Reviewed by Laura Angers, LPC
Here's a look at gender dysphoria treatment and how it can help.
Assigned Gender Vs. Expressed And Experienced Gender
Before looking at the definition of gender dysphoria, it helps if you know what assigned and experienced gender is.
Your assigned gender is the gender you were proclaimed to be at birth. Perhaps a doctor or midwife looked at you and told your parents whether you were a boy or girl. Or maybe your parents made that determination themselves. They treated you as that gender as you grew up. They probably dressed you in the typical clothes for that gender, encouraged you to behave as that gender, and discouraged you from participating in the usual activities of the other gender.
Your experienced or expressed gender is the gender you feel inside. It's aligned with the gender roles that feel right to you. And it's the gender that society associates with the types of behavior that you feel natural doing. When you and others accept your experienced and expressed gender, you can feel comfortable in your skin.
Gender Dysphoria Definition
Gender dysphoria can happen when there's a mismatch between the gender you were assigned at birth and your own experiences of gender. Your body parts may indicate that you're male or female, but you feel strongly that you're the opposite. The dysphoria part refers to a sense of discontent or unhappiness with your biological gender and the gender roles you're expected to conform to in society. The dysphoria definition emphasizes the distress caused by the mismatch between assigned gender and experienced gender.
Gender Dysphoria Vs. Gender Identity Disorder
In the past, transgender people were often diagnosed with a gender identity disorder. But psychology experts realized that this diagnosis could be harmful. It suggests that it's your gender identity that's the problem. It seems to say that if you don't identify with your assigned gender, there's something wrong with you. And, gender identity disorder gives the impression that you need to think, feel, and behave as society expects you to because of your assigned gender.
That's why the DSM 5 changed the name and criteria for diagnosis. Now, the term used is gender dysphoria. What's the difference? The phrase "gender dysphoria" recognizes that the real problem is the distress you feel about the mismatch. Part of the distress may come from ideas you and your family have about gender you or they think you should be. Also, you and they may be uncomfortable with how you express gender. Another part of the discontent might be because of the social stigma attached to being transgender. In any case, the new term recognizes that your gender identity isn't a problem.
Is Gender Dysphoria A Mental Illness?
As defined in the Diagnostic and Statistical Manual, the DSM-5, gender dysphoria is listed among all the recognized mental disorders. After all, the purpose of the manual is to guide the diagnosis of mental conditions.
However, the label "disorder" was eliminated in this version of the DSM to reduce the stigma of having that diagnosis. And in the sense that mental illness indicates an abnormal way of thinking, feeling, or behaving, gender dysphoria really can't be considered a mental illness.
Again, it's important to remember that it's the distress or dysphoric experience of being transgender, making it a mental problem. If you're transgender but have no dysphoric feelings, thoughts, or behaviors about it, you don't have dysphoria.
DSM Gender Dysphoria Criteria
The DSM 5 lists specific criteria for gender dysphoria to help mental health professionals recognize and diagnose this condition. Receiving this diagnosis means that two things are true. First, your assigned gender is different from the gender you experience and express. Second, you have distress about that and may even have problems functioning because of it.
Furthermore, you must have at least two of the following symptoms, and they must last for at least six months.
- There's a significant difference between your experienced gender and your primary or secondary sex characteristics.
- You strongly wish you could eliminate your current primary and secondary sex characteristics.
- You have a deep desire to have the primary or secondary characteristics of another gender.
- You strongly want to be the other gender.
- You want others to treat you as the other gender.
- You feel confident that you behave and react the same as people of the other gender usually do.
Gender Dysphoria Treatment
Treatment for gender dysphoria is designed to help you deal with or overcome your dysphoric experience of gender. It can consist of various types of individual or group therapy. This treatment won't change who you are. It has different goals and outcomes you may not expect.
Goals Of Treatment
The goals of treatment for gender dysphoria all have to do with coming to terms with your gender. Here is a brief list of some of the goals you might work towards psychological treatment for gender dysphoria.
