Something the general public doesn’t understand is that disorders are only disorders if they’re actually an issue for the person. An obsessive compulsion is only OCD if it’s an issue; if the person doesn’t care, it’s probably not a disorder. A neuro-endocrine difference is only a disorder if the person feels it is. And even then, “disorder” doesn’t mean they’re required to do anything about it if they don’t want to, because it’s their body and their choice. This goes against the eugenics-y idea most people have that diagnosis means you must have that “fixed”.

I wish people would interpret these as potential issues with studied options rather than brokenness requiring fixing.

I think it’s just the scientists and doctors who specialize in this area who are aware of this, e.g. here’s a talk from the (relatively famous) neuro-endocrinologist Robert Sapolsky talking about it: www.youtube.com/watch?v=8QScpDGqwsQ

some people want to label trans folks as natural variation, and realistically it probably is for many - but I think you can’t deny that many of us experience distress from having the wrong sex, so … I tend to think if there is dysphoria it’s still a pathology, even if that is rooted in the distress people experience rather than anything like how others view the condition.

(Imagine a world where society is 100% accepting of trans people, there is no stigma at all, etc. - would a typical transsexual still experience distress? I think so, and I think that is grounds to examine this still as a disorder rather than merely natural variation.)

Obviously this doesn’t apply to so many trans and non-trans people who don’t experience dysphoria, who may or may not medically transition, and who don’t experience any distress from the incongruence between their unconscious sex and their natal sex.

My distress does not arise purely from social relations, I experienced mental health symptoms that seemed entirely caused by having the wrong amounts of hormones - things like anhedonia, depression, anxiety, parasomnias, etc. went away just from suppression of testosterone, and it seems that this tracks the experiences of many other people who medically transition (so much so that the community has coined a new term “biochemical dysphoria” to describe this), so I believe biologically there is something pathological / disordered going on for some of us.

This debate happens also with autism (and other disabilities), btw - some people have autism and don’t mind it at all, they feel it’s consistent with who they want to be, and the problems they experience from autism are all rooted in society not adequately accommodating their difference, and there isn’t anything innately disordered about their condition (it’s natural variation, not pathology). For others, it’s not that way and the autism can be a source of innate distress and disability in ways that those people feel is pathological and not consistent with who they want to be, and which would be a problem even in a world where society accommodates them as much as possible. So, autism can be either pathology or variation, depending on the individual, the severity, the particular traits, etc.

In terms of citations and links to some of the research on this topic establishing that “gender dysphoria” is a neuro-endocrine developmental disorder:

• Joshua Safer’s “Evidence supporting the biologic nature of gender identity” (DOI)
• Joshua Safer’s “Etiology of Gender Identity” (DOI)
• the collective research of Daphna Joel and Dick Swaab for the current scientific theories of “brain-sex”:
  • Joel & Swaab, 2019, “The Complex Relationships between Sex and the Brain”, (DOI)
  • Joel, 2015, “Sex beyond the genetalia: The human brain mosaic”, (DOI)
  • Swaab, 2008, “A sex difference in the hypothalamic uncinate nucleus: relationship to gender identity”, (DOI)
  • Swaab, 2000, “Male-to-female transsexuals have female neuron numbers in a limbic nucleus”, (DOI)
  • Swaab, 1995, “A sex difference in the human brain and its relation to transsexuality”, (DOI)

Some videos touching on the biology:

• Trans People and Biological Sex: What the Science Says by Julia Serano
• Robert Sapolsky: Brain Gender
• Neuro-biology of trans-sexuality: Prof. Robert Sapolsky
• Sex and Sensibility by Forrest Valkai

The best explanation we have for why people end up with gender dysphoria is that during early development as a fetus, the brain sexually differentiates one way and later the body sexually differentiates another way.

EDIT:

oh, and I think what you are missing about the transphobes is that they are usually science denying, they already reject the science on biological sex, intersex conditions, and what we know about gender dysphoria - just like homophobes reject what we know about the biology of homosexuality, they are not in any way beholden to the science, and I think it’s entirely wrong-headed to expect the right science and theory to somehow fix or solve transphobia - it just doesn’t work that way, the bigots will hate us and want to eliminate us no matter what.

Also, they will sexualize us regardless of how we’re categorized - it’s not like the ICD is why trans people (and tbh queer people and women in general) are sexualized. It’s more like the other way around, the ICD category is reflecting the existing way people think about us in terms of sexual matters.

EDIT2:

Oh, and this also covers some of the same ground:

• What is the Cause of Gender Incongruence? from the Gender Dysphoria Bible
• The causes of gender incongruence Wikipedia article