Reviewed by Aaron Horn, LMFT
Every day, more and more people have the resources to understand and become comfortable with their identity, including their gender.
You may have heard of gender dysphoria (or perhaps gender dysmorphia) in discussions about transgender experiences. But what is gender dysphoria? What does it look like? How can you help others cope with it?
What Is Gender Dysphoria?
Gender dysphoria is the feeling of disconnection, discomfort, or distress surrounding the conflict between the gender assigned at birth and the gender one identifies as.
In other words, individuals with gender dysphoria often feel as though the gender they are “inside” (personal gender identity) doesn’t match with the gender they are on the “outside” (physical sex characteristics).
Gender dysphoria often motivates those who struggle to make changes in their lives to address their symptoms. This can include behavior, appearance/dress, interactions with others, transitioning to a different gender socially and/or through surgery, and more.
Also related to gender dysphoria is gender confusion or questioning one’s established gender identity. Gender confusion can refer to uncertainty or unhappiness with one’s gender, and it might include elements of dysphoria.
Gender dysphoria is not a mental illness, but dealing with it can lead to other mental health issues (like anxiety or depression).
Signs Of Gender Dysphoria
Gender dysphoria looks different for every person who deals with it. But some common trends are:
- A strong desire to be seen and treated as a different gender
- Discomfort surrounding biological sex characteristics
- Discomfort surrounding being treated and seen as the gender assigned at birth
As part of the DSM-5, gender dysphoria is recognized as an official psychiatric condition.
The American Psychiatric Association lists the following as gender dysphoria (to match DSM-5 criteria for an official diagnosis, at least two of these symptoms must continue for six months or more).
- A feeling of conflict and incongruence between one’s experienced gender (the gender one identifies as) and primary and secondary sex characteristics (the gender assigned at birth)
- A strong desire to no longer have their secondary or primary sex characteristics
- A strong desire to have the primary and secondary sex characteristics of the other gender
- A strong wish to be the other gender
- A strong wish to be treated and seen as the other gender
- A strong belief that one has the typical reactions and feelings of the other gender, not their sex
Gender Dysphoria In Children
For many individuals who struggle with gender dysphoria, symptoms start during childhood. However, it can be difficult to diagnose gender dysphoria in children.
Children may experience symptoms differently from adults, especially since they may have a harder time clearly expressing and understanding their emotions. It might also be difficult to determine which behaviors indicate gender dysphoria and which behaviors are a typical part of the child’s identity changing and maturing.
Gender dysphoria DSM-5 symptoms for children are fairly similar to those for adults, but they can reveal themselves differently. Some signs of gender dysphoria in children can include:
- A strong desire to be another gender
- Displaying behaviors typically associated with the opposite or other genders (crossdressing, fantasy play as another gender, a preference for toys or activities stereotypically used by the other gender)
- Clear discomfort or distress around one’s biological sex
- This can manifest in different ways thanwe’re used to seeing in adults: for example, a child might be especially distressed about sitting or standing to use the bathroom.
- Preference for friends and playmates of other genders
- Rejection of or dislike of things associated with assigned gender (this can include biological sex characteristics as well)
Some of the above symptoms for children can be normal parts of development and identity formation. However, continued and significant distress or discomfort surrounding one’s body is a key sign of gender dysphoria and should always be taken seriously.
Suppose you think you may be struggling with gender dysphoria. In that case, you might find it beneficial to take our free, confidential gender dysphoria evaluation designed to help you understand your symptoms and what possible steps to take next.
What Does It Mean To Be Transgender?
The AMA defines transgender as “the broad spectrum of individuals who transiently or persistently identify with a gender different from their gender at birth.” In simpler language, the term “transgender” refers to someone who identifies with a different gender than the one they were born as/assigned at birth.
The term transgender is not reserved for those who transition from one gender to another; it can also include those who don’t fit neatly into the gender binary or fall somewhere between genders.
Each transgender individual is different, and it’s important not to generalize the entire demographic. Gender is incredibly complex and can be quite fluid.
Also, not all transgender individuals express themselves in the same way. Some might decide to transition either socially (being referred to as and generally perceived as their preferred gender by others), physically (appearance, gender confirmation surgery, etc.), or some combination of both. Some might not want to transition publicly, and some might change how they transition over time.
The important thing is to do what feels right to you, be supportive of, and respect others’ decisions.
Gender Dysphoria Vs. Transgender: Are They The Same?
Having gender dysphoria does not necessarily mean that an individual is a transgender. The vast majority of transgender individuals typically struggle with gender dysphoria, but the two are not mutually exclusive.
Gender dysphoria can be felt at different points in an individual’s life as he/she/they begin to develop and come to terms with their own identities. Gender nonconformity can also coincide with gender dysphoria feelings, which might make a person “seem” transgender.
However, what’s important in deciding whether or not someone is transgender is how they choose to identify.
Do You Need Dysphoria To Be Trans?
Transgender vs. gender dysphoria: are the two always inherently linked? The truth is that it is entirely possible to be transgender or identify as such, without gender dysphoria. Public awareness surrounding these issues has made it easier than ever to make sense of one’s identity.
