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, Jackie Green, whose short educational videos often tackle questions about sex, gender, and biology. In a recent video she posted, she addressed a familiar accusation often directed at her and transgender people: the claim that they are “mentally ill.”

In barely two minutes, Jackie managed to explain something that many public debates about gender still struggle to articulate clearly. Being transgender is not classified as a mental illness. What medicine recognizes is gender dysphoria, the distress that can occur when a person’s body and gender identity do not align. The focus of care is not to erase someone’s identity, but to relieve that distress.

Listening to her explanation, coincidentally, was reminiscent of an exchange I had nearly fifteen years ago with Michael Brown, when I attempted to defend a similar position in a public discussion. (I wrote about it yesterday on my blog.) I may not have used exactly the same terminology, and I appreciate how language has continued to evolve in ways that make these conversations more nuanced and precise. It would also be presumptuous of me to suggest that I expressed the ideas as clearly as Jackie did in such a short space of time.

What struck me even more than the video itself, however, was the discussion that followed. In a corner of the internet where conversations about gender often collapse into hostility, something surprisingly different unfolded. People asked sincere questions. Others responded with thoughtful explanations. Even where disagreement appeared, many participants tried to engage with the ideas rather than simply dismiss them.

What follows is a synthesis of the insights that emerged from that remarkably civilized discussion.

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

“Using ‘mentally ill’ as an insult misunderstands both mental illness and gender identity.”

One of the first things that became clear in the discussion was the power of language. Words like “mentally ill,” “abnormal,” or “disordered” carry strong emotional weight. In medicine they are meant to describe specific clinical realities. In everyday conversation, however, they are often used as insults. When mental illness becomes a rhetorical weapon, it harms everyone involved. It stigmatizes people living with genuine psychiatric conditions and dismisses the lived experiences of transgender individuals.

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Dysphoria Is Not Dysmorphia

“Body dysmorphia involves a distorted perception of the body. Gender dysphoria usually involves an accurate perception, but distress because the body doesn’t match one’s internal sense of gender.”

An important clarification raised in the thread was the difference between gender dysphoria and body dysmorphic disorder. Body dysmorphic disorder involves a distorted perception of one’s body. Someone might believe that a physical feature is defective or grotesque even when others see nothing unusual. Gender dysphoria is different. In gender dysphoria the person usually perceives their body accurately. The distress arises because the physical characteristics of the body do not align with the person’s internal sense of gender.

This distinction matters because it leads to different approaches in treatment. Altering the body rarely resolves body dysmorphia because the underlying perceptual distortion remains. By contrast, aligning aspects of the body or social role with gender identity often reduces distress in people experiencing gender dysphoria.

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How Medical Understanding Evolved

“Medicine has moved forward on this. Earlier language treated identity as the disorder. Today the focus is on reducing distress and supporting wellbeing.”

Participants in the discussion also noted how medical language has evolved over time. Earlier editions of the Diagnostic and Statistical Manual of Mental Disorders used the term “Gender Identity Disorder,” which implied that a person’s identity itself was pathological. In 2013 the DSM-5 replaced that term with “Gender Dysphoria,” shifting the focus toward the distress some individuals experience rather than labeling their identity as disordered.

Another milestone 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 out of the mental disorders chapter and placed under sexual health. This change reflected the growing recognition that gender diversity itself is not a psychiatric illness.

Some contributors also discussed research suggesting that gender identity may have biological components related to brain development. During prenatal development, hormones influence the formation of 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 this divergence may contribute to the experience of gender dysphoria.

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Why Gender Often Goes Unnoticed

“For many people whose identity and body align, gender fades into the background of daily life.”

Another observation from the conversation was that many cisgender people rarely think about gender at all. For those whose identity and body developed in alignment, gender fades into the background of daily life. Awareness tends to emerge only when something is out of alignment. For individuals experiencing dysphoria, that mismatch can become a persistent and sometimes painful awareness.

The discussion also touched on intersex conditions, which involve natural variations in sex development. These variations may involve chromosomes, hormones, or anatomy. Intersex individuals are sometimes mistakenly conflated with transgender individuals, but the two are distinct. Intersex traits involve variations in biological sex characteristics, whereas transgender identity concerns a person’s internal sense of gender.

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The Tone of the Conversation

“It’s refreshing to see people explain things instead
of just attacking each other.”

Perhaps the most encouraging aspect of the thread was the tone of the conversation itself. Many participants, both trans and cis, approached the topic with curiosity rather than hostility. Questions were asked sincerely. Explanations were offered patiently. Even where disagreement appeared, the discussion often remained focused on ideas rather than personal attacks.

Online discussions frequently attract silent readers who never comment but follow the conversation closely. When respectful explanations are offered, those readers may encounter perspectives they had never previously considered.

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Epilogue

What struck me most about the conversation that followed Jackie Green’s video was not simply the clarity of her explanation, but the tone it helped set. Instead of collapsing into the predictable shouting match that often surrounds discussions of gender, something quieter happened. People asked questions. Others responded thoughtfully. A few detractors appeared, as they inevitably do, but they did not dominate the exchange.

Moments like this remind us that understanding rarely arrives through arguments alone. More often it emerges 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: that even in contentious times, seeds of understanding are still being planted.

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LISA SALAZAR — BLOG