What kind of dysphoria? Developing and validating the body and social gender dysphoria scale

Introduction. Gender dysphoria (GD), understood as the discomfort that can be associated with a mismatch between one's assigned gender at birth and their experienced gender identity, has traditionally been conceptualized and assessed through a clinical and medical lens, which has focused on the bodily dimension of incongruence and dissatisfaction. This perspective underpins the main clinical scales and research tools used, which recent studies show are seen as inadequate by many transgender and nonbinary (TGNB) individuals, particularly those with a nonbinary gender identity. Several studies (Cooper et al., 2020) have recognized GD as a complex and heterogeneous experience that involves and interrelates various dimensions such as the body, identity, and gender social norms. Likewise, qualitative research (Galupo et al., 2021; Lindley et al., 2024; Pulice-Farrow et al., 2020) has highlighted the importance of the interpersonal dimension and social context in the experience of gender dysphoria. When consulted firsthand, TGNB individuals provide diverse descriptions of dysphoria experiences that extend beyond the bodily aspect. The present study aims to develop and validate the Body and Social Gender Dysphoria Scale for assessing gender dysphoria within the TGNB population. Methods. In Study 1 (N=8), focus groups with transgender men and women and nonbinary young adults were conducted to explore both dimensions—bodily and social—of gender dysphoria, their interaction, and their variations over time and across different contexts. A thematic analysis (Braun & Clarke, 2006) was applied to each transcript, from which a pool of items was generated for the development of the scale. In Study 2 (N=50), transgender and nonbinary individuals, along with cisgender LGBQ participants, completed an online survey. The survey included an ad hoc schedule with questions investigating socio-demographic characteristics, and self-report measures of gender dysphoria, body dissatisfaction, minority stress, anxiety, depression, and rumination. Results. Preliminary results from the validation study of the Body and Social Gender Dysphoria Scale have shown a two-component factor structure, consistent with the constructs being operationalized. Moreover, the scale demonstrated good psychometric properties in terms of both reliability and convergent validity. Discussions. A broader understanding of the experience of gender dysphoria, informed by the voices of those who directly experience it, proves fundamental in both research and clinical settings. It is essential to move towards a more comprehensive assessment that captures all dimensions of gender dysphoria in their complexity and towards a treatment that is more sensitive and tailored to individual needs.