Actually, it's interesting, but this can
be one of the symptoms of clinical gender dysphoria. It is related to another mental issue which is known as (interpersonal) rejection sensitivity syndrome — one of the many possible symptoms of atypical
depression, which has high comorbidity with gender dysphoria.
Now in plain English :-)
Gender dysphoria is almost always diagnosed with (at least) depression and anxiety — where the anxiety is often being expressed as 'irritation' (i.e. being easily angered by circumstances, by what others tell us, and so forth). 'Depression' is actually a family
of mental disturbances — at least five major types, but I believe they have recently added a few more — of which the most well-known is the so-called melancholic depression
. Laypersons will often equate 'feeling sad' with a melancholic state, and it's true that individuals suffering from melancholic depression will often feel sad (or, rather, they will lack the ability to feel pleasure and interest in anything
), and, exactly because they cannot derive any pleasure from anything, they will often become apathetic, unwilling to leave their homes (or even beds!), refusing to do even the simplest things (like taking a bath every day), and so forth — everything is for them incredibly painful and difficult to do, requiring an overwhelming effort.
However, although melancholic depression is the most common case, and the one that is more easily diagnosed both by doctors and even laypersons, it's by no means the only alternative. Unfortunately (for gender dysphoric persons, that is), there is a different type that is also very common among us, known as atypical depression
. As its name implies, the atypical depression has atypical symptoms — and that means it's usually very hard to diagnose, both by the person itself, but also by friends and family dealing with them on a daily basis, and often eluding the perception of many doctors as well.
In melancholic depression, the brain lacks enough serotonin to feel pleasure in any activity, or, even if the levels of serotonin are high enough, it gets flushed too quickly out of the brain for it to have any effect. Early 'happy drugs' to treat depression would increase the level of serotonin, in the hope that it would also affect the brain positively that way. Today, if doctors suspect that the serotonin cycle is working well, just being flushed out of the brain too soon, it's better to tweak the 'flushing' mechanism so that the brain still has time to react to the serotonin. This works rather well, and there are a lot of complex chemicals that can be synthesized to command the 'gates' inside the nervous system that regulate the 'flushing' mechanism. Those medicines will allow serotonin to pass into
the brain, but make it very hard to escape the brain again. That's why most
depression treatments will work reasonably well.
In atypical depression, things are a bit weirder. The serotonin cycle works well for just one single activity
, but is not functional for any other. What this means is that the individual will constantly seek the only
activity that provides them some pleasure, while avoiding all other activities (just like melancholic depression). The activity can be 'anything' really — from loving to eat food, to doing sports (or watching them), to reading books/watching TV/playing computer games, to having sex... which will make the diagnosis harder, since it will make the depressed person seemingly avoid all activities (including work, or taking care of their families) just to engage in the single activity that gives them pleasure. So they will be seen as lazy and superficial, since all they do is having fun with that particular activity, and refusing to do anything else. While doing that activity they are of course very happy, energetic, even euphoric — so they are not seen as being 'depressed' at all. Not surprisingly, the diagnosis might really take a long
time to be observed (it might happen when someone is kicked out of their job because they're always absent or becoming incompetent), and, once it is
diagnosed, most people will not really believe
in the diagnosis (often not even the one suffering from it!), because it's a 'mental disease' so different from what people have experienced or read about. Atypical depression, even though reacting well to similar medication than other kinds of medication, as well as being treatable with similar therapies, tend to be way harder to 'cure' than the more common melancholic depression.
For a crossdreamer with gender dysphoria and atypical depression, this means obsessively focusing on the crossdreaming activity (whatever it might be) and pretty much forget the rest. If they crossdress, this means crossdressing as much as possible (because not
being crossdressed will not trigger the serotonin mechanisms) in order to feel a bit of 'happiness' again — because everything else is just incredibly boring and uninteresting and even worthless. For my wife, this was quite strange, since I truly focus all
my time and energy in crossdressing, and, when doing so, I'm quite willing to spend endless hours in 'dressing up', be with friends, go out to all kinds of places, and so forth — and in the occasions when I'm not
crossdressed, at least I keep in touch with the community, write articles on my blog, and so forth. It's not unusual, therefore, for such people to be truly convinced that if they had
been born in the gender they identify with, they would always
be happy, because when they crossdress, they are always
happy — the solution to their problem, therefore, seems
to be transition (and, indeed, it works well in many cases).
