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Nevaeh Schmieg

RaeAnn Anderson

Abnormal Psychology

30 October 2020

Memoir Paper 2: The Last Time I Wore A Dress

Daphne Scholinski’s memoir, The Last Time I Wore A Dress, is a personal account of her

experiences with the diagnosis of gender identity disorder at the age of fifteen. Throughout her

childhood, she recalls being asked why she doesn’t act more like a girl. The idea of stereotypical

gender behaviors is a growing discussion in today’s society, just as it was all these years ago.

Throughout this paper, I will discuss her many diagnoses, how these issues may have developed,

how they relate to one another, how she was “treated” for her diagnosis, and the treatment

options available today.

At fifteen years old, Daphne’s father drove her to the first hospital where she was

diagnosed with gender identity disorder, now known as gender dysphoria. Gender dysphoria is a

strong and persistent cross-sex identification in which a person’s biological sex and gender

identity do not match (Beidel et al, 279). Gender dysphoria is not to be confused with sexual

orientation. One’s gender identity is not determined nor affected by the gender they are sexually

attracted to. “He said the other diagnosis was something called Gender Identity Disorder, which

he said I’d had since Grade 3, according to my records. He said what this means is you are not an

appropriate female; you don’t act the way a female is supposed to act” (Scholinski, 16). As she

probably felt hearing this, I too was frustrated to hear the doctor’s statement about her behavior.

For my first research question, I’d like to explore what is considered to be the appropriate

standards of gender behavior for both males and females. How do we determine the ways in
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which a male or female is supposed to act? Also, how has the idea of stereotypical gender roles

changed throughout the years, if at all?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the diagnostic tool

published by the American Psychiatric Association. Doctors repeatedly stated in diagnosing

Scholinski with gender identity disorder that she’d had it since third grade. This caused me to

wonder what diagnostic criteria was required for a child so young to be diagnosed with such a

disorder. Among children, gender dysphoria is apparent in repeated statements that the child

wants to be the opposite sex or is the opposite sex; cross-dressing in clothing stereotypical of the

other sex; persistent fantasies of being the opposite sex or persistent preference for cross-gender

roles in pretend play; a strong desire to participate in games and activities usually associated with

the opposite sex; and strong preference for playmates of the opposite sex (Beidel et al, 279).

Although the fifth edition of the DSM has been released since her years in treatment, the criteria

for diagnosis has remained relatively similar. Patients with gender dysphoria were often

experiencing difficulties getting the care they needed and were criticized at times for being

disordered. Providing a new name for these symptoms and behaviors offered more respect to the

individuals as well as kept their access to treatment.

As with many other psychological disorders, gender dysphoria is considered to have

comorbidities, or the presence of more than one disorder. In fact, people with gender dysphoria

often have other psychiatric disorders, most commonly anxiety, depression, and personality

disorders. However, these disorders do not occur more frequently among people with gender

dysphoria than people with other psychiatric disorders. They are also not the cause of gender

dysphoria. Rather, these anxiety and depressive symptoms are a response to the condition and to

the ridicule that people with gender dysphoria often face as a result of their behavior (Beidel et
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al, 279). Upon admission to the first hospital, Scholinski was noted as being depressed and

anxious among many other things, but depression and anxiety were never listed in her official

diagnoses. “One of the diagnoses was Conduct Disorder, which made sense to me. I’ve never

been one to lie about my bad behavior. He said another diagnosis was Mixed Substance Abuse,

which I knew to be a stretch of the truth but what did I care if he thought I had a drug problem”

(Scholinski, 15). Scholinski admits to the problems she presented with upon being admitted to

the hospital including violent and abusive behaviors, multiple drug use, shoplifting and petty

theft, school failure, and difficulties with her parents’ separation. However, these are not

necessarily comorbidities to gender dysphoria but rather a reaction to the distress her situation

has caused, as previously stated from the textbook. The difficulty with issues like these is

discovering how they developed and / or what effect they had on her other diagnoses.

