Gender dysphoria in the era of ideology: consequences of the misuse of concepts and their clinical implications

Abstract

Gender dysphoria is a complex phenomenon, characterized by profound distress resulting from an incongruence between biological sex and gender identity. Its understanding has been influenced by queer theory perspectives, which interpret gender as a fluid cultural construct detached from biological sex. This perspective, rooted in extreme constructivism, promotes the notion that gender identity is entirely self-determined, leading to epistemological confusion and significant clinical consequences.From an epistemological standpoint, ideology can be defined as the subjective perception of ideas, highlighting how these may differ from objective reality. Applied to the gender debate, this approach underscores the risk of misinterpreting concepts when they are detached from their scientific foundations. The distortion of the term "gender" as an exclusively subjective category has contributed to the pathologization of transient experiences and the premature medicalization of individuals, particularly minors. By prioritizing self-identification, this perspective contradicts established clinical principles outlined in manuals such as the DSM-IV, DSM-5, and ICD-10-11, which recognize gender dysphoria as a condition requiring rigorous and contextual evaluation. This shift has led to the promotion of rapid interventions, such as puberty blockers or irreversible surgeries, while disregarding psychological, social, and biological factors. Moreover, the exclusion of critical perspectives and the imposition of ideological frameworks have polarized public debate and introduced ethical and clinical risks. Reintegrating an epistemological analysis is essential for addressing gender dysphoria in a multidimensional and ethical manner.