Highlights
- Gender dysphoria describes the distress and discomfort a person feels when their gender identity doesn’t match their assigned sex at birth.
- Transgender people and other gender-diverse people can experience gender dysphoria.
- Diagnosis of gender dysphoria requires the presence of two or more of the clinically significant symptoms defined within the DSM-5.
- Gender-affirming care and social support are critical aspects of quality, effective treatment for gender dysphoria.
- Learn more about gender dysphoria, treatment, and supporting gender-diverse loved ones with the resources available at eDrugstore.com.
Society’s understanding of gender and gender identity continues to evolve. In recent years, experts have publicly recognized the need for gender-affirming care to support people with gender dysphoria. Fortunately, there are now many resources available for gender-diverse people to overcome gender dysphoria.
What Is Gender Dysphoria?
Gender dysphoria is the term used to describe intense feelings of discomfort or distress that a person might feel when their gender identity doesn’t match their assigned sex at birth or sex characteristics. For example, someone who was assigned female at birth but knows they are male might experience symptoms of gender dysphoria.
Who Experiences Gender Dysphoria?
It’s common for transgender and other gender-diverse people to experience gender dysphoria at some point in their lives. This means that people who are nonbinary, agender, or even intersex can also experience gender dysphoria. However, being transgender or gender-diverse doesn’t necessarily mean you will experience gender dysphoria.
Is Gender Dysphoria a Mental Illness?
Being transgender or gender-diverse isn’t a mental illness or mental health condition. Similarly, feeling discomfort about this mismatch or incongruence isn’t a mental health condition itself. When this discomfort and distress becomes severe, a person might be diagnosed with gender dysphoria.
Gender dysphoria is currently categorized as a mental health condition within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The DSM-5 includes this diagnosis to help people access gender-affirming care.
The stigma and discrimination a transgender or gender-diverse person faces can contribute to new or can worsen existing mental health conditions. Untreated gender dysphoria can contribute to these conditions. For example, some people with gender dysphoria also experience:
- Anxiety
- Depression
- Disordered eating
- Post-traumatic stress disorder (PTSD)
- Substance use disorder
From Gender Identity Disorder to Gender Dysphoria
History shows us that transgender and gender-diverse people have been part of our communities since early civilization. However, the way we understand and pathologize various gender identities has changed over time. The way a society perceives gender and the support (or lack thereof) it provides to people across the gender spectrum helps shape how people feel about their gender identity.
The DSM-5 included gender dysphoria in place of the previous term, gender identity disorder. It also included a clear statement that “gender non-conformity is not in itself a mental disorder.” This marked a significant shift in the medical community’s pathologization of gender-diverse people.
Symptoms of Gender Dysphoria
Gender dysphoria is characterized by significant distress and discomfort related to the incongruence between a person’s body and their gender.
Many people experiencing gender dysphoria feel overwhelmed by feelings of dislike for their gender, genitals, or other physical characteristics. Experiencing these feelings within a culture that doesn’t support gender diversity can lead to severe mental distress.
Symptoms of gender dysphoria include:
- Strong desire to be a different gender
- Strong belief that one’s feelings, behaviors, and reactions are typical of another gender
- Aversion to one’s own genitals
- Desire to be rid of one’s own secondary sex characteristics
- Desire to be treated as a different gender
- Desire to have the genitals or secondary sex characteristics of the sex they were not assigned at birth
- Other symptoms related to distress that affect functioning in social situations
When Does Gender Dysphoria Start?
Gender dysphoria often begins in childhood or adolescence. However, some people may experience gender dysphoria but not realize it or have the language to describe it until later into adulthood.
A recent study found that most transgender adults first experience gender dysphoria in early childhood. Out of 210 adults, 73 percent of trans women and 78 percent of trans men reported experiencing gender dysphoria by the time they were seven years old.
How is Gender Dysphoria Diagnosed?
The DSM-5 has two sets of diagnostic criteria, one for adults and one for children and adolescents. The DSM-5 requires that someone experiences at least two of the defined symptoms of gender dysphoria before they can be diagnosed. The symptoms must also cause significant distress or affect functioning for at least six months.
Causes of Gender Dysphoria
The cause of gender dysphoria remains unclear, but there are many theories as to how it develops. Many experts believe that gender dysphoria is a result of a combination of both biological and psychosocial factors.
Researchers have examined:
- Environmental factors. Exposure to certain chemicals during prenatal development may disrupt sex determination. A 2022 study comparing twins to non-twin siblings suggests that shared environmental influences during prenatal development may contribute to gender dysphoria.
