The Problem with Medicalizing Trans Identity

Dr. Z addresses a topic that frustrates her deeply as someone who has specialized exclusively in gender dysphoria for 20 years: the medicalization of transgender identity.

The harmful narratives proliferating in trans communities:

"You're not transgender unless you're on hormones or having surgeries." "You're not woman enough because you're not on hormones, or you're on hormones but not socially presenting, or you haven't had bottom surgery." "You're not trans unless you have very severe gender dysphoria."

These statements reflect a narrow, limited understanding of how dysphoria manifests, presents, and affects individuals across the lifespan, contexts, cultures, and circumstances. No two people experience gender dysphoria in the exact same way. Dysphoria ranges depending on a multitude of factors, including psychological makeup.

The core problem:

This way of thinking medicalizes gender identity—it defines being trans by hormones in your body and gender-affirming surgeries. It says your gender identity doesn't start until you go through hormones and a medical transition. That makes zero sense.

In this video, Dr. Z addresses:

Why reducing trans identity to medical interventions is false and harmful. How it negates non-binary individuals and those with social dysphoria but not physical dysphoria. Why gender identity is a subjective reality—not just anatomy, hormones, or chromosomes. How medicalization shepherds people into surgeries they may not need. What gender transition tools actually provide versus what defines your identity.