Reviewed by Lauren Guilbeault
At birth, the doctor typically assigns your gender right away. They simply look at your genitalia and say, “It’s a boy!” or “It’s a girl!” Immediately, everyone has ideas about who you are and how you should be treated. Your parents generally give you a boy’s name or girl’s name, dress you up in boy’s or girl’s clothing, and proceed to raise you to be that gender.
But what if you don’t feel exactly comfortable with that initial gender assignment? What if the uncomplicated way everyone has assumed your gender doesn’t reflect the complicated feelings you may have about your own gender identity?
If this is the case, you maybe experiencing gender dysphoria. Read on to learn about what it is, signs of gender dysphoria to watch for, and what to do next.
What Is Gender Dysphoria?
Gender dysphoria, put most simply, involves feelings of dissatisfaction or unease with your assigned or biological gender. It can be considered a mental disorder because it often causes emotional and mental distress and may make it hard to function in everyday life and social situations.
Gender Identity Disorder Vs. Gender Dysphoria
Gender dysphoria is arguably a new name for an older condition: gender identity disorder. The old name suggested that the problem was in your gender identity itself. However, the new name emphasizes dysphoria, which means being uneasy or dissatisfied with your gender. The critical difference between the old and new terms is that gender dysphoria recognizes that your gender identity can be whatever you experience it to be, so long as you’re comfortable with it.
Gender Dysphoria Statistics
Gender dysphoria used to be a rare or at least hidden phenomenon. But it’s becoming more accepted, better understood, and, as a result, more widely reported. Researchers have compiled gender dysphoria statistics that show the significance and extent of this mental health problem.
As of 2017, somewhere between 0.5% and 1.3% of people said they identified with a different gender than their physical gender or the gender they were assigned at birth. A recent U.S. survey found that 1.4 million people identified as transgender. However, because of the social stigma involved, researchers believe that the accurate number is likely higher.
The prevalence of other mental health issues in people with gender dysphoria is relatively high. For example, about 28% reported that they had issues with substance use. Even more alarming, about 48.3% said that they had suicidal thoughts, while 23.8% had already attempted suicide at least once. Gender dysphoric people may have a higher likelihood of problems with anxiety, depression, and personality disorders as well.
If you think you may hurt yourself or attempt suicide, reach out to 911 or call a suicide hotline. In the U.S., you can dial 1-800-273-TALK (1-800-273-8255) to reach the National Suicide Prevention Lifeline. Or, use the webchat atsuicidepreventionlifeline.org/chat.
Screening For Gender Dysphoria
The quickest way to assess your symptoms of gender dysphoria is to take a simple screening test. You can do an online screening in a few minutes and receive instant, confidential results. The purpose of the test is not to tell you what gender you should or shouldn’t be. Instead, it’s a measure of whether—or how much—you are distressed or impaired by a mismatch between your assigned and experienced gender.
Gender Dysphoria Symptoms
If you have gender dysphoria, you may experience two different types of symptoms. Gender identity symptoms are signs of a mismatch between your assigned or biological gender and your own experience of your gender. Dysphoria symptoms, on the other hand, are signs of distress, discomfort, and impairment related to this mismatch.
Gender Identity Symptoms In Adolescents And Adults
If you have the following symptoms, you may identify with a gender that’s different from the one you were assigned at birth or from your physical gender. Your inner gender identity can also be called your experience of expressed gender. Here are some of the signs you might notice if you have gender dysphoria.
Inner Gender Vs. Sex Characteristics
One sign is if your inner gender is different from your sex characteristics. That can include both primary sex characteristics present at birth, such as a penis and testes or vagina. It can also include secondary sex characteristics that develop later, such as beards and deep voices for males or breasts and high voices for females.
Desire To Get Rid Of Your Current Sex Characteristics
You may have gender identity issues if you have a strong desire to eliminate your primary or secondary sex characteristics. If you’re a young adolescent, for example, you might wish you could prevent secondary sex characteristics from developing altogether.
Desire To Have Sex Characteristics Of The Other Gender
Another sign of gender identity mismatch is if you strongly wish you had the primary or secondary sex characteristics of the other gender. An example is if your assigned gender is female, but you wished that you had a beard. Or, if you were male but wished that you had breasts.
