Program: Gender euphoria and an untold story of joy

News report: A suicide every two weeks. That's the grim report on the mental health crisis gripping the trans community....

Sana Qadar: Often when you hear stories about trans or non-binary people in the news, it's about the negative aspects of their experience.

News report: ...Transitioning has been a mental struggle for...

Sana Qadar: So you'll hear stories about how trans and non-binary people suffer elevated levels of mental distress or are more likely to attempt suicide. And you'll hear about their gender dysphoria.

Riley: Gender dysphoria sucks. It's unpleasant. It's a bad time.

Sana Qadar: All of those issues are real and distressing. But there are other stories about the trans experience that you don't get to hear as often. Like the story of gender joy, gender euphoria.

Dax Carnay-Hanrahan: For me gender euphoria means you can look at yourself and just enjoy yourself. Not just physically, but internally and emotionally that you are living the truth that you are meant to be living.

Sana Qadar: This is All in the Mind. I'm Sana Qadar. And this weekend kicks off Pride Month. So to mark that, we are flipping the script on trans stories today and finding out why researchers are interested in gender euphoria. Because for a lot of people, this can be a transformative experience.

Professor Damien Riggs: Even though other people might challenge their existence or their gender, that experiencing euphoria is a reminder that yes, this is right. This is who I am and I know what I'm doing.

Sana Qadar: Producer Rose Kerr has this week's episode.

Rose Kerr: Earlier this year, Dax Carnay-Hanrahan experienced something completely new and life-changing.

Dax Carnay-Hanrahan: Just very recently, it's like finally enjoying what you see. Finally smiling and looking at photos or looking at self in the mirror. Like posting photos of you in your underwear, not because you're doing a thirst trap. I'm finally enjoying what I see. I finally like my body for what it is.

Rose Kerr: This moment is so special to Dax, but it wasn't something she was waiting for. She didn't even expect it to happen, maybe ever. Dax is a non-binary trans feminine person. And in 2020, she moved to Melbourne from the Philippines.

Dax Carnay-Hanrahan: When they announced that the country was about to lock down, we lived in this tiny apartment in the city. My husband's parents had this huge house. If I'm going to get locked in a house, I'm going to get locked in a giant house before they close everything down and fly out tomorrow. So I flew to Melbourne with 10 sets of clothes, meant forManila weather.

Rose Kerr: Not Melbourne, not Melbourne weather.

Rose Kerr: She says the move to Australia was hard. It's not like it was something she planned to do.

Dax Carnay-Hanrahan: And I was at a level where I was in a comfortable place in terms of who I am, what I'm doing and where I'm at. And then suddenly being plucked out of it and everything that you feel that you've worked for and you're already reaping the rewards for doesn't matter. Because you're in a different country. Nobody cares who you were.

Rose Kerr: Because life for Dax was pretty different in the Philippines.

Dax Carnay-Hanrahan: It was a very different life. I was a corporate person. I was running an integrated marketing communications firm. I was pretty known at what I do. So for me, in the context of being trans and social transitioning, I had it a bit easier than most. Because since I had some level of position of power, nobody really questioned it.

Rose Kerr: And she was known in her community for being supportive.

Dax Carnay-Hanrahan: I was trying to be the person that I needed growing up.

Rose Kerr: Dax saw herself as a mother figure, a protector for trans young people.

Dax Carnay-Hanrahan: I try to make people feel better in whatever way I can, whether it's by being completely real with them or just supporting them or validating them in whatever way that I can. That's why I've been mother. At the tender age of 30 plus. I have so many children.

Rose Kerr: Fast forward to 2024, living in Australia, Dax has been able to find herself again. She's following her passion, working as a creative.

Dax Carnay-Hanrahan: My practice is based on the intersection of immigration, trans experience and the POC experience.

Rose Kerr: If you've not heard the term POC before, it stands for person of colour.

Dax Carnay-Hanrahan: I'm generally a writer, a performer and a speaker.

Rose Kerr: And earlier this year, she experienced a particular kind of joy for the very first time, gender euphoria.

Dax Carnay-Hanrahan: After I transitioned medically is that when I actually found happiness in seeing my face and seeing my body, which used to be just when I wear makeup. Because before, especially growing up in Manila, if you're dark and you're fat, you're automatically ugly. You're not intentionally beautiful. Nobody thinks you're beautiful. So that I grew up with that.

Rose Kerr: So for Dax, who's been out as trans non-binary for around eight years, experiencing gender euphoria for the first time was a pretty big deal.

