What Is Gender Dysphoria?
Gender dysphoria is a condition that causes distress and discomfort when the gender you identify with conflicts with the sex that you were assigned at birth. You may have been assigned a male sex at birth but feel that you’re female, or vice versa. Or you may believe yourself to be neither sex, or something in between or fluid.
Is gender dysphoria a mental disorder?
This disconnect between how society regards you and how you feel physically and mentally can cause severe distress, anxiety, and depression. Gender dysphoria used to be called “gender identity disorder.” But it’s not a mental illness.
Gender dysphoria is not the same as sexual orientation.
Gender nonconforming (GNC) is a broad term that includes people whose gender identity isn’t strictly female or male or moves between the two. Other terms for this include genderqueer, gender creative, gender independent, bigender, noncisgender, nonbinary, and third sex.
Gender Dysphoria Causes
Doctors aren't sure what causes gender dysphoria but think it could be due to hormones in the womb before you're born, genes, and cultural and environmental factors.
Gender dysphoria risk factors
Schizophrenia and autism. Research shows you're more likely to have gender dysphoria if you have conditions such as schizophrenia and autism, which suggests a possible brain-related connection. But some studies challenge this link.
Abuse and trauma. There's also evidence connecting childhood abuse, neglect, and trauma to gender dysphoria. People with the condition often have higher rates of mental health issues like depression, suicidal thoughts, and substance use.
Brain changes. Scientists have found brain structure differences in some people with gender dysphoria, especially in areas like the hypothalamus and amygdala, which relate to gender identity.
Genetics. Since gender dysphoria appears more often in identical twins than fraternal twins, scientists think genes may play a role. They've connected some genetic markers with the condition, but it's unclear whether these are direct causes or just links.
Gender Dysphoria Symptoms and Diagnosis
You have gender dysphoria if you have constant distress or problems with your assigned gender that last 6 months or longer.
Gender dysphoria symptoms in kids
In children, these symptoms include at least six of the following:
- Insisting on or strongly desiring the gender that differs from one that was assigned at birth
- Wanting to wear the clothing of the gender with which they identify
- Strongly preferring friends of the gender with which they identify
- Strongly preferring toys, activities, and games typically aimed at the gender with which they identify
- Preference for cross-gender roles during play or make-believe
- Refusing typically masculine or feminine toys, games, and activities that don’t match their gender identity
- Deep dislike of the genitals they were born with
- Strong desire for sex characteristics, such as breasts or a penis, that match their gender identity
In teens and adults, a diagnosis requires at least two of these traits:
- Certainty that their gender doesn’t match their physical body
- Strong desire to be rid of their genitals and other sex traits
- Deep urge to have the sex traits of the gender with which they identify
- Strong want to be a different gender
- Strong desire to be treated as a different gender
- Deep conviction that their feelings and reactions are typical of their gender identity
Children or adults might dress and present themselves like the gender they believe they are.
Undiagnosed or Untreated Gender Dysphoria
Gender dysphoria isn’t an illness. But the distress from it may be linked to mental health problems, such as anxiety disorders, schizophrenia, depression, substance abuse disorder, eating disorders, and suicide attempts. Some estimates say that 7 out of 10 people with gender dysphoria will have some other mental health diagnosis in their lifetime.
Gender Dysphoria Treatment
The goal of treatment is not to change how you feel about your gender. Instead, it addresses distress and other emotional harm. Treatments include:
Therapy
“Talk” therapy with a psychologist or psychiatrist is a key part of treatment for gender dysphoria. You could also take steps to bring your physical appearance in line with how you feel inside. You might change the way you dress or pick a different name.
Puberty blockers
These are hormones that suppress physical changes of puberty. For someone who is an assigned female, the blocks may hold back the growth of breasts.
Hormones
You may take the sex hormones estrogen or testosterone to develop traits of the sex that you identify with.
Surgery
You could choose to have gender-affirming surgery after a year of hormone treatment. This used to be called a sex-change operation. Experts suggest surgery only after age 18 and after you've lived as your desired gender for 2 years.
