Gender Expression Deprivation Anxiety Disorder

Transition is hard. Not transitioning can be harder.

These people are sad, depressed and deeply resentful… the more the individual struggles to rid themselves of gender dysphoria by increasing social and physical investments in their assigned sex, the greater the generalized anxiety and the harder it becomes to restart life sexually reassigned. I found Anne Vitale PhD on A Life Merely Glimpsed, whose writer identifies as a man who dreams of being a woman. There I also find Third Way Trans has stopped blogging, and made his blog private. Dr Vitale has reached her conclusions after decades of providing psychotherapy to gender variant patients. Now 71, she still maintains a website as a psychologist offering appointments by video call.

Dr Vitale says gynephile gender dysphoric AMAB people have an awful life, when they don’t transition. The androphiles have little difficulty expressing their femininity, dress androgynously and then transition successfully young. The gynephiles try to make men of ourselves. She was writing in 2003, and reporting childhood experiences in some cases from many years earlier. I hope no six year old boy would now be shamed for playing hopscotch with the girls- Arlene was brought to the front of the class, who were encouraged to laugh at her. The teacher had tied a broad pink ribbon to her. Now, some children transition.

Dr Vitale at first appears to blame intra-uterine hormones for gender identity- insufficient or inappropriate androgenization of the brain– but later says in some cases a “gender identity misunderstanding” can be “corrected” in some children. The explanation someone has for phenomena can affect their observations, as can any preconception. But I recognise the stories told. The children generally seek to fit in and follow the rules. They may be solitary, spending a lot of time reading or in solo sporting activity. They pray to God for transformation. In adolescence they cross-dress and masturbate.

In early adulthood many AMAB people present desperate to be told they are not transsexual, they fear transition so much. They can be particularly sexist- thinking negatively about women helps them fight the desire to be one. They think marrying, and then having children, will make their desires lessen.

Between 28 and 33 people generally reappraise their dreams and aspirations, and then gender dysphoric people may change sex or fight harder to stick to their assigned sex. In middle age those who have not transitioned may find the gender dysphoria gets worse as transition seems impossible, leading to depression, generalised anxiety disorder, panic attacks, despair and thoughts of suicide. One would close his office door, curl into the foetal position and weep- I only did that at home.

While Dr Vitale was aware of someone having GRS aged 71, other older people had low self-esteem and loathed their deteriorating bodies, though when aging reduced their testosterone levels that was a relief. Had they known their dysphoria was going to last, and be so dreadful, they say they would have transitioned when younger. They are depressed and resentful.

Written in 2003, this article anticipates the DSM V principle that the desire is not the mental health problem, rather the distress it causes is. Treatment should mitigate the distress. Dr Vitale observes hormones and surgery in most cases eliminate the anxiety. She says gender identity disorder is a continuum: some people will be satisfied with cross-dressing and do not need to transition.

This is an old article reporting twentieth century experience. Yet there are still older people who have not transitioned, who live closeted, who experience the distress and depression described. Younger people fighting against acknowledging their gender dysphoria, and terrified of transition, should consider how they would feel with similar desires in old age. Those who advocate against transition should be made to demonstrate some other treatment or course of action will produce better results.

Aware of mirrors in art in the Arnolfini portrait and Las Meninas by Velasquez, I magnified this mirror- but Simeon Solomon does not appear.

5 thoughts on “Gender Expression Deprivation Anxiety Disorder

    • Thank you. You wrote,

      Several years ago, we did a Transition Thoughts and Reflections series of guest posts on T-Central. One of the posts was written by a very closeted man in his 90’s, known internationally in his field during his working years. I referred to him as “A”. He had read some of my early blog posts and closely related to my own thoughts of not transitioning. We emailed back and forth for several years. It was very clear from the discussions I had that this 90 year old guy would have transitioned in his teens or 20’s had he been that age today. Instead, he lived closeted his entire life, partially because he was afraid of what his family would think but also because he was so well known. A couple of years ago, I received an email from his son, letting me know that he had passed away. The son knew nothing of his father’s inner gender identity demons until he got into his father’s computer and discovered my emails. He was so sorry his father had never revealed any of this to the family.

      Yes. Love and sacrifice. I know people who have made that sacrifice, and it is hard. Sometimes it produces beautiful things as well as the pain.


  1. Hi! I googled GEDAD on a whim tonight and found your lovely article. I hadn’t thought about Dr.Vitale’s article in a looong time but stumbling over it randomly a few years ago prompted me to pick up the phone and get a referral to a GIC (in my mid-40s) after a lifetime in the closet trying to find some androgynous compromise that let me have my cake and eat it.

    I had my 2nd GIC appointment a couple of weeks ago (3 years since I got the referral) and I’ve been fully out as myself for almost 2 years now and have never been more content. Coming out was almost too easy! I don’t really spend a lot of time philosophising about being trans any more (I decided long ago that accepting being trans was way more important than understanding it) but it crossed my mind this evening that I never see any reference to GEDAD or Dr.Vitale so looked it up. Your essay was really interesting to read and I appreciate how dated GEDAD must seem now but I wanted you to know how much of a powerful chord it struck in me all those years ago. Thank you. Jax x


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