Cognition, emotion, and motivation in gender diversity

This was a research paper that I got to write for my doctorate program!

Cognition, emotion, and motivation in gender diversity
 
Lisa R. Macafee
California Southern University
PSY 8724 Cognition, Emotion and Motivation
Dr. Debra Pearce
August 15, 2021
 
Cognition, emotion, and motivation in gender diversity
This paper discusses how cognition, emotion, and motivation affect the construction of gender.  This paper will discuss the personal, environmental, and sociocultural components involved with gender diversity.  Gender diversity includes any gender identity outside of cisgender (identifying as the gender assigned at birth).  Transgender identities, often called “trans” for short, include anyone who does not identify 100% with the gender assigned at birth and can include trans men, trans women, non-binary, gender fluid, 3rd gender, agender, gender non-conforming, and pangender identities.  Approximately 0.6% of adults and 2.7% of adolescents in the United States identify under the transgender umbrella, with younger individuals coming forward and an increasing number of non-binary individuals (Bowman, Casey, McAloon, Wootton, 2021).  Trans and gender diverse are used interchangeably in this paper.  I am writing about gender diversity because I identify as non-binary and work with the LGBTQIA+ population to provide supports for the community.

Cognition around gender
Thankfully, people are broadening their understandings of gender and are beginning to see sex and gender more broadly and less on the binary.  Cisgender heterosexual individuals have the least cognitive understanding of gender and sex as fluid or complex and tend to define more based on biological terms, while transgender and gender diverse individuals understand gender in more complex terms in sociocultural context.  Younger individuals perceive gender more as a spectrum when compared to older individuals who think more in binary terms that are explicitly tied to the sexual parts an individual possesses.  The more power and privilege a group has, the more likely they are to hold in place discriminatory systems that benefit them.  For example, White people and men are both more likely to hold essentialist beliefs about sex and gender and are more likely to attribute gendered traits to genetics.  Groups who have been disenfranchised are more likely to question the same hierarchies and critically engage with them, leading to a more nuanced understanding of the hierarchies of gender and sex.  Minoritized people are more likely to think about sex and gender in inclusive terms, such as: sex and gender may not match, gender assigned at birth may be different from gender identity, individuals may move between genders, be somewhere in between, or be no gender.  Thinking more inclusively better ensures that others are not harmed by the individual’s definitions and excluded from their conceptions and resists biological essentialism (Schudson, Beischel, van Anders, 2019).

There are many gendered expectations for those who are gender diverse that can be confusing at times.  For myself, I remember clearly being told in high school that I was a “dude with ovaries” and that I should just admit that I was a lesbian, because clearly a person assigned female at birth (AFAB) who was gender non-conforming must be gay.  The conflation of gender and sexuality is rampant both within queer communities and cisgender-straight communities.  People often see atypical gender presentations such as a feminine man or masculine woman and assume they are gay.  This assumption is sometimes accurate, but often it is not.  Gender and sexuality are not tied together, but our socialization tells us it is.  Trans individuals are expected to be straight and hyper-gendered.  Being trans and gay confuses people who do not experience the gender dysphoria present in many trans individuals pre-transition.  Many trans individuals continue to experience gender dysphoria during and after transition.  These individuals may have adopted the idea that they need to transition all the way to the opposite binary gender assigned at birth and that an in-between gender identity is somehow unintelligible.  There is pressure that to be truly trans, one must conform to society’s expectations of “male” and “female”.  To avoid criticism, individuals must adopt a cisgender mask to be palatable and not confuse others.  For trans folk, “passing” is a privilege and difficulty.  Dealing with microaggressions and aggression causes gender diverse folk to constantly question themselves; ‘Should I try to pass more to avoid harassment?’;  ‘Should I live “out” more to advocate for trans rights?’;  ‘Is it my responsibility to educate every person who misgenders me or tries to convince me I’d be happier as a cisgender person?’  Existence is an act of rebellion for many of us gender benders, and it is exhausting. (Jones, 2021).