Treatment may depend in part on whether you're satisfied with your new social role, hormonal side effects, and whether you want surgical changes. Work with your doctor and therapists to choose the best treatment for you.
After transitioning to your desired gender, you may benefit from therapy. Sometimes, friends, family, and others may not fully understand or support the changes. You'll also need to continue to see your doctor for hormone therapy and transition.
Gender Dysphoria Complications
Gender dysphoria can impact many areas of your life. You might struggle in school because of pressure to dress according to your birth-assigned sex or due to fear of harassment. People who are transgender are victimized more often than the general public.
If gender dysphoria makes it hard to function at school or work, it can lead to dropping out or unemployment. Relationship issues are common, and you may have mental health problems like anxiety, depression, self-harm, eating disorders, and substance misuse.
Prejudice is also common, leading to added stress. Many people with gender dysphoria have trouble accessing health services because of stigma and a lack of providers with knowledge about the condition.
Without gender-affirming treatment, kids and adults with gender dysphoria may be at risk of suicidal thoughts or actions. Transgender people have higher rates of suicide than those who are cisgender.
Living With Gender Dysphoria
Support from family, friends, and peers, and treatments that help align your inner gender identity with your assigned sex at birth, can ease gender dysphoria. Other ideas for living with the condition include:
- Mental health care. A mental health professional can help you explore your gender, work through relationship issues, and address anxiety or depression.
- Support groups. Connecting with other transgender or gender-diverse people, in person or online, can provide a sense of community.
- Self-care. Prioritize sleep, healthy eating, exercise, and relaxation activities you enjoy.
- Meditation or prayer. Spiritual practices or faith communities can offer comfort and support.
- Getting involved. Volunteering, especially in LGBTQ organizations, can help you feel connected and give back to your community.
Social affirmation
This includes embracing pronouns, names, and other features of gender expression that match your gender identity.
Legal affirmation
This involves changing your name and gender on different kinds of government IDs.
How to Support Loved Ones With Gender Dysphoria
Here are some ways that you can support someone in your life who is living with gender dysphoria:
- Listen to your loved one.
- Recognize and validate how they feel.
- Avoid trying to change their mind.
- Consider family therapy to address challenges together.
- Use their preferred name and pronouns.
- Get counseling for them if they’re having suicidal thoughts or self-harming.
If Your Child Has Gender Dysphoria
Children as young as 2 can start showing signs of gender dysphoria. Not all of them will continue to feel a mismatch between their assigned gender and gender identity into their teens or adulthood. Kids who express strong views that they’re in the wrong gender (such as a boy who says, “I’m a girl”) are more likely to become transgender adults.
Experts advise that you take the lead from your child. Let your child be who they are, and get help if you or your child needs it.
If gender dysphoria goes past puberty, studies show that the young person will likely continue to feel that way. For them, their internal sense of gender is not a choice. It is who they are, and they need professional and social support.
Takeaways
Gender dysphoria is the distress that happens when your gender identity doesn't match your sex assigned at birth. It can cause serious anxiety, depression, and other mental health issues due to conflicts among physical appearance, social expectations, and internal feelings.
Diagnosis involves distress that doesn't go away over 6 months, with symptoms varying for children, teens, and adults. Treatment focuses on addressing emotional distress rather than changing gender identity, including therapy, social transitioning, puberty blockers, hormone therapy, and, for some, surgery. Support from family, friends, and health care professionals is crucial, especially for children.
Gender Dysphoria FAQs
At what age is gender dysphoria most common?
Gender dysphoria usually appears in early teenage years, but it’s not unusual for some people to have it in early adulthood. About 25%-30% of those with gender dysphoria get help after age 18, often due to pressure from family and peers, which can delay them from getting support or treatment.
Can parents cause gender dysphoria?
While your relationship with your parents can influence gender identity, parents don't cause gender dysphoria. A mix of biological, psychological, and social factors and parental influence shape gender identity.
What gender has more gender dysphoria?
In children, gender dysphoria is 2 to 4.5 times more common among boys than girls. As kids get older, the ratio is closer to equal.
