Is Gender Dysphoria A Mental Illness?

Reviewed by Melinda (Santa) Gladden, LCSW

Published 06/27/2022

What Is Gender Dysphoria?

Gender dysphoria is a condition formerly referred to as gender identity disorder. The condition occurs when a strong conflict exists between the physical sex of a person or the gender assigned to them at birth and the gender they identify with. It tends to arise from a strong feeling of discomfort arising from the biological sex of the person.

When a baby is born, they get sex assigned to them based on their anatomy. The sex of such a child may often time serves as a factor in determining how parents will act and behave with their children. Most times, one may notice that these activities and behaviors may be tied down to one gender or the other. For example, a parent may buy toys that seem tech-based for a child assigned “male” and may get a child that was assigned “female” dolls instead.

Over some time, the child may begin to feel that their anatomy does little or nothing to represent the gender they tend to view themselves. For example, a person who has a vagina and was assigned female at birth based on anatomical features may have the strong feeling that despite those anatomical features, they are instead more masculine than feminine and may prefer to have a male body. This may cause them to adopt certain behaviors associated with the male gender, as dressing in clothes stereotypically regarded as men’s clothing. Some may go-ahead to get a change of name and prefer that people use pronouns that align with the gender they have chosen to identify with, which is the male gender.

Each person may experience a varying level of transition, which may affect the extent of change they are likely to pursue. Some people with gender dysphoria may feel most comfortable in their body by making more changes. For example, some people may eventually undergo medical or surgical transition alongside hormonal therapy to allow themselves to feel more like themselves in their body. 

There is no certainty of how common gender dysphoria is. This is because people with gender dysphoria tend to feel anxious or dissatisfied about their gender, so many people may not come out or share their true identity with others due to fear of not being accepted as who they really are.

Gender dysphoria is often used as the umbrella term by the American Psychiatric Association in the general description of the distress and discomfort that often co-occur with the difference between a person’s biological sex and gender they choose to identify with.

What Gender Dysphoria Is Not?

Gender dysphoria should not be mistaken for gender nonconformity. While it can be regarded as a subset of gender nonconformity as a group, it is not the same as gender nonconformity. Gender nonconformity is a broader term used to refer to various behaviors that may not align with the gender expectations held by a majority of society. Some nonconforming persons may experience gender dysphoria, but not all.

Behavior that may be considered nonconforming is when a girl would instead put on clothing that is more masculine. This girl may also tend to exhibit behavioral traits that are typically expected of boys. However, this may not be sufficient to state that she has gender dysphoria.

In addition, gender dysphoria is not the same as homosexuality, not related to sexual behaviors. A homosexual is someone that is sexually attracted to people of the same sex as them. The sexual attraction of a person is not a consideration in the diagnosis of gender dysphoria.

Is Gender Dysphoria A Mental Illness?

Most experts do not regard gender dysphoria as a mental illness though it appears on the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). This is because the feeling of not belonging to the sex you were assigned at birth is not a mental illness in any way; it is the discomfort that the gap in identity may bring that may highlight specific mental health issues in gender dysphoria.

Diagnosis

 

Being able to accurately diagnose gender dysphoria can go a long way in helping a person to understand the reasons behind their feeling of discomfort from having a different gender identity from their biological gender. A proper diagnosis could help them experience lesser anxiety and fear. It may also help answer several questions that such a person may have had for long periods.

Adults and adolescents with gender dysphoria may experience a feeling of conflict between the gender assigned to them at birth and the gender they may have come to identify themselves with. This may also cause them to experience some significant levels of distress, which may affect how they function in other aspects of their life.