Dax Carnay-Hanrahan: I mean, like life is an eternal search and pursuit of happiness and joy. At the root of it all. And once you find it in any aspect or pockets of your life, the joy, it always definitely helps. I mean, every little drop that fills your cup will make it closer to the top. And the sooner that you fill your cup, the sooner it overflows, the sooner you can share that joy and happiness to everybody else. And like, if you're a happy and joyful person, that's the only way that you can share joy and happiness. Because if you're not, you can't give what you don't have. Yeah, it definitely affects just my, not my mental health, but also my relationship with the people around me, my friends, my relationships with my work, my art and my general perceptions of life.

Rose Kerr: So what is gender euphoria? And how did Dax go from struggling to see her beauty to feelings of joy?

Rose Kerr: When it comes to an exact definition of gender euphoria, it's kind of hard to define.

Dr Ruby Grant: This could mean feelings of rightness, joy, intense happiness, self-love, pride, and just generally feeling comfortable or at home in your gender and in your body.

Rose Kerr: This is Dr Ruby Grant. She's a sociologist and researcher at the Australian Research Centre in Sex, Health and Society at La Trobe University.

Dr Ruby Grant: I specialise in LGBTQ health and wellbeing.

Rose Kerr: She says gender euphoria can be experienced by anyone, regardless of gender or identity.

Dr Ruby Grant: I'm not trans, but if I'm having a particularly good day or I'm at the gym and I like, I bench like a really high amount, I'm like, I'm feeling great, this is really good. Yeah, I think there are loads of gender affirming things that cisgender people do. You know, girlies go out and get their hair done, get their nails done. And I guess on the flip side of that, like you could experience, you know, sometimes when you're wearing something or like you haven't shaved that day or something like that, as a cis woman, you can be like, oh, I'm not feeling that good.

Rose Kerr: Dax has a similar analogy that they use when describing the feeling to people who aren't trans.

Dax Carnay-Hanrahan: Like I would say to some girls, it's like, you know, when you finally have your nose done and then you look at yourself, like, God, I look hot. That, but for all of my body - that's trans joy. Or like, for a dude, like you finally got that haircut or got that beard trimmed and then you look at yourself, you're looking, you have a nice fit and you're like, damn, I look hot.

Dr Ruby Grant: So it's not just something that trans people experience, but because of the system, the cisnormative world that we live in, that really is trying to kind of force trans people into particular boxes, those feelings of euphoria are incredibly important and meaningful in that context.

Professor Damien Riggs: Gender euphoria can be a really helpful way to remind people that they are who they are, that they know who they are, that even though other people might challenge their existence or their gender, that experiencing euphoria is a reminder that, yes, this is right. This is who I am and I know what I'm doing.

Rose Kerr: This is Dr. Damien Riggs. He's a professor in psychology at Flinders University and a psychotherapist who practices with trans young people. He says gender euphoria can be a validating experience.

Professor Damien Riggs: You know, when I think about euphoria and joy, I think about feeling at home. When I'm in my house and I love my house and the way I've decorated it and the way it's set up, I feel euphoric. And that's because I feel safe because it's my home and it's somewhere where I can be myself and not be challenged. And I think it's a very similar thing for gender euphoria is we want to feel safe and at home in our bodies. And for some trans young people, that isn't the case, perhaps because they feel dysphoria. It's because other people discriminate against them and tell them there's something wrong with them.

Rose Kerr: Gender dysphoria isn't strictly the opposite of gender euphoria, but it does refer to the negative feelings trans or non-binary people may feel about their body or appearance. Some people may never feel dysphoria and you don't have to feel dysphoria to be trans.

Professor Damien Riggs: But when we experience euphoria, we feel anchored in our body. We feel at home. We feel right. We feel as though this is what is meant to be.

Rose Kerr: This is how Dax describes their experiences of gender dysphoria.

Dax Carnay-Hanrahan: Gender dysphoria for me is basically not understanding why you can't see the beauty that you have or why you cannot see what other people are seeing in terms of your positive traits or how you look. Because I remember growing up, they would always say that you're a hot dude. A lot of girls have a crush on you, andI don't see it. And if I don't see it, I won't believe it. And if I don't believe it, I won't feel it. If I don't feel it, I'm just going to be miserable.

Rose Kerr: But why are we talking about this at all? Why is it important to talk about gender euphoria for trans and non-binary people? Dr Ruby Grant says part of the reason is because of the mental health challenges faced by the trans community.