Many trans and non-binary individuals experience some degree of gender dysphoria.  Gender dysphoria is experienced when there is an incongruence between the gender assigned at birth and the gender identity an individual holds that causes them distress.  Individuals experiencing gender dysphoria may feel uncertainty, stigma, guilt, and body dissatisfaction on their journey to living more authentically as their authentic gender instead of performing as the gender they were raised to be.  The feeling that the experience of gender a person has is wrong is often accompanied by increased levels of anxiety, depression, self-harm, and suicidality.  Many individuals are able to resolve the gender incongruence that causes distress by gender-affirming practices such as social transition, hormone blockers for adolescents, hormone therapy, and surgery.  Others may also need therapy to resolve the internalized gender issues.  When a person has been raised from infancy to be a certain gender with certain gendered personality traits and they do not feel that is an authentic way of being for them, it is often not simply a light switch to be turned on and off from one gender presentation to the other, it requires a great deal of processing to be able to exist in a  new presentation to the world from the previous indoctrinated presentation.  I have been in my gender journey for only a few years as before that I simply attempted to be what I was told I should be.  I have always known I was different from others, and a “tomboy”, but didn’t have the vocabulary to process what that might mean for me until recently (Bowman, Casey, McAloon, Wootton, 2021).

Emotion and gender
One of the emotional factors that most people who are not gender diverse don’t understand is the constant presence of fear.  Fear of being discovered, fear of sharing one’s identity with someone and being rejected for it, fear of persecution, fear of the unknown fear of oneself.  One of the most harmful fears is the fear of getting effective and appropriate medical and psychological care.  Many trans individuals navigate shame and social rejection just for living as who they are.  Seeking out mental health support often results in a gender dysphoria diagnosis and pathologisation leading to pressure to live as the gender assigned at birth or 100% the opposite gender assigned at birth instead of mental health support for the depression and anxiety that is often the result of being different.  Not enough therapists are adequately trained to work with gender diverse clients (Jones, 2021).

Many people, both gender diverse and cisgender, have a great deal of internalized cis-sexism; the unconscious belief that being cisgender is superior to being transgender.  Leading to this outcome are the heightened levels of physical, verbal, and sexual assault that transgender and gender non-conforming (TGNC) individuals experience compared to their cisgender peers.  TGNC folks also experience higher levels of mental and physical health problems and higher levels of substance abuse as a coping methos compared to their cisgender peers.  This is understandable considering the amount of minority stress and cis-normative frameworks that TGNC people experience.  When TGNC people attempt to educate those around them who microaggress against them by imposing cis-normative expectations, this often leaves the TGNC individual exhausted and anxious after being vulnerable with people who often have hostile and negative responses.  I have experienced this so many times now that instead of calling someone out in the moment, I have begun offering LGBTQIA+ Foundations trainings to faculty, staff, and students at my campuses so those who do want to be better can.  It is my intention by speaking up loudly and clearly and getting administrative and mainstream support across campus that the culture of the institutions that I work in will change enough to better support TGNC students and staff and suppress anti-trans hostility (Ehlinger, Folger, Cronce, 2021). 

Non-binary individuals often feel pressure from the LGBTQIA+ and straight communities to try to “pass” as male or female, being neither often makes people uncomfortable.  I identify as non-binary and the experience of having my very existence making people uncomfortable makes me feel anxious and pressure to conform, it is difficult not to internalize that making people uncomfortable is problematic on my part, and not their responsibility to accept more diverse people.  I am left with a sense of “otherness” that I am unable to shake, a feeling that I will never be part of any group, because I do not fit into their molds.  I realize that as a White person, I experience a greater privilege than TGNC people of color.  It becomes clear that TGNC people of color are some of the most disproportionately impacted people in the Unites States because they face cis-sexism in their cultural communities and racism in the queer communities.  The feelings of alienation and otherness from most communities leaves TGNC individuals at high risk for substance abuse and self-harm, increasingly so with added marginalized statuses such as race, ethnicity, immigration status, socio-economic status, (dis)ability, and sexual minority status (Ehlinger, Folger, Cronce, 2021).

Motivation and gender diversity
For some to get gender treatment, they must conform to binary gender stereotypes and be transgender to qualify for physical and mental health services.  This pressure to fit into a false binary existence to get care causes motivation to be hyper-masculine or hyper-feminine, which can cause its own gender dysphoria (Jones, 2021).  For individuals who are delayed in their gender and sexuality exploration and identity formation, they often experience negative mental health impacts (Hawke, Hayes, Darnay, Henderson, 2021). I am 39 years old and only started to think about my own gender four years ago when I attended a presentation that discussed a term I had not heard before, transgender and gender non-conforming (TGNC).  This identity label changed my life.  I had lived with a baseline level of anxiety and depression and lack of belonging my entire life, and this term just explained why.  While I do not identify as a female, as I was assigned at birth, neither do I identify as male.  I identify as outside of those repressive roles and cannot fathom how others truly feel safe in those identity boxes.  