One of the most uncommon and unusual symptoms of atypical depression is (interpersonal) rejection sensitivity syndrome
(RSS). This is a condition where people are afraid of saying something wrong, in order to avoid being scalded/laughed at/pointed at/ostracized, whatever. Such persons tend to try to make others happy, or at least avoid to make them angry at them; they try to give their best (even when often it's physically impossible to do so!) because they are truly afraid that being 'slightly below the best' might elicit complaints — which they will try to avoid like the plague. This naturally complicates things, as it's impossible to please everybody at all times; sooner or later, there will
be someone unhappy or angry at us, and this will completely render us with a feeling of being useless and hopeless — or sometimes will make us unreasonably angry in return — therefore feeding both
the depression and
Most people don't even recognize the 'rejection sensitity syndrome' as being an abnormal mental condition — they just believe it to be a trait of their personalities, the desire to make others happy (so that they don't get angry at them, therefore making them happy too). It's not a totally altruistic feeling (since ultimately someone with RSS will just want to be left in peace, without anybody being angry at them) but because our societies actually encourage
altruistic behaviour, people with RSS will (incorrectly) believe that they have the 'right' attitude by trying to please others all the time, while, at the same time, neglecting their own well-being, which is seen as 'secondary' compared to everybody else's well-being.
Lastly, gender dysphoria also may
have some symptoms of body dysmorphia
, even though there is a strong purpose in that specific kind of body dysmorphia: they believe they look terrible as the gender that they were assigned at birth, and which to look like the 'ideal' person of the gender they identify with, even though this is hard to do without major surgery and hormone treatments.
So... to conclude... all these things play together and feed each other. Someone with gender dysphoria might look themselves in the mirror and see how 'ugly' they are in the gender assigned at birth, with which they don't identify at all. So they want to 'become' the person of the gender they identify with. They might just start crossdreaming about it, but this, in turn, might not be enough. Crossdressing might become the next step, but it will never be 'right'. In the desire to please everybody, it will also mean becoming obsessive in 'passing', in looking great like 'the other girls' (in the case of MtF crossdreamers with gender dysphoria). This will be very hard to accomplish in most cases (unless you have the luck of having been born in the perfect androgynous body!), so there will be a sense of frustration which will slowly and over time develop as anxiety (the urge to 'look your best', becoming nervous or very irritated when you do not
'look your best' even after hours of applying make-up) and depression (because somehow there is never enough time to do a 'good job', or one lacks the required skills for doing 'a good job', or any of a million possible — but not really plausible — excuses). This continues to feed upon itself, and driving crossdressing to an obsession: the obsession to pass, the obsession to spend as much time as possible as the person of the gender one identifies with. The serotonin system in the brain starts to fail, and only
crossdreaming/crossdressing activities will make the person happy … nothing else will matter. This, in turn, will increase the obsession — and, as the result is never
perfect, it will only make the cycle loop back and back on itself, becoming much more aggravated with each turn. At some point, that person will genuinely think that they will only be able to overcome all those mental disturbances with transition, and living full time as the gender they identify with — anything else short of that will not provide any happiness. Also note that all of the above feels as 'absolutely normal' to the person suffering from all that, because those mental conditions will strongly affect one's perceptions.
Now of course I'm talking about the extreme cases, but this is a bit what 'gender dysphoria' feels like to me — someone not only with gender dysphoria, but with severe atypical depression, anxiety (fortunately cured by now, thanks to awesome new-generation medication), and rejection sensitivity syndrome and (slight) body dysmorphia, present at least since my pre-teens. I don't know exactly when the atypical depression started, although I recognise the triggers that turned it from 'mild' into 'severe' ('mild', in this scenario, just means that the symptoms were there, but I could deal with them and lead a 'normal' life; 'severe' means that only medication and a lot of therapy will have any chance of allowing me to deal with 'reality'). It's obvious for me now that what I have been feeling for a long, long, LONG time has been nothing more and nothing less than decades-long gender dysphoria, which has never been diagnosed, but rather strongly repressed for decades upon decades. And at some point this simply 'blew a fuse' :) My brain stopped its 'rational' bit, engaged in atypical depression as an 'escape' mechanism (i.e. by forcing
me to focus on my crossdreaming/crossdressing/identity discovery experiences), and, to make sure that I didn't deviate from the Path to Enlightenment, it provided me a nice host of complementary issues (anxiety, obsession, slight body dysmorphia, rejection sensitivity...), so that I can only focus on the gender I identify with (or think that I identify with) and completely forget about everything else — because, as soon as I start dealing with the Everything Else, I actually get psychosomatic symptoms (dizziness, ear ringing noises, nausea, strong headaches, and so forth), the product of a deluded brain, distorting my experience of reality, which is fighting hard against my strong and stubborn will to resist — and using truly unfair 'weapons' in this fight!
Ironically enough, the 'cure' to deal with so many issues at the same time is to crossdress more (while doing other tasks that my brain refuses to do, like working on my job — from home, of course, since there is no way I could return to my job as a woman :) ). It's interesting how some simple tricks (psychologists, of course, call it 'therapy'...) are able to completely 'fool' the brain and forcing it to 'behave', i.e. to do what we expect it to do. Such moments make me always pause in wonder, as I notice that I can detach my mental processes (those that I attribute my identity to) to the activities of the brain, some of which make no sense to me — but I nevertheless do them.