Gender dysphoria is a psychological term for the deep emotional distress experienced by an individual whose gender assigned at birth does not match their gender identity—in other words, how they perceive their gender.
Gender dysphoria is not about an individual’s preference, but is a complex interplay of psychological, biological and social factors that can result in severe distress and social impairment.
Although gender dysphoria is often misunderstood by the general population, it has been widely studied in medical and psychological settings over the years. Our understanding of the specific causes, treatment methods, and symptoms of this condition has significantly evolved, as clearly demonstrated in the newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
DSM-5 Definition of Gender Dysphoria
Compared to the previous version, the release of DSM-5 brought many important changes in order to reduce stigma around gender dysphoria and improve access to care for individuals who need it.
The term for the condition was changed from “gender identity disorder” to “gender dysphoria,” and the language used has moved from rigid definitions of male/female towards recognizing gender as a spectrum.
DSM-5 defines gender dysphoria as a condition (not a disorder) characterized by a significant incongruence between one’s experienced or expressed gender and the gender assigned at birth. In order to be diagnosed, the condition needs to last at least six months and cause significant distress and impairment in important areas of life, such as work, social relationships, and daily functioning.
For adults and adolescents, DSM-5 outlines several indicators:
- A strong desire to be treated as another gender
- A strong conviction of having the typical feelings and reactions of another gender
- A significant dislike of one’s sexual anatomy
- A desire for sexual characteristics/anatomy of the experienced gender
Symptoms
Symptoms of gender dysphoria can significantly vary depending on social and cultural context, age, and personal experience.
The most reported symptoms include:
- Persistent discomfort with one’s sex characteristics, for example the tone of your voice
- A strong desire to be rid of physical traits associated with your assigned gender
- A desire to have the physical traits of the other gender
- A desire to be treated as another gender in your daily life (clothing, different name, different pronouns, etc.)
- Emotional distress, depression, and anxiety causing social withdrawal, due to misalignment of your physical appearance with your experienced gender
In children, symptoms may present as a strong desire to play with toys, wear clothes, or take part in activities that are usually associated with another gender. Children can sometimes also insist that they are, or wish to be, a different gender.
These symptoms can lead to severe mental health issues, such as self-harm or suicidal ideation, if left untreated or unsupported.
Treatment Methods
The treatment of gender dysphoria is highly individualized, often involving different medical and mental health professionals. The goal of each treatment is to reduce psychological distress and support gender affirmation.
A few common methods include:
Psychotherapy
Often one of the first steps, psychotherapy can help individuals explore their gender identity, manage their anxiety and depression, and develop healthy coping strategies. Psychotherapists use a supportive approach to the individual’s identified gender, without trying to change it.
Hormone therapy
Under the guidance of medical professionals, a patient can start hormone therapy (estrogen or testosterone) in order to align their physique more closely with their gender identity. Hormonal changes usually affect voice, body hair, and fat distribution, and can lead to an improved emotional state.
Gender-affirming transition
Gender-affirming transition involves individuals transitioning both socially and physically. Some people decide to change their name, pronouns, and the way they dress or overall present themselves in front of other people. In addition, patients can undergo gender-affirming surgeries, such as reconstruction of their genitalia, in order to relieve dysphoria.
Each of these steps is entirely optional and depends on factors including age, health, available support, and the individual’s personal goals and comfort level.
Further Resources and Reading
- American Psychiatric Association – DSM-5 Overview on Gender Dysphoria
https://www.psychiatry.org/psychiatrists/cultural-competency/education/best-practice-highlights/gender-dysphoria - National Institutes of Health (NIH) – Mental Health and Gender Identity https://www.ncbi.nlm.nih.gov/books/NBK532313/
- UCSF Transgender Care – Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People https://transcare.ucsf.edu/guidelines
- The Trevor Project – Resources and support for LGBTQ+ youth, including those who experience gender dysphoria https://www.thetrevorproject.org/
- National Center for Transgender Equality – Offers more educational materials https://transequality.org/