Most disorders come with many theories as to how they developed both biologically and

psychologically. However, in the case of gender dysphoria, there is very little research to support

or explain the predicted causes of the disorder. A number of theories explain the etiology of

gender dysphoria but virtually no empirical data support many of them. On the biological side,

some hormonal data provide intriguing but nonspecific evidence for a biological contribution to

the development of this disorder. Psychosocial theories have examined the role of family,

particularly parent-child relationships (Beidel et al, 282). Scholinski’s family history had no

biological connection to her disorder. Psychosocially, she shares several details into the

difficulties she experienced with her parents after their separation. Although she was hesitant

when being admitted to the first hospital, she states, “but part of me kind of wanted to go. Any

place had to feel safer than home” (Scholinski, 4). She goes on to talk about the abuse she

received while staying with her father and how her mother seemed to have lost all care as she
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parties with strange people and keeps marijuana in her bedside table. She also explains how she

snuck out unnoticed and ended up in the bathtub with a hit man naked at the age of thirteen. This

would be one of multiple times in which she was sexually assaulted at home and throughout her

hospitalization. After all of these experiences, she’s here at the age of fifteen beginning what

would soon be three years of hospitalization with no true treatment for her disorder. We may not

be able to determine the cause of all disorders but in her situation, there seem to be many good

places to start. This brings me to my second research question; why is there so little research for

the cause of gender dysphoria? Is there an ethical issue holding back the studies or is there just

no cause to be discovered?

Treatment for gender dysphoria occurs in the following three phases: living as the desired

gender (for at least two years), using hormone therapy to feel more like the desired gender, and

finally, sex reassignment surgery (SRS). It’s important to note that not everyone with gender

dysphoria chooses to have surgery but it’s an option available to them. There is also

psychological treatment available which provides attention and reinforcement of same-sex

activities. Historically, treatment for adults with gender dysphoria attempted to change the

person’s social and sexual behaviors to match his or her biological sex. Currently, treatment

focuses on helping adults live as their chosen gender identity, maximizing their psychological

and social adjustment (Beidel et al, 284). Scholinski’s treatment was very different from what

she may have experienced today since the diagnosis has been more broadly accepted in today’s

society. Her treatment cost one million dollars in insurance money for three years of

hospitalization and yet, little was actually treated. In one of the hospitals, she was given points

for acting like a female. When she used make-up, styled her hair, or wore feminine clothes, she

was rewarded with points which allowed her the freedom to walk unaccompanied around the
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facility. Sometimes she was even rewarded for hugging the male staff. This is not an appropriate

treatment for the disorder but when she was diagnosed, this is how it was treated. “A lot of

people don’t want to hear about the hospitals. I can understand this. I don’t know how to explain

that I’m an ex-mental patient who never had a mental illness. There’s no use in insisting you’re

not crazy. All ex-mental patients seem to be lumped together, schizophrenics, manic-depressives,

whatever” (Scholinski, 198). I can only imagine how difficult and traumatizing it must have been

to go through these experiences and to be so misunderstood to this day.

In the end, her treatment was not the answer for her diagnoses and she ended up coming

out of it with more awful experiences than before. Although she went through such traumatizing

events both at home and in these many hospitals, she is strong today for overcoming these

difficult times in her life. It’s good to see her telling her story through this memoir and through

the art she creates. The art on the cover of the book truly wraps up her feelings about where she

stands with her gender identity; the last time she wore a dress was the last time she was required

to wear a hospital gown. We can all see the powerful message through the image and I hope she

continues to show her strength through her art.

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Works Cited

Beidel, D., Bulik, C., & Stanley, M. (2017). Abnormal Psychology: A Scientist-Practitioner

Approach. New York, NY. Pearson Education Inc.

Scholinski, Daphne and Jane M. Adams. (1997). The Last Time I Wore a Dress. New York, NY.

Riverhead Books.