The moment I decided it was okay to be atypical in my gender presentation approximately two years ago was when my confidence started to scale upwards, and my motivation increased.  I collected others involved in gender justice, organized groups, gave trainings, and started multiple services at the colleges I work at for students like me (and those not like me, but struggling with similar fears and anxieties).  I recognize the suffering in others and am more able to take action to lessen such suffering now that I have accepted myself.  It’s only been four years since I started to think about how the gender role expectations that I had tried to live inside of for my adult life were stifling and depressing.  In those four years my career has blossomed as others see drive and confidence instead of fear and nervousness.

Personal Factors
Many gender diverse individuals end up losing their positionality in their family of origin as certain members are too rigid in their beliefs or strict in whom they accept to allow a non-binary family member a proverbial seat at the table.  Gender diverse individuals often lose financial supports, familial supports, and socio-emotional supports if they dare to express themselves as who they are.  The real or perceived fear of losing these supports may cause gender diverse individuals to attempt to conform to cisgender expectations to avoid losing social and financial assets (Jones, 2021). 

There has been talk in conservative media outlets claiming that 80% of gender expansive children will grow up to be cisgender in adulthood.  The flawed research studies that promote this idea warn parents of trans children not to provide life-saving gender-affirming treatments to youth because their experience of being transgender is a phase.  There are many personal factors that account for individuals who did receive gender-affirming treatments and regret it such as a realization that they are non-binary instead of trans-binary, the cost of living out and trans was too much for the individual to bear, and discrimination, among only a few of the reasons people de-transition that are not “a phase”.  However, more recent research suggests that 96% of all trans youth continue to identify as gender diverse into adulthood.  Gender-affirming social transition such as name and pronoun change, clothing, hair, and demeanor, have shown to save lives and increase general well-being for gender diverse individuals.  Those who socially or medically transition are more likely to have personal factors of family and peer support, be White, and have a high socio-economic status (Ashley, 2021).

An additional personal factor that influences an individual’s desire to present as gender non-conforming for those assigned female at birth (AFAB) is internalized sexism.  Many AFAB individuals have internalized so much negativity and associations of weakness about femininity that they cannot stand to associate with it.  For some, to be female is to be vulnerable, more emotional, less successful, more domestic, and associated with being a caring nurturer instead of an independent provider.  These individuals may present as “butch” lesbians, trans men, or other identities.  They can bring a high degree of sexism to the queer community and discriminate against feminine lesbians, trans women, feminine gay men, and others, often their own partners (Ivey, 2017).

Environmental Influences
Environmentally speaking, there is a serious safety concern when out in society as a gender diverse person.  When someone doesn’t fit into the expected binary categories, people who are uncomfortable with non-binary genders often react with hostility.  This can range from micro-aggressions to physical assault.  I was harassed and called names daily because I did not conform to gender expectations and took to carrying a knife with me to school because I did not feel safe.  Some trans folk are told they make others uncomfortable and are barred from working with vulnerable populations such as foster youth and domestic violence survivors.  This is especially unfortunate because a high percentage of foster youth are gender non-conforming, which is often why they are in foster care in the first place (Jones, 2021). 

There is an upsetting amount of cissexism and racism in queer and trans places that further marginalizes gender diverse people of color.  Queer communities were mostly built around the work of White gay men, and many queer spaces are not as welcoming to gender minorities as they are to sexual minorities.  The racialization of trans individuals of color impacts their experiences and differentiates them from their White trans peers, often making it difficult to find communities where they feel they belong.  Being a trans individual is marginalizing and being a trans individual of color is exponentially marginalizing due to the increase in factors that may bring discrimination from different groups.  Trans people of color are some of the most marginalized people in the United States and benefit from being in environments that are actively anti-racist along with anti-cissexism and White allies that do their homework to learn about the disproportionate impacts on queer people of color (Simms, Nicolazzo, Jones, 2021).

For individuals whose gender does not conform to what they were assigned at birth, typically referred to under the transgender umbrella, the rates of PTSD are significantly higher than the general population with trans rates of PTSD between 17.5%- 45% compared to 5%-10% for the general population.  This heightened rate of PTSD is likely due to the increased risk of victimization and trauma that trans people experience living in a hostile social environment of discrimination, rejection, harassment, non-affirmation, internalized transphobia, expected rejection, and concealment.  When someone lives outside their gender expectations and they experience anti-transgender bias and non-affirmation, this is traumatizing to the individual who is not only feeling rejected and as though they don’t have a right to exist, but also because the more negativity around their gender they experience, the more they are likely to internalize transphobia and negative feelings around their gender themselves.  The more the individual has internalized transphobia, the less regulatory functions their brain is able to use to protect their self from the effects of trauma and the more severe their PTSD symptoms tend to be.  It is crucially important that trans individuals find environments that validate and celebrate their gender identity for them to reduce their internalized transphobia (Barr, Snyder, Adelson, Budge, 2021).