- Explore Your Gender Identity– Maybe you don't know what your gender identity is. You might have had conflicting feelings or experiences related to gender. In therapy, you have the freedom to question your assigned gender without any requirement to change or not change your gender identity. And, you can explore what it means to you to be male or female.
- Accept Yourself As The Gender You Feel Inside– With society pushing you to behave as your assigned gender, it might be hard to accept yourself for who you are inside. You may criticize yourself constantly or feel like a failure when you don't conform to others' wants. Before you can deal with their disapproval, you have to learn to love yourself like your gender. Therapy can help you come to terms with the mismatch and even boost your self-esteem.
- Deal With Family And Society's Expectations.It can be disheartening when those around you expect you to behave differently than you do. Even if you don't express the gender you feel inside, knowing that others expect you to can be very upsetting. But as you learn to deal with their disapproval, you can begin to feel more confident in being who you are.
- Learn How To Handle Bullying – Often, transgender people are the targets of bullies. It's a common experience to be hurt physically or emotionally by people who don't understand gender differences. So, knowing how to deal with situations where you're being bullied can make your life easier and less distressing.
- Express Your Dysphoric Feelings In A safe, Non-Judgmental Environment– One goal of therapy is to support you. This therapy aspect is often critical because so many transgender people face disapproval and are even shunned by their family and society; having a place to express yourself freely can be invaluable.
- Explore Options For Expressing And Living Your Gender Identity–Your therapist can provide information and educational materials about the ways you might choose to approach gender incongruence. They can offer info on topics like living as the other gender, getting gender reassignment surgery, and each option's psychological challenges. They can also support you as you talk through your reactions to each of these solutions.
- Manage The Coming Out Process– If you decide to let others know that you're transgender, you may be afraid of what will happen. And indeed, you may face numerous challenges during this crucial period. A counselor allows you to express yourself and helps you deal with your fears. They can offer insights about what to expect and offer support during this time.
- Help With Living According To Your True Gender Identity–If you have gender reassignment treatment, you'll probably spend some time living as the other gender before making the transition. Even if you don't intend to make a medical transition, you might decide to live in a way that's congruent with your gender identity. This change may involve many practical dilemmas and adjust to societal attitudes about how you choose to live. A therapist can help you cope with and manage your new living situation.
- Deal With Gender Reassignment– At some point, you may decide to make a physical transition to your experienced gender. If you do, therapy can help you deal with any mixed feelings or fears you have about changing your gender through medical procedures.
Many of the same treatment methods are used for gender dysphoria as for many other mental problems. The difference is that the subjects you deal with in therapy will be different. But the techniques used may be about the same.
The exception, of course, is gender reassignment. Medical treatment for gender dysphoria usually consists of the triadic treatment model. The triadic treatment has three parts: living as your true gender identity, taking hormones, and getting surgery to change your sex characteristics.
As for psychotherapy methods, your counselor may help you using a variety of techniques and therapy types. These include:
- Individual counseling
- Couples, family, or group therapy
- Educational counseling
- Coping skills development
- Insight therapy
"Do I Have Gender Dysphoria?"
You might be well aware there's a mismatch between your assigned gender and your experienced gender. Or perhaps you're only questioning whether you have gender identity issues. Even if you are sure of your gender identity, though, you may not be sure that it's causing you significant distress.
One way to find out is to take a gender dysphoria test. An online screening test for gender dysphoria is a confidential and objective assessment of your symptoms. It isn't a diagnosis, but it can reveal the need to explore the possibility further. Suppose the results show you probably have this condition. In that case, you can then consider working with a mental health professional to resolve your gender issues.
Gender dysphoria is a condition that can cause significant distress. The first step to relieving your fears or discomfort is to find out if you have the symptoms of gender dysphoria. If you do, you can move on to seeking mental health help for diagnosis and treatment.
In the end, whatever your gender identity, you can learn many ways to deal with the feelings that come with it. With the best treatment for you, you can learn to accept your inner gender identity and live the life that matches your gender experience.