Dr Ruby Grant: We see when we look at rates of mental health diagnoses, experiences of psychological distress and right through to suicidal ideation, suicide attempts, that time and time again, trans people of all ages face really increased rates of mental ill health.

Rose Kerr: And Dax says on our screens, there's a lack of happy stories.

Dax Carnay-Hanrahan: Most of the time, trans people in media and on screen or whatever are represented as sad, depressed, defeated, distraught people that never find happiness. Either they're killed in the end or they kill themselves. But that is not true. There is joy. I got married, changed my careerat 35. I am doing panels. I'm following my dream and pursuing my passion. And I am a proud trans person. So there is trans joy.

Rose Kerr: And when it comes to looking at gender euphoria through an academic research lens, Dr Ruby Grant says it can paint a broader picture of the trans experience.

Dr Ruby Grant: And it's just really wonderful. Isn't it great to learn about positive experiences that people have and the really good things and trans joy and great things that happen in trans communities. So we shouldn't just be always responding to the negatives. We see that gender euphoria is an amazing, wonderful, good experience for a lot of people. What can we be doing to have health systems and to have community supports that promote those kind of good feelings for people in their daily lives?

Professor Damien Riggs: Academics, including trans academics, didn't invent the concept of gender euphoria.

Rose Kerr: Here's Dr Damien Riggs again.

Professor Damien Riggs: The concept of gender euphoria has been used by trans communities for decades. What academic research does is gives another audience to the concept of gender euphoria. So trans people have been, including trans academics, have been talking about euphoria for a long time. But when we write about it, it broadens our audience so that more people may understand, more people may think, oh, this is rather than taking a damage-centered account or a pathologizing account, there are other ways of thinking about trans people's lives, just like everyone else. And joy is one of those ways we can think about trans people's lives.

Sana Qadar: You're listening to All in the Mind on RN. I'm Sana Qadar. Today, producer Rose Kerr is looking at the links between gender euphoria and well-being, because plenty of research shows that trans and non-binary people are at higher risk of mental distress. For example, according to the Australian Bureau of Statistics, four in five have seriously considered suicide and almost three in four have self-harmed. And the rate of self-harm among LGBTQI +Australians is almost six times higher than it is for heterosexual people. But amongst those very real problems, positive stories about the experience of trans and non-binary people can get lost. So for Pride Month, we're looking at the experience of gender euphoria. And there's research starting to come out on this topic, too. Here's producer Rose Kerr again.

Rose Kerr: In a paper released earlier this year, Dr Ruby Grant and her team looked at the potential connection between experiences of gender euphoria and levels of psychological distress. And she says it's one of the first big statistical projects that have looked at gender euphoria in Australia. Their key finding?

Dr Ruby Grant: If people were currently or had even in their whole lives experienced those positive feelings of gender euphoria, that it was associated with reduced psychological distress.

Rose Kerr: So how'd they find that out?

Dr Ruby Grant: We were interested to kind of think about what are the mental health outcomes that we can see associated with gender euphoria? Because there's a lot of work that really looks at gender dysphoria and the sort of negative associations with that and the impacts that it tangibly has on trans people's lives. But we kind of did want to flip it on its head and think about, well, OK, if we're looking at gender euphoria or thinking about it as kind of an outcome of gender affirmation, which is a fairly simplistic way of looking at it. But if we're thinking like, I mean, what's the goal of trans affirming practices of gender affirming care? We want people to feel good about themselves and to be living their best lives. And we don't see a lot of evidence for that or, you know, we don't see a lot of we know that it's probably the case anecdotally, but we wanted to kind of explore that a bit more through this really big data set that we have from the Private Lives 3 study.

Rose Kerr: The Private Lives 3 study is one of the largest national surveys looking at the well-being of LGBTIQ+people in Australia. It explores a range of experiences across health, education, work and community.

Dr Ruby Grant: So we were doing correlations between gender euphoria and a bunch of mental health outcomes. So we've looked at the likelihood of people experiencing gender euphoria alongside a range of other things. When we did that, we also controlled or we took into account a lot of key demographic things that we thought might be something that could shape it. So we're isolating those so that we can see just that relationship between gender euphoria and those mental health outcomes. So we received 1,359 trans participants. So it's a really large, a large sample in terms of Australian research. So we wanted to take the opportunity to use that data to explore what are the mental health outcomes associated with current experiences of gender euphoria, lifetime experiences and comparing those to people who haven't experienced gender euphoria as well.

Rose Kerr: What is the connection between gender euphoria and mental well-being? Like why are we putting them together and looking at them and comparing them?

