Planting Seeds: Reflections on Gender, Language, and a Civilized Conversation

- April 16, 2026

Introduction

“What one remarkably civilized online discussion revealed about gender dysphoria, language, and the slow growth of understanding.”

I follow an intersex woman on Facebook named Jackie Green. She regularly posts short educational videos about sex, gender, and biology, usually in a calm and accessible way. In one recent video, she responded to a charge often aimed at both intersex and transgender people, that they are “mentally ill.”

In less than two minutes, Jackie explained something that still seems to get lost in many public arguments. Being transgender is not classified as a mental illness. What medicine recognizes is gender dysphoria, the distress that can arise when a person’s body and gender identity are experienced as being at odds. The purpose of care is not to erase identity, but to alleviate distress.

Her explanation brought to mind a public exchange I had nearly fifteen years ago with Michael Brown, when I tried to make a similar point in a very different climate. I wrote about that conversation yesterday on my blog.) I probably would not have used exactly the same language Jackie used, and I am aware that the terminology around these subjects has continued to develop. In many ways, that evolution has made the discussion more precise. I would not presume to say that I expressed the matter as clearly as she did.

What stayed with me even more than the video, though, was the discussion that followed. In a space where conversations about gender often descend almost immediately into slogans, accusations, or contempt, this one unfolded differently. People asked questions that seemed genuine. Others answered carefully. There was disagreement, of course, but much of it came across as an effort to understand rather than merely to score points.

What follows is a brief synthesis of some of the more thoughtful points that emerged from that exchange.

To Understand Gender Dysphoria, Mental Health, and Human Variation, Language Matters

One of the clearest themes in the discussion was the importance of language. Terms such as “mentally ill,” “abnormal,” and “disordered” are not neutral in ordinary conversation. Even when they originate in clinical settings, they often carry a sting far beyond their technical meaning. In public debate, they are frequently used less to describe than to diminish.

That matters because once “mental illness” becomes a casual insult, the damage spreads in more than one direction. It deepens stigma toward people living with actual psychiatric conditions, and at the same time, it flattens or dismisses the lived reality of transgender people. The language may sound blunt and definitive, but it often obscures more than it clarifies.

Dysphoria Is Not Dysmorphia

Another helpful distinction raised in the thread was the difference between gender dysphoria and body dysmorphic disorder. The two are often confused by people unfamiliar with either term, but they are not the same.

Body dysmorphic disorder involves a distorted perception of the body. A person may become convinced that some feature is defective, ugly, or grotesque, even when others do not perceive it that way. Gender dysphoria generally works differently. In most cases, the person perceives their body accurately enough. The distress does not stem from misperceiving what is there, but from the painful experience that what is there does not align with their internal sense of gender.

That distinction is not merely academic. It helps explain why the response to each condition differs. In body dysmorphia, changing the body often fails to resolve suffering because the core issue is distorted perception. In gender dysphoria, by contrast, aligning the body or social role more closely with one’s gender identity often relieves distress rather than intensifying it.

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How Medical Understanding Evolved

Another theme that surfaced in the discussion was how medical language has changed over time. Earlier editions of the Diagnostic and Statistical Manual of Mental Disorders used the term “Gender Identity Disorder.” The wording implied that the person’s identity itself was the problem.

In 2013, the DSM-5 replaced that term with “Gender Dysphoria.” The shift was subtle but important. Rather than framing identity as pathological, the focus shifted to the distress some people experience when their bodies and gender identity feel out of alignment. In that framework, treatment aims not to erase identity but to reduce suffering and support well-being.

A similar change occurred in 2019, when the World Health Organization released the eleventh edition of the International Classification of Diseases. In ICD-11, gender-related diagnoses were moved from the chapter on mental disorders to the section on sexual health. That change reflected a growing international consensus that gender diversity itself should not be categorized as a psychiatric illness.

Some participants in the thread also noted research suggesting that gender identity may have biological components related to brain development. During prenatal development, hormones help shape brain structures that contribute to a person’s internal sense of gender. In most individuals, these developmental processes align with reproductive anatomy. In some cases, they do not, and that divergence may play a role in the experience of gender dysphoria.

While the science in this area continues to evolve, the broader point raised in the discussion was simple: human development is complex, and variation is part of that complexity.

Why Gender Often Goes Unnoticed

Another point that emerged in the conversation was something many people rarely consider. For those whose gender identity and physical development align, gender often fades into the background of daily life. It becomes almost invisible.

For individuals experiencing dysphoria, however, that alignment is absent. What others barely notice can become a constant awareness. The body becomes a source of tension rather than a source of familiarity, and the mismatch can shape everyday experiences in ways that are difficult for others to fully imagine.

The discussion also briefly touched on intersex conditions, which involve natural variations in sex development. These variations may affect chromosomes, hormones, or anatomy. Intersex individuals are sometimes mistakenly grouped with transgender people, but the two are not the same.

Intersex traits involve biological variations in sex characteristics. Being transgender relates to a person’s internal sense of gender and how they experience themselves in relation to their body and social identity. The two categories sometimes intersect, but they describe different aspects of human variation.

The Tone of the Conversation

What stood out most about the thread, however, was not simply the information being shared but the tone of the exchange.

Many participants approached the topic with curiosity rather than hostility. Questions seemed sincere. Others responded with patience and care. Even when disagreement surfaced, the conversation often stayed focused on ideas rather than personal attacks.

Anyone who spends time online knows how rare that can be.

Another notable aspect of these discussions is the presence of silent readers. Many people follow conversations without ever commenting. When respectful explanations are offered, those unseen readers may encounter perspectives they had not considered before. In that sense, a thoughtful exchange can reach far beyond the handful of people actively participating.

Epilogue

What struck me most about the conversation around Jackie Green’s video was not only the clarity of her explanation but also the tone it seemed to encourage.

Instead of devolving into the familiar shouting match that often surrounds discussions of gender, something quieter unfolded. People asked questions. Others offered explanations. A few detractors appeared, as they almost always do, but they never fully took control of the conversation.

Moments like that remind us that understanding rarely arrives through arguments alone. More often, it grows slowly, through patient explanation, evolving language, and the willingness of ordinary people to listen to one another.

If nothing else, that small thread of conversation offered a glimpse of something hopeful. Even in contentious times, seeds of understanding are still being planted.

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