Psychopathology of the present: the case of gender dysphoria

G. Stanghellini

G. d’Annunzio” University, Chieti, Italy; “D. Portales” University, Santiago, Chile


Dialectic, person-centred psychopathology acknowledges the vulnerability constitutive of human personhood. It assumes that the person is engaged in trying to cope and make sense of disturbing experiences stemming from the encounter with alterity. Each patient, urged by the drive for intelligible unity of life-construction, with their unique strengths and resources, plays an active role in interacting with these experiences. The product of this yearning for meaning can be either the construction of a new identity, or vice versa mental symptoms. Mental symptoms are the outcome of a miscarried attempt to make sense of one’s disturbing experiences.

The crisis of the dialogue of the person with an alterity that inhabits one is at the heart of mental disorders. So-called ‘gender dysphoria’ is an exemplary case study of this interrupted dialogue between the person and oneself. In gender dysphoria, the person suffers from a marked incongruence between his or her experienced gender and the assigned sex, for instance, a person living with a man’s body who struggles to shape his body as a female body. This provides an illustration of the vulnerable duplicity that is inherent in the human condition and of the emergence of symptoms as the cypher of a miscarried dialogue with alterity. In gender dysphoria, the dialectics between one’s sexual body as alterity and one’s identity comes to a stop. Dysphoria, which is an unpleasant mood state characterised by uneasiness, irritability, restlessness and despair, is the core symptom of this disorder.

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