Sociocultural Components
Being gender diverse in a culture that only approves of the cisgender narrative creates mental stress.  The two typically accepted cultural spaces for gender diverse individuals are to put on a cisgender mask and bury their authentic gender diverse self or transition to the opposite binary gender and be accepted in some queer communities but live in a marginalized and dangerous space.  For people choosing a binary trans experience, they are often exposed to the word by their physical characteristics as transgender.  For those trans folks who are “passing” (viewed as cisgender the gender they present as), when people learn of their transgender identities, some individuals may feel as though they have been lied to, which produces agitation and resentment.  Few spaces allow for identities in between the binary gender expectations (Jones, 2021). 
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Many queer activists believe that trans folk should be “out” to the world as trans to propel the cultural acceptance of trans identities, but living publicly as a gender diverse individual brings safety risks and discrimination, exponentially so if the trans individual lives in intersecting identities of racial, socioeconomic, or (dis)ability status.  Many gender diverse individuals feel pressure to represent transgender identities in the world while at the same time negotiating their physical safety (Jones, 2021). 

Conclusion
I am completing my PsyD to provide gender-affirming therapy services to trans and gender diverse individuals.  I know from experience how frustrating it was when I asked my therapist about non-binary and she blew me off.  I know how discouraging it was when I asked my health care provider about being intersex and having her tell me that “if you were a hermaphrodite, you’d have a penis”.  Please note the two very different words used of “intersex” and “hermaphrodite” (an offensive and dated term).  The mental and physical health communities are grossly undereducated about queer issues and uncomfortable providers often come off hostile to individuals who are just trying to survive.  I know that when people feel supported and validated in their intersecting identities, they have higher senses of well-being, are more successful, and exhibit less mental health struggles.  I want to be part of the solution.

References:
Ashley, F. (2021). The clinical irrelevance of “desistance” research for transgender and gender creative youth. Psychology of Sexual Orientation and Gender Diversity. https://doi-org.csu.idm.oclc.org/10.1037/sgd0000504

Barr, S. M., Snyder, K. E., Adelson, J. L., & Budge, S. L. (2021). Posttraumatic stress in the trans community: The roles of anti-transgender bias, non-affirmation, and internalized transphobia. Psychology of Sexual Orientation and Gender Diversity. https://doi-org.csu.idm.oclc.org/10.1037/sgd0000500.supp (Supplemental)

Bowman, S. J., Casey, L. J., McAloon, J., & Wootton, B. M. (2021). Assessing gender dysphoria: A systematic review of patient-reported outcome measures. Psychology of Sexual Orientation and Gender Diversity. https://doi-org.csu.idm.oclc.org/10.1037/sgd0000486

Ehlinger, P. P., Folger, A., & Cronce, J. M. (2021). A qualitative analysis of transgender and gender nonconforming college students’ experiences of gender-based discrimination and intersections with alcohol use. Psychology of Addictive Behaviors. https://doi-org.csu.idm.oclc.org/10.1037/adb0000752

Hawke, L. D., Hayes, E., Darnay, K., & Henderson, J. (2021). Mental health among transgender and gender diverse youth: An exploration of effects during the COVID-19 pandemic. Psychology of Sexual Orientation and Gender Diversity, 8(2), 180–187. https://doi-org.csu.idm.oclc.org/10.1037/sgd0000467
Ivey, G. (2017). Gender mobility in the countertransference: An autoethnographic investigation. Counselling & Psychotherapy Research, 17(1), 42–52. https://doi-org.csu.idm.oclc.org/10.1002/capr.12101

Jones, D. B. (2021). De-colonising My Trans Body: Fanon and the masks I have worn. Existential Analysis: Journal of the Society for Existential Analysis, 32(2), 322–332.
Schudson, Z. C., Beischel, W. J., & van Anders, S. M. (2019). Individual variation in gender/sex category definitions. Psychology of Sexual Orientation and Gender Diversity, 6(4), 448–460. https://doi-org.csu.idm.oclc.org/10.1037/sgd0000346

Simms, S., Nicolazzo, Z., & Jones, A. (2021). Don’t say sorry, do better: Trans students of color, disidentification, and internet futures. Journal of Diversity in Higher Education. https://doi-org.csu.idm.oclc.org/10.1037/dhe0000337