Desire To Be Another Gender
Perhaps you simply want to be another gender besides the one indicated by your sex characteristics or on your birth certificate. You might want to be the opposite binary gender, or you might want to be somewhere else on the gender spectrum, including non-binary.
Desire To Be Treated As Another Gender
You might want others to treat you as a person of a gender different from your assigned or physical gender. For many people, the most distressing part of gender dysphoria may be not being treated like the gender they feel inside.
Strong Belief That You Have The Emotions And Reactions Of Another Gender
It can also be upsetting if you believe your emotions and reactions are right for another gender but not your own. You might think that your feelings are more appropriate, more acceptable, or downright “normal” for someone of a different gender.
Gender Identity Symptoms In Children
Several of the gender identity symptoms are the same for children as adults. However, there are a few differences. Here are the signs to watch for in children.
- Desiring to be or insistence that they are the other gender
- Preferring to only wear clothes of the opposite gender
- In make-believe play, preferring to choose the other gender’s roles. For example, a girl choosing to be the father when playing house
- Preferring toys or games usually played by the other gender
- Preferring to play with children of the opposite gender
- Rejecting toys, game, or activities stereotypically associated with their assigned gender
- Disliking their own sexual anatomy
- Desiring the primary or secondary sex characteristics that match their inner gender rather than their biological one
The dysphoria symptoms are the signs that your gender identity issues are upsetting to you. These symptoms usually start with distress over the mismatch. They can also include impairment in daily functioning. For example, you might have trouble at work or in social situations because you don’t feel comfortable with your gender or others’ perceptions.
Diagnosis Of Gender Dysphoria
Psychiatrists and therapists use the DSM-5 diagnostic manual to evaluate gender dysphoria according to well-established criteria. For this disorder, the criteria include both gender identity symptoms and dysphoria symptoms.
A diagnosis of gender dysphoria in children requires that at least six of the gender identity symptoms listed above have been going on for at least six months. One of those symptoms must be the first one on the list—a strong desire to be or insistence that they are the other gender. As for the dysphoria symptoms, the difference between their experienced and assigned gender must be significantly distressing and impair their ability to function at school, in social situations, or in other areas.
In Adolescents And Adults
The DSM-5 criteria for diagnosing an adolescent or adult with gender dysphoria is somewhat different. To receive this diagnosis, you must have had at least two of the gender identity symptoms for the last six months. For adults, that means any two of the six symptoms on the adult gender identity symptoms list. In addition, there must be dysphoria. This can show up as impairment at work, in social situations, and in other functioning areas.
What Gender Dysphoria Isn’t
You may have a clear understanding of what is meant by gender dysphoria. But it’s also essential to recognize what this term is not referring to. First, gender dysphoria doesn’t necessarily mean that you don’t conform to gender norms or stereotypes. You can have gender dysphoria and conform to the norms or not.
If it causes you no distress, it isn’t gender dysphoria. It’s important to note that being gay or lesbian has nothing to do with gender dysphoria. Neither of these issues is a mental disorder. However, gender dysphoria is a mental disorder because it causes distress and can impair functioning.
What Causes Gender Dysphoria?
No one really knows precisely what causes gender dysphoria. However, researchers have been studying this question and have developed a few possible causes of gender dysphoria. They can include:
- Being born with ambiguous sex organs
- Exposure to certain chemicals before birth
- Possible neural/anatomical link between schizophrenia or autism and gender dysphoria
- History of maltreatment, neglect, or physical or sexual abuse as a child
- Faulty development of the nervous system
- Differences in the hypothalamus
- Differences in the amygdala
- Genetic predisposition
It’s essential to recognize that none of these potential causes has been proven to be the reason why anyone has gender dysphoria. There’s still a lot of research left to do before the answer is clear. In the end, the cause may seem less important than the effect it has on your life.
Gender dysphoria can be a severe mental health issue. It can affect your life by causing you emotional distress and making it hard to function in everyday life. The best way to deal with those effects is to talk to a mental health professional and get treatment. You might start by taking a screening test, then seek help if you choose. When you address your gender dysphoria issues, you can express your thoughts and emotions in a safe place, learn to cope with the dysphoria, and consider your options.