To be diagnosed with gender dysphoria, someone also needs to experience at last two of the following signs:

  • An overwhelming inclination to be another gender
  • An overwhelming inclination to possess the sex characteristics of their expressed gender, either primary or secondary
  • An overwhelming inclination to no longer possess the sex characteristics of their biological gender
  • A strong sense of detachment from the sex characteristics of their biological gender and the gender they identify with
  • A strong feeling that their behavior aligns with their expressed gender
  • A strong want for being treated as their expressed gender

Diagnosis In Children

Children can also be diagnosed with gender dysphoria. Around the ages of 2 and 3 years, most children may already have started developing behaviors that align with their biological sex. Some children may already begin to exhibit signs that show that they may be gender nonconforming at that stage.

As early as four, some children may start experiencing conflict between their assigned gender and sex. Most early signs may be very subtle initially and may increase in severity as they grow older. When they reach puberty, it may be at the point that the initially mild signs might become clear enough for a diagnosis.

Children that have gender dysphoria are likely to experience levels of distress significant enough to slightly disrupt their normal activities because they are developing strong feelings that their bodies are not in alignment with who they think they are. The severity of the distress they may experience could affect them in other areas of their lives like school, interpersonal relationships for as long as six months.

For a child to be diagnosed with gender dysphoria, they have to meet at least six of the following criteria:

  • An overwhelming inclination to be another gender
  • A continuous assertion that they are not the gender people refer to them as
  • A strong predisposition for games, toys, and activities that are typically linked with the opposite gender
  • A strong predisposition for roles that are of the opposite gender roles when they act make-believe plays
  • A strong predisposition for clothes that are typically linked with the opposite gender
  • A firm refusal to participate in games and activities and the refusal to use toys that typically match the gender they were assigned
  • A strong predisposition to have playmates that are of the opposite gender.
  • A strong distaste for the sexual anatomy they were born with
  • A strong inclination for sex characteristics that aligned with the gender they tend to identify with

Generally, children are likely to exhibit behaviors that may be regarded as gender-nonconforming during their early development years. These behaviors can be considered as usual. However, if the signs begin to get more persistent and severe as they grow older and seem to be experiencing distress resulting, they may have gender dysphoria. Research has shown that children who experienced more severe signs around puberty and adolescence have higher chances of eventually becoming transgender adults.

Managing Gender Dysphoria

Technically, gender dysphoria is not exactly treated. To say it is treatable would mean the condition could be made to go away. This is not the case when it comes to gender dysphoria, and it is not the aim of gender dysphoria treatments.

Rather, the treatment of gender dysphoria is targeted at helping people that have gender dysphoria to find comfort from the anxiety and conflict that may have been caused by the condition and to prevent other possible mental health issues from developing.

Treatment Of Gender Dysphoria

For the treatment of gender dysphoria, there are quite a number of available options:

Therapy

Many people with gender dysphoria may experience depression and anxiety. If the cases degenerate to become more severe, there may be the occurrence of self-harm behaviors. Therapy can help individuals learn how to handle those feelings healthily and safely.

Puberty Suppression

In children diagnosed with gender dysphoria, doctors can suppress the release of hormones in treating the condition. Becasue of the absence of the hormones, the child’s body will remain unchanged.

Cross-Sex Hormones

Some persons with gender dysphoria may want to transition to the gender they identify with. Hormone therapy can be used to start this process. Women may take testosterone supplements to encourage the growth of hair, the development of muscles, and a lower pitch of voice. On the other hand, men may take estrogen to encourage the growth of breast tissue, the redistribution of fat around the body, and changes in facial.

Gender Confirmation Surgery

A number of people with gender dysphoria may want to change their bodies to match the gender they identify with.

The process of transitioning genders is one that may be challenging regardless of the age of the person. As a result, having professionals on board is very necessary. People who plan to transition genders may also require a strong support system of people they trust.

If you think you have gender dysphoria, take this test to find out.

NOTES: Great article, but again place next to the test that they should seek help from a mental health professional. The test can be a guide but not a replacement to appropriate treatment.
 Does not go against what is clinically accepted.
 Does not encourage mindsets or practices that may be harmful to the reader.
 Is factual and up-to-date.