own blog or announce something to the GTL Community?
Please let us know by responding to this email!