In a recent essay, I explored longstanding dissatisfaction about a bodily fact.  I'm happy being a woman, so I focused on a bodily fact that I've never been happy about.  My "persistent, insistent, consistent" desire for a rock-star voice was my best window into the disappointment over an aspect of one's body that has life-changing implications.

My description of unrequited desire for a powerfully pleasing voice was met with some sympathetic attention, which I found quite sweet.

Mine is one of many potential unhappy bodily realities, including height, build, hair (color, frizz, thickness, absence), eyesight (nearsighted, farsighted, colorblind), weakness, etc.  Seeing a healthy, functional limb as intrusive and alien causes unhappiness compounded by rational reasons that this doesn't evoke sympathy.

I don't intend my example to satirize or trivialize gender dysphoria.  I wanted a context, for which I had firsthand experience, of a bodily reality that precluded numerous desirable outcomes.  Cultivating a talent for singing has many positive implications, including a solid work ethic, mental concentration, clear professional objectives, romantic opportunities, and creative satisfaction.  Rock star ability and status can be deployed bringing joy to sick, suffering, and dying people.

But let's explore another scenario for a young girl lacking the dream voice.

In Melody's universe, singing deficits are viewed as gravely as gender dysphoria is now (not that gender distress is less serious in this universe, but bad singing is equally serious).  Identifying with one's distress would be given endorsement and support.  Tumblr groups would focus on the tragedy of unrequited longing to sing.  The official diagnosis would be Songbird Anguish Syndrome.  Surgeons would offer highly invasive and questionably effective experimental rock star affirmation procedures.  Experts would make wildly optimistic predictions about the potential for surgeries on the larynx, throat, esophagus to drastically improve singing.  Since people don't normally seek surgery for trivial reasons, most people would conclude that the problem is quite severe.  Insurance would cover rock star affirmation procedures. 

Reports of rockstar affirmation surgery failures would be met with disbelief.  Any skepticism of Songbird Anguish Syndrome would be denounced as songphobic.  Anyone suggesting noninvasive treatment for SAS and all desisting songbirds would face cancelation, doxxing, and social media brigading.

In this universe, an adolescent Melody would be highly vulnerable to unhappy ruminating about singing.  The one path she'd see would be the one leading toward singing.  If her mother had a thwarted career as a performer, or Munchausen by Proxy, Melody would be even less likely to discover other talents or interests compatible with a happy and productive life.

Our universe seems to be at the culmination of the frogs-in-a-pot scenario.  If, only a decade ago, we'd been presented a unitary phenomenon encompassing trans activism, trans politics, and trans medicine, it would have appeared misguided, unworkable, and unrealistic — perhaps a joke.  But more and more people have made various claims and demands.  Different innovations and controversies were getting increasing media attention.  In fits and starts, public perceptions shifted.

So great is the human capacity for thoughts, memories, and feelings to be reshaped by outside influences that even deeply personal memories can be distorted in a short time with simple techniques (demonstrated by Dr. Elizabeth Loftus implanting fictional memories of being lost at a shopping mall).  Our perceptions of ourselves, our wellness (or illness), and our emotions can be distorted by inaccurate or missing information and social contagion.  Recent cohorts of unhappy youth have engaged in waves of cutting, anorexia, goth gloom, and more recently gender dysphoria.  Not only self-harm, and harmless fashion fads, but also suicide rises and falls with public attention.

An example of awareness campaigns' potential to distort understanding or experience of a potentially serious personal health situation is overestimation of breast cancer frequency and the meaning of personal mammogram results.  In a 2012 NIH study, women with suspicious mammogram findings estimated their chances of cancer to be  32.8-41.1%.  In fact, follow-up of suspicious mammogram findings show benign conditions 9 times in 10, and only 0.5% are cancer (including noninvasive ductal carcinoma in situ or lobular cancer in situ).  Subjects' estimates that their diagnosis would be cancer were up to 80 times higher than their actual risk.

It would be foolish to rank suffering, or prioritize resources, for body dysmorphia based on which organ is the focus, rather than meeting needs based on the individual situation.  Since people with the same affliction can experience different levels of suffering, and distress can be increased — even accidentally — by outside influences, caution requires not assuming that gender dysphoria means extreme emotions in all instances.  Distress with serious, even life-threatening afflictions can rise and fall, and influence can greatly reduce the suffering.  Hospice care is based on the idea that even death itself doesn't have to be approached with terror and anxiety.

I say the above not to trivialize the suffering experienced by any living individual, but with hope that shifting focus to means short of extreme surgery and reconfiguring large swaths of our culture can both reduce suffering and maximize opportunities for such individuals to experience joy.

Image via Pxfuel.