What is Gender Dysphoria?
Gender dysphoria is a condition where a person experiences discomfort or distress because there's a mismatch between their biological sex and gender identity. It's sometimes known as gender incongruence.
Biological sex is assigned at birth, depending on the appearance of the genitals. Gender identity is the gender that a person "identifies" with or feels themselves to be.
While biological sex and gender identity are the same for most people, this isn't the case for everyone. For example, some people may have the anatomy of a man, but identify themselves as a woman, while others may not feel they're definitively either male or female.
This mismatch between sex and gender identity can lead to distressing and uncomfortable feelings that are called gender dysphoria. Gender dysphoria is a recognised medical condition, for which treatment is sometimes appropriate. It's not a mental illness.
Some people with gender dysphoria have a strong and persistent desire to live according to their gender identity, rather than their biological sex. These people are sometimes called transsexual or trans people. Some trans people have treatment to make their physical appearance more consistent with their gender identity.
Signs of Gender Dysphoria
To be diagnosed with gender dysphoria, a person has to have symptoms that last for at least 6 months.
In children, these symptoms may include:
- Consistently saying they are really a girl even though they have the physical traits of a boy or really a boy if they have the physical traits of a girl
- Strongly preferring friends of the sex with which they identify
- Rejecting the clothes, toys, and games typical for boys or girls
- Refusing to urinate in the way - standing or sitting - that other boys or girls typically do
- Saying they want to get rid of their genitals and have the genitals of their true sex
- Believing that even though they have the physical traits of a girl they will grow up to be a man; or believing if they have the physical traits of a boy they will still be a woman when they grow up
- Having extreme distress about the body changes that happen during puberty
In teens and adults, symptoms may include:
- Certainty that their true gender is not aligned with their body.
- Disgust with their genitals. They may avoid showering, changing clothes, or having sex in order to avoid seeing or touching their genitals.
- Strong desire to be rid of their genitals and other sex traits.
Children or adults might dress and otherwise present themselves like the gender they believe they are.
How is Gender Dysphoria Treated?
The goal is not to change how the person feels about his or her gender. Instead, the goal is to deal with the distress that may come with those feelings.
Talking with a psychologist or psychiatrist is part of any treatment for gender dysphoria. "Talk" therapy is one way to address the mental health issues that this condition can cause.
Beyond talk therapy, many people choose to take at least some steps to bring their physical appearance in line with how they feel inside. They might change the way they dress or go by a different name. They may also take medicine or have surgery to change their appearance. Treatments include:
- Puberty blockers. A young person in early puberty with gender dysphoria might ask to be prescribed hormones (testosterone or estrogen) that would suppress physical changes. Before making that decision, the young person should talk with a pediatrician and sometimes a psychiatrist about the pros and cons of taking these hormones, especially at a young age.
- Hormones. Teens or adults may take the hormones estrogen or testosterone to develop traits of the sex that they identify with.
- Surgery. Some people choose to have complete sex-reassignment surgery. This used to be called a sex-change operation. But not everyone does. People may choose to have only some procedures done in order to bring their looks more in line with their feelings.
With their therapists, people choose the treatment that is right for them based on what they want and what they already look like.
After transitioning, a person may no longer feel dysphoria. But the person may still need therapy. Friends, family, co-workers, potential employers, and religious groups can sometimes have a hard time understanding when someone's gender appears to change. This and other challenges of transitioning can call for professional help.
WHEN TO SEE A MENTAL HEALTH PROFESSIONAL
Mental health issues are real, common, and treatable. According to the National Alliance on Mental Illness (NAMI) 1 in 5 adults experience mental illness and 20% of those are considered serious. 17% of 6-17 year olds experience a mental health disorder. So the first thing to remember is this: You are not alone.
If you feel that you are suffering from a mental illness, and particularly if those issues are preventing you from living life to the full or feeling yourself, you may want to consider professional help which can make an enormous difference.
And to be clear, you don't need to be going through a crisis in order to justify getting help. In fact, it can be advantageous from a treatment perspective to identify and deal with issues early and before they have a major impact on your life. Either way you should feel encouraged and able to seek help however you are feeling.
Mental health professionals such as licensed therapist can help in a range of ways including:
- Help you identify where, when, and how issues arise
- Develop coping strategies for specific symptoms and issues
- Encourage resilience and self-management
- Identify and change negative behaviors
- Identify and encourage positive behaviors
- Heal pain from past trauma
- Figure out goals and waypoints
- Build self-confidence
Treatment for mental health issues, and psychotherapy (sometimes known as 'talk therapy') in particular, frequently helps people to feel better, manage, and even get rid of their symptoms. For example, did you know that over 80% of people treated for depression materially improve? Or that treatment for panic disorder has a 90% success rate?
Other treatment options include medication which, in some cases, can be highly effective when administered in combination with psychotherapy.
So what is psychotherapy? It involves talking about your problems and concerns with a mental health professional. It can take lots of forms, including individual, group, couples and family sessions. Often, people see their therapists once a week for 50 minutes to start with and then reducing frequency as time goes on and issues subside. Treatment can be as short as a few weeks or as long as a few years depending on your particular situation and response.
Never think that getting help is a sign of weakness. It isn't. In fact, it can be a sign of strength and maturity to take the steps necessary to becoming you again and getting your life back on track.
WHEN TO GET EMERGENCY HELP
Are you in distress? If so, or if you think that you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.
Also consider these options if you're having suicidal thoughts:
- Call your mental health specialist.
- Call a suicide hotline number — in the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).
- Seek help from your primary doctor or other health care provider.
- Reach out to a close friend or loved one.
- Contact a minister, spiritual leader or someone else in your faith community.
If a loved one or friend is in danger of attempting suicide or has made an attempt:
- Make sure someone stays with that person.
- Call 911 or your local emergency number immediately.
- Or, if you can do so safely, take the person to the nearest hospital emergency room.