Some individuals who identify as transgender might have discovered their identity through self-reflection, social or outside factors, or even just communication with/exposure to others within the community.
Additionally, those who have completed a transition to another gender might stop experiencing dysphoria feelings; however, this doesn’t necessarily make this person less transgender than others.
A large number of those who are transgender indeed do experience gender dysphoria, sometimes to a debilitating and devastating extent. However, it is possible to experience minimal to no gender dysphoria but still feel more comfortable identifying as transgender (especially since it’s an umbrella term).
Dealing With Dysphoria
Gender dysphoria can often make you feel like a prisoner in your own body. It can make you feel as though you can never be yourself, don’t fit in, or like the life you’re living is not the one you want.
All of these things can be incredibly draining, saddening, and painful. If you’re struggling with gender dysphoria or know someone who is, it’s important to reach out for help if it’s needed. Instances of serious mental health complications and consequences are especially high in the transgender community, arguably due to the amount of mental turmoil and anguish that comes with dysphoria and a societal reluctance to accept transgender individuals and people who struggle with gender dysphoria.
Help is available to those who need it. Having a good support system of friends, family, and other loved ones is a great first step. You might also consider working with a mental health professional, like a therapist, to tackle your obstacles as you begin to understand your gender identity.
It might also be helpful to find ways to express gender identity and emotions externally. This could be creative, like writing a poem or creating an art piece, or it might involve the way you present yourself (clothing, hair, makeup, etc.).
Figure out what sort of activities, comments, or situations can be triggering and avoid them. You might also try to develop coping strategies to help you deal with intense emotions at the moment.
Supporting Those With Dysphoria
Gender dysphoria can be debilitating for those who deal with it. It can also be hard for outsiders, or those who are unfamiliar with the topic, to fully understand or empathize.
So, how can you be an ally? How can we best make an effort to understand and support friends, family, or others who are experiencing gender dysphoria?
The following are some tips to become a better, more thoughtful ally to transgender people and those who struggle with gender dysphoria in general:
- Don’t assume gender or sexual orientation.
It’s easy to look at someone and address them as a certain gender/ with certain pronouns based on what we see. This can be very uncomfortable and upsetting for those with gender dysphoria, who often already feel like they’re struggling to be recognized as who they are by the rest of the world.
- Use the pronouns an individual identifies with/is comfortable with. If you’re not sure which pronouns to use, be sure to ask rather than assume.
- Respect the language and terminology someone uses to describe their gender identity.
- Don’t ask about intrusive or personal matters, like biological sex/sex changes, what someone’s “real name” (the name they had before transitioning, also referred to as a “dead name”) is, etc.
- Perhaps most importantly, use your platform and ideas to advocate for LGBTQIA+ individuals and communities. One of the best ways to be supportive is to help make the world, in general, a better place for transgender people and those with gender dysphoria alike.
Other Important Terms
Gender identity is incredibly complex and dependent upon the individual. To understand your own gender identity and those of others, you might find it helpful to be familiar with the following terms:
- Gender Identity: one’s own (deep, long-lasting) sense of self or gender; someone may feel that they are a woman inside despite their physical sex characteristics, or someone might feel like deep down they don’t identify with any gender at all.
- Gender Assigned at Birth: this refers to the gender that matches the biological sex one is born. The gender assigned at birth is based on others’ observations (in this case, physical sex characteristics) rather than an individual’s actual gender identity.
- Gender Nonconformity: Behaviors or attitudes that do not match those stereotypically associated with one’s gender. This can be related to gender dysphoria, but it can also be a normal development and expression.
- Gender Dysmorphia: Dysmorphia means “malformation” and generally describes a situation in which one’s view of their body does not match reality. Body dysmorphia, when someone sees their body image as different than it is. It can be a struggle for those with gender dysphoria. Gender dysmorphia may relate to parts of one’s appearance that are especially distressing, like genitalia, breasts, or body shape.
- Late-Onset Gender Dysphoria: This is gender dysphoria that starts later in one’s life than usual. Individuals with late-onset gender dysphoria start to experience symptoms as older adolescents or adults rather than during childhood.
- Gender Binary: The gender binary is the gender classification that splits individuals into either female or male. These gender assignments are typically based on biological sex. Some people feel most comfortable identifying somewhere between the two binaries of male and female, and some people identify with a different side of the spectrum depending on the day.
- Agender: Meaning “without gender,” agender individuals identify as having no gender identity.
- Non-binary: Individuals who identify themselves as a gender outside the strictly defined lines of the gender binary. This umbrella term encompasses lots of different gender expressions and personal choices; non-binary individuals might identify with a combination of multiple genders, feel that their gender is subject to change and fluidity, and more.
As you can tell, gender identity, gender dyphoriaq, and gender dysmorphia are complicated topics. They can be hard to talk about, but even harder to deal with is the stigma that (unfortunately) comes with them.
Now that you understand the gender identity vs. transgender topic, you can be a better ally to trans or questioning loved ones and friends. You might even gain a better understanding of your own identity.
The most important thing is to be true to yourself and how you feel.
There is no right or wrong way to be transgender or to experience dysphoria: your personal experiences and feelings are valid and deserve to be expressed and embraced.