Dr Ruby Grant: Well, it's interesting. So we did find that if trans people in our study were experiencing gender euphoria currently, they were much less likely to also report high or very high psychological distress. They were also less likely to report recent suicidal ideation. So our study doesn't, we can't sort of, we can't say what the relationship between those is. So we can't say that gender euphoria necessarily directly leads to or reduces psychological distress. But there is a really strong association there. So we can infer one way or the other. And, you know, it sounds like, you know, if you're experiencing really intense, more positive experiences, positive feelings, happiness, contentment about how you feel about your body and gender, it's likely that that might kind of reduce experiences of psychological distress. It could also go the other way, though. I mean, if you are just generally in a good place mentally, that might open up more opportunity for you to feel more positive about your body and gender as well. So it's sort of, they're bound up together, I think.

Rose Kerr: So are you finding in the, as you looked through the data, that people who had recently experienced gender euphoria were more likely to also report okay or quite good mental wellbeing?

Dr Ruby Grant: Absolutely.

Rose Kerr: So what factors can contribute to someone experiencing gender euphoria? Well, it's a very personal experience that differs from person to person. When I asked Dax what she thinks contributed to her own experience, she said her medical transition was a big part of it, plus a bunch of external factors.

Dax Carnay-Hanrahan: It might sound a little bit superficial, but it's definitely a lot of social validation. Like, as a femme-presenting person, like being addressed as a femme-presenting person, not using male pronouns on me. You know, like treating me as a femme-presenting person, that affirms and helps you validate yourself even. That I am this and nobody's questioning it. And that helps. And I acknowledge my privilege that somehow I am passing, which also helps. Regardless, social validation for everyone out there listening who's not transgender diverse, it's not hard to give somebody the social validation they need to affirm their gender. Because that would change literally a person's perspective of life and their life themselves.

Rose Kerr: I also spoke to 28-year-old astronomer Riley.

Riley: I am non-binary in some way. I'm transmasculine. I feel like my body should be more male than it currently is. And I'm working on getting it there. And every time I do something that points that way, I feel better and I feel more at peace.

Rose Kerr: When I asked him if he had experienced gender euphoria, he wasn't actually sure. He said it depended on what definition he was using. But he did highlight some moments when he felt really good, maybe even euphoric.

Riley: I've spent most of my life having this kind of contention and for a lot of my life not understanding where that came from. And so the euphoria could even be like, oh, this is how it's meant to be. Some of the happiest times that I remember were the most recent one. I had my first shot of testosterone a few weeks ago. Putting on a binder for the first few times and then putting a shirt on and then looking at yourself in the mirror and then looking sideways and being like, oh my god. Oh, wow. My, yeah, that's correct. That's what my chest is meant to look like. It's really, really good. Those are probably some of the closest moments of gender euphoria I'd be feeling. I don't necessarily know if that's euphoria or if it's just a relief of not having to mentally push away the dysphoria all the time. There are like these little things that you can do, for me anyway, like medical transition in various ways is not the right thing for everyone. But for me, I am pretty sure that it is. And I say pretty sure as a kind of sarcastic joke. I'm 100 percent sure I know what I'm doing.

Rose Kerr: Dr. Ruby Grant said in their study they were able to identify some individual differences between participants.

Dr Ruby Grant: So people were more likely to experience gender euphoria if they'd been easily able to access gender affirming care. This is fairly unsurprising, I guess. People were more likely to experience gender euphoria if they had a stronger connection with LGBTQ communities, which is really lovely and interesting. I guess if you've got a lot of other queer friends or queer or trans friends who, yeah, you're talking about and celebrating who you are, that that might promote more positive feelings or an ability to recognize positive feelings or even gender euphoria as a thing, I guess. And we see connection to LGBTQ community leading to positive mental health outcomes for a lot of people.

Rose Kerr: They also found that there was no difference between mental health outcomes for people who had never experienced gender euphoria and people who had experienced it previously but not currently.

Dr Ruby Grant: Which is kind of interesting because it shows that the immediacy of those feelings of gender euphoria are likely a factor that's really important. I think it shows if you're currently experiencing it, it might have a stronger effect on your mental health than if it's something that might have happened in the past but not feeling anymore. But that doesn't discount the importance of it. And I think if anything it really shows that we need to be creating opportunities for more frequent gender affirmation that will likely lead to feelings of euphoria for trans people.

Rose Kerr: Dr. Ruby Grant says not everyone experiences gender euphoria and not always in the same way.

