Beyond and through the body: Developing and validating the Body and Social Gender Dysphoria Scale

Background: Gender dysphoria (GD) has traditionally been approached through a medical lens emphasizing bodily incongruence and dissatisfaction. Recent studies show that the main clinical scales and research tools used to assess GD are perceived as inadequate by many transgender and nonbinary (TGNB) individuals, since they fail to consider many aspects of their subjective experience. Qualitative research indicates that GD involves multiple dimensions, highlighting the importance of interpersonal and contextual factors. This study aimed to develop and validate the Body and Social Gender Dysphoria Scale among Italian TGNB and cisgender LGBQ adults. Methods: In Study 1 (N = 13), focus groups were conducted with TGNB young adults (mean age = 21.8, SD = 2.8) to explore bodily and social dimensions of GD, their interactions, and fluctuations over time and across contexts. A thematic analysis of the transcripts, together with prior qualitative research, informed the creation of an initial item pool. Study 2 (N = 229) included TGNB and cisgender LGBQ adults (mean age = 25.7, SD = 6.3) who completed an online survey. Results: Exploratory factor analysis (EFA, promax rotation) conducted on the newly developed items indicated excellent sampling adequacy (KMO = 0.94) and a significant Bartlett’s test (p < .001). Preliminary findings revealed a three-factor structure—Bodily Dysphoria, Interpersonal Dysphoria, and Sociocultural Dysphoria— consistent with the constructs being operationalized. Discussion: A comprehensive understanding of GD, informed by firsthand experiences, is crucial for both clinical and research contexts. The scale has the potential to capture multiple dimensions of GD—bodily, social, and contextual—and thereby offer a more inclusive approach for assessment and intervention. Future steps include confirmatory factor analyses and longitudinal validations. This broader perspective may foster more sensitive, tailored treatments addressing TGNB individuals’ diverse needs.