- Genetic factors. An early study of twins suggested that identical twins are more likely to share gender dysphoria prevalence than fraternal twins. The 2022 study mentioned above may indicate a genetic as well as environmental factor. Researchers haven’t confirmed specific genetic pathways responsible for the development of gender dysphoria. However, research suggests that genes involved in sex hormone-signaling may contribute to gender dysphoria.
- Hormonal factors. Hormonal influences in the womb may contribute to gender development. For example, exposure to high levels of testosterone in utero may contribute to the development of gender dysphoria in people assigned female at birth.
- Social factors. There are many factors that influence how we experience gender and how we form our identities. This includes social factors, such as culture, education, family systems, and significant life events.
The research on gender dysphoria is ongoing. Gender is complex, and there are many areas that researchers continue to explore.
Treatment for Gender Dysphoria
Treatment for gender dysphoria varies, based on individual needs and access to care. The ultimate goal of treatment is to reduce or resolve suffering and to promote flourishing.
People who experience gender dysphoria often find relief when they receive ongoing gender-affirming care. This may include a combination of exploring gender identity, social support, counseling or therapy, hormonal therapy, or surgical intervention. Some people who experience gender dysphoria experience relief without undergoing medical or surgical treatment.
Research supports gender-affirming care for improving the health and well-being of gender-diverse people. For example, a recent study demonstrated that transgender and nonbinary youth who receive gender-affirming care show improved mental health outcomes.
Barriers to Care for Gender Dysphoria
There are many barriers for transgender and gender-diverse people in seeking the care they may want or need. They often face discrimination when seeking care, roadblocks in accessing care through their insurance company, and extraordinarily high costs for care that isn’t covered by insurance. Some people may choose not to seek care because they feel it’s unsafe for them to do so.
Expression and Affirmation of Gender Identity
It’s easier to work through gender dysphoria when someone feels comfortable to explore and express their gender identity. It’s easier to do this when the people (and systems) around you affirm your identity.
Outwardly expressing your gender identity can help to reduce feelings of gender incongruence. Expressing your gender identity might include dressing to align with your gender, using a name and pronouns that align with your gender, or taking steps to change your appearance or physical sex characteristics to align with your gender.
Some people legally change their names and gender on their government documentation or identification.
Medical Intervention for Gender Dysphoria
A multidisciplinary team that coordinates care can help to improve treatment outcomes. A well-rounded care team for someone with gender dysphoria may include a psychologist, psychiatrist, endocrinologist, and surgeon. The providers you need will depend on the level of care you’re seeking.
Some people may seek gender-affirming medical interventions, such as:
- Hormone therapy. Hormone therapy can help bring a person’s body into alignment with their gender. This typically includes continuous use of estrogen or testosterone.
- Surgery. Some people may seek surgery to bring their primary and secondary sex characteristics into alignment with their gender. This may include surgery to change the chest, external genitalia, internal genitalia, facial features, or body composition.
Therapy for Gender Dysphoria
There are many types of psychotherapy and counseling that can help manage gender dysphoria. Many people benefit from both individual and group-based therapies to help work through gender dysphoria and related stressors.
Therapy and counseling options may include:
- Psychotherapy to help you work through feelings, practice acceptance, and learn new coping skills
- Couples counseling or family counseling to help create understanding and improve family support
- Sex therapy to help you work through challenges with sex or intimacy
- Peer support groups to build community and validate your experiences
Research clearly demonstrates that counseling that attempts to change a person’s gender identity or sexual orientation are harmful and ineffective. For this reason, conversion therapy has been banned in many states.
Conclusion
Gender dysphoria is a serious condition that can cause significant distress in gender-diverse people. People who receive gender-affirming care show improved outcomes for their overall health and well-being. When transgender and other gender-diverse people are accepted and respected within their communities, they can live healthier and happier lives.
There’s still more work to be done to raise awareness that gender is a spectrum and that being gender-diverse is a natural human variation. Fortunately, there are many resources available to help support people who experience gender dysphoria.
At eDrugstore, we strive to provide quality resources to people of all gender identities. Follow our blog for up-to-date, evidence-based information about intimacy and relationships along with sexual health issues like erectile dysfunction.
Shelby is a public health professional with research and field experience in sexual and reproductive health. She holds a Master of Public Health (MPH) and is a Certified Health Education Specialist (CHES).