Dr Ruby Grant: And that doesn't make those experiences of being trans any more or less valid. Yeah, and it certainly, we see that it might have some really positive mental health outcomes for a lot of people. But there are also other important things like, you know, regardless of whether people experience euphoria, we still need to be moving towards, you know, better access to healthcare for all trans people. And just also access to spaces where, and places where trans people are supported. And so, yeah, I think it's important that, and it's great to study this, but there's other work that we also need to be doing always alongside.

Rose Kerr: In some of those hard times where you were feeling dysphoric, did you still have hope that you'd get to the euphoric stage or did you have no idea that you were going to make it there?

Dax Carnay-Hanrahan: To be honest, I was clueless. And like, as I keep on repeating, just chase the little joys that will get me through the day. The little ray of sunshine, the little drops of rain that will just make you a bit happier about yourself, a little bit at least. Wearing makeup, wearing nice clothes, getting my hair done. Something that will get you through until you completely enjoy looking at yourself and like, yeah, this is it. This is me. This is what I want. And I'm finally in my actual skin.

Rose Kerr: That's a really beautiful, positive way of seeing through dark times. Where does that come from?

Dax Carnay-Hanrahan: I don't know. I've been through a lot of challenging times and I live a very challenging life, but I've also seen worse experiences from other people. And there's so much negativity already going on that I don't need to add to that. What I want is to reach out a hand or lighten your load in whatever shape or way I can. And I realize that for me has a grander effect in the grand scheme of things. I would always say people will forget what you said to them, but people will never forget how you made them feel.

Rose Kerr: Nowadays, in her work as a performer, Dax is super keen to share her experiences with audiences, and that includes trans joy. Have you felt a shift in your performing or your writing?

Dax Carnay-Hanrahan: Oh, definitely. Now, because I only write from what I know. Now it's definitely coming from a place of confidence. I know what I'm talking about and I'm ready to share it so that if there's somebody else or went through the same phase as I did, and they see this or they read this, they'll somehow get a piece of nugget of wisdom here and there that they can apply in their own personal lives. In terms of performing, the worst thing that an actor or a writer can be is insecure. Because then you will question everything. You will question everything that you put out. You will question yourself. So once you experience, for example, in terms of gender euphoria, when you are sure of yourself, then you give that same energy off on stage or on paper or when you talk to people. And then that's when people can appreciate it and accept it as well. Some people haven't even met a trans person in their life. Being able to showcase this kind of things to them, it's something new to them. So all my lived experiences, I usually find the joy of it and put it there. Or even some of the traumatic things, but wrapped up in humour and laughter, so people can easily digest it.

Rose Kerr: These days, Dax is living a life she never pictured for herself. She even got married recently.

Dax Carnay-Hanrahan: It's something that I never imagined that would happen to me, especially when I realised that I was trans. How many trans women do you see or trans people do you see that gets married? So it never really occurred to me that it would happen to me. It was very joyful. It was very happy. And people flying in here to attend a wedding. So that was great. That was great. I'm very lucky. I'm very blessed and lucky to have all these things happening to me and being married on top of that. For it to happen, it's like the impossible happening.

Rose Kerr: Dax is hoping sharing her story of gender euphoria will help other trans and non-binary people.

Dax Carnay-Hanrahan: Just follow your joy. Whatever that gives you joy or happiness, pursue it. Your identity, your gender identity is your business. It's nobody else's business. So if this gives you happiness, regardless of what other people say about it, stick with it. That's what you do. Because again, your objective, especially as a trans person who's transitioning, is to get to that point where you are finally happy about yourself. That you can finally share that happiness to other people. Just do it. If people give you a hard time about it, then maybe those are the people you don't want to be around with. It's hard being trans, guys. You have to figure it out. It's not being born into the body that you want, that it's just there. We have to work to get it. So whatever little droplet or ray of sunshine that you can get at any place, euphoria, fill your cup, do it. Just do it. And then eventually, the trans joy would happen. Because it is real. It is there. You might think it's not going to happen, but it will. It took me around 35, 36 years to be able to feel it, but it was definitely worth the wait.

Sana Qadar: That is Dax Carnay-Hanrahan, a creative and performer from Melbourne. You also heard from Dr. Ruby Grant from La Trobe University, Dr. Damien Riggs from Flinders University, and 28-year-old astronomer Riley. This episode of All in the Mind was reported and produced by Rose Kerr. Our sound engineer was Nathan Turnbull. I'm Sana Qadar. Thank you for listening. I'll catch you next time.