People with gender dysphoria feel a strong disconnect between the sex they were assigned at birth and their gender identity. While some individuals with gender dysphoria may not experience any distress related to their physical bodies, many struggle to come to terms with their internal gender identity and the way society perceives them.
The discrepancy between the sexual characteristics of one’s physical body and their gender often creates psychological distress. While friends and family may be able to lend emotional support, many people require something more. Support from mental health professionals is a great way to learn how to process the emotional distress that comes with dysphoria.
What does gender dysphoria feel like?
Gender dysphoria can manifest in people of all ages, racial identities, socioeconomic statuses, and sexual orientations. While the conversation about gender dysphoria seems to have just started, the medical condition has a long history. Fortunately, people now have more safe spaces to share their stories.
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People with gender dysphoria feel that their gender assignment does not reflect their experienced gender. For example, some people may experience themselves as male or masculine regardless of their physical sex characteristics. In other words, individuals experience gender incongruence and have a strong conviction or understanding that the gender assigned at birth does not suit them.
Every person experiences gender dysphoria in their own way. Some people may become keenly aware of painful self-image issues, while others may not realize what’s going on for a long time. A delay in recognition can equate to a delay in getting support, which can potentially lead to mental health issues or substance use disorders.
Individuals with gender dysphoria may struggle with certain aspects of their daily lives. While children and teenagers may find it hard to make friends at school and even struggle in school, adults with gender dysphoria may find it difficult to keep a job or go out. People with gender dysphoria may also find it difficult to have healthy relationships with others and often battle anxiety, depression, eating disorders, and substance misuse. Many experience discrimination and bullying which creates stress and, in the most severe cases, suicidal ideation.
What are the symptoms of gender dysphoria?
Although we are talking about gender dysphoria symptoms, it is important to understand that gender dysphoria is not a mental health disorder. The diagnosis of gender dysphoria is included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association to help individuals get access to health care and treatment, but the condition is no longer considered a gender identity disorder.
The diagnosis of gender dysphoria does not focus on the internal sense of identity as the problem. It targets the discomfort created by the marked incongruence between the expressed gender and the assigned gender at birth based on physical characteristics. Individuals with gender dysphoria usually experience:
- a desire to be treated as a particular gender, either the opposite gender or an alternative gender from what they were assigned at birth.
- a desire to be a different gender, either the opposite gender or an alternative gender
- a desire to no longer have the primary sex characteristics (sexual organs) and/or secondary sex characteristics (breasts, facial hair)
- a desire to have the primary sex characteristics and/or secondary sex characteristics of the opposite gender
- a strong preference for clothing usually associated with the opposite gender
- a strong rejection of traditional gender roles of their birth-assigned sex
- feelings of distress that affect social interaction and work or school behavior
Gender dysphoria can affect everyone from toddlers to adults. Moreover, gender dysphoria may not be a permanent condition. People may experience periods where gender dysphoria is no longer an issue for them or gender dysphoria may fluctuate throughout life.
What gender dysphoria is not
Gender-dysphoric/gender-incongruent persons may not always identify as transgender people. While many transgender people suffer from gender dysphoria, the medical condition can also impact gender-fluid or gender non-conforming people, some of which do not identify as trans.
It is important to understand that not all transgender and gender-diverse people struggle with gender dysphoria. Some of them might battle the condition at some point in their lives, but not all have the persistent sense of unease that characterizes gender dysphoria. Furthermore, some people find that their trans experience is more marked by gender euphoria, rather than dysphoria.
People should also understand that gender dysphoria has nothing to do with an individual’s sexual orientation. Gender dysphoria can affect straight, gay, lesbian, or bisexual individuals. There is a clear distinction between gender identity and sexual identity. While gender identity reflects a person’s sense of gender, sexual orientation defines their physical and emotional attraction to other people. Gender dysphoria does not make a person gay, lesbian, or bisexual.
Can gender dysphoria be treated?
As gender dysphoria is not a mental health disorder, the treatment for gender dysphoria should never focus on forcing an individual to accept and act according to their assigned sex. Any so-called treatment that tries to change an individual’s gender identification and force them to be cisgender is cruel, brutal, and ineffective. Conversion therapy is not a scientifically-backed treatment and is considered unethical.
What mental health providers can do is provide gender-affirming treatment. They can guide people with gender dysphoria on their path to gender expression and help them explore their feelings of gender dysphoria. Gender-affirming therapy is essential for folks struggling with gender dysphoria because it creates a safe space for them to share and affirm their identity. They learn how to feel comfortable with their identity and lead healthier lives.
Furthermore, therapy equips them with the right tools with which to cope and reduce feelings of distress and discomfort and improve their quality of life. Gender-affirming therapy focuses on exploring one’s gender identity and expression and opens the way to self-acceptance. It also helps individuals improve their relationships with other people and make decisions about the medical treatments and transition options they should pursue.
People struggling with gender identity issues may choose to undergo extensive medical treatments, and even gender-affirming surgery (previously known as sex reassignment surgery), to align their gender expression with their outward presentation. Hormone therapy and gender-affirming surgery are both viable options for individuals with gender dysphoria. These interventions can minimize secondary sex characteristics that do not reflect their gender identity.