Trans Health: Mindfulness and Exercise

If you have been following me for a while, or have read some of my earlier content, you already know that I experience something called gender dysphoria, a condition in which a person feels dissatisfaction, distress, or restlessness as a result of their assigned sex not being in-line with their true gender. If you haven’t, shame one you! Now go pay penance for your sin by catching up on my stuff! Don’t worry–I’ll wait.

The American Psychological Association explains that much of the distress trans people feel is a result of their struggle to fit in and find acceptance from others in addition to other obstacles such as lack of access to proper medical care. They also take care to mention the following regarding the diagnosis “gender dysphoria” that appears in the DSM-5:

“According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people who experience intense, persistent gender incongruence can be given the diagnosis of ‘gender dysphoria.’ Some contend that the diagnosis inappropriately pathologizes gender noncongruence and should be eliminated. Others argue that it is essential to retain the diagnosis to ensure access to care.”

As with other diagnoses, the gender dysphoria diagnostis unnecessarily applies a label to a human experience that brings with it all kinds of negative connotations. Hence all the transphobes who mistakenly use the DSM-5 to dismiss trans people as mentally ill (never mind the ableism contained in the dismissal). However, it looks like the diagnosis isn’t going away any time soon and regardless of its status in the DSM-5, many transgender individuals still have to deal with their distress. Of course, there are all kinds of resources for that such as gender confirming surgeries, hormone replacement therapy, counseling, support groups, etc. Now, that’s all fine and dandy if you have access to all of those things, but what is a trans girl/boy/enby to do if those are not realistic options?

Good question! One thing that anyone–regardless of their ability to access other forms of treatment–can rely on is good old meditation and exercise. It is already well known that mindfulness, the practice of being present, provides all kinds of psychological benefits that range from reduced stress to enhanced working memory. In her paper published in the journal Cognitive Therapy and Research, Patricia C. Broderick compared three different coping mechanisms for dealing with dysphoria (what she refers to as “dysphoric mood”)—a more generalized kind of distress—that include rumination, distraction, and mindfulness meditation.

She found that rumination was associated with increased dysphoria while distraction was associated with a mild improvement (consistent with research that came before). Mindfulness meditation proved to be the most effective with the greatest associated decrease in dysphoric mood. So it looks like being in touch with yourself and your feelings from a non-judgmental point of view is healthy. Imagine that!

Okay, so based on this and other research, it looks like mindfulness is a good way to go. Indeed, it was a fantastic therapeutic technique that I did in and outside of therapy that helped me learn how to cope in a way that was far more productive than what I tend to do: ruminate,i.e., get caught in a vicious cycle of feeding my depression and anxiety by thinking all kinds of horrible things about myself or what might happen to me. Regarding rumination, Broderick explained the following:

“Because the link between ruminative coping style and negative [emotional states or dispositions] is so clear, it is extremely important for clinicians to be able to interrupt this negative cycle…”

Another way to treat dysphoria involves physical activity and exercise. Physical activity and exercise can be forms of distraction, but they can also be sources of improved overall mental health. Okay, so that’s all well and good, but what if you don’t have time to meditate and exercise? Though it is not totally clear whether or not exercise combined with other forms of treatment such as mindfulness meditation results in improved mental health more than either one would when done in isolation, doing both can save time, and, as some have argued, it can enhance performance for all you gym bros out there.

The techniques described in the link should work well for anyone, trans or cis. However, when it comes to transgender folks, I am inclined to think that when combined with mindfulness, exercises that target proprioception can have the best results for transgender individuals experiencing gender (or in this case body) dysphoria. Recall that in a previous post, proprioception was the internal sense of ones body parts in relation to each other. It is the sense that allows you to do all kinds of tasks without having to see everything you are doing, such as bringing your food from your plate to your mouth when you eat. Mmmm…yummy!

Examples of exercises that can easily combine exercise with mindfulness is yoga. If you are not a yoga master, never fear–you can do exercises as simple as stretching while focusing on the breath and the sensation of that comes from stretching. Another simple type of exercise would be balancing exercises that require you to stay present on your current state in order to remain in balance. Once you become more skilled, you can practice mindfulness during more complex exercises such as pushups or lunges. Whatever exercise you do, make sure you can focus on the breath as well as the proprioceptive inputs.


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