Key Takeaways
- Gender dysphoria (GD) is a mental health condition characterized by emotional discomfort and distress when someone’s gender identity — their internal sense of gender — is different from the gender they were assigned at birth.
- Gender dysphoria symptoms may vary by person and age but typically involve a strong desire to be and to be treated like a different gender. Gender dysphoria is common among transgender people, but not all transgender people experience it.
- Gender-affirming therapy and social support can help people with gender dysphoria reduce their distress and feel more comfortable in their bodies.
Imagine feeling like your body doesn’t align with who you truly are or that others don’t see your true self. This is what life can feel like for people with gender dysphoria (GD). Previously known as gender identity disorder, gender dysphoria is a mental health condition that refers to the psychological distress a person experiences when their gender identity differs from the gender they were assigned at birth.
Without support, gender dysphoria can lead to anxiety, depression, and/or suicidal thoughts* and behaviors. Fortunately, therapy, social support, and gender-affirming interventions can help people reduce their distress and improve their sense of comfort and alignment with their identity..
*The 988 Suicide and Crisis Lifeline provides 24/7, confidential support with trained crisis counselors. If you or a loved one is in emotional distress or a suicidal crisis, please call or text 988. If you’re experiencing a life-threatening emergency or you need immediate help, please call 911.
Symptoms and causes of gender dysphoria
Gender dysphoria can cause very real feelings of discomfort and distress, but the exact reason for these symptoms is not yet fully understood. Research suggests that biological, cultural, and environmental risk factors may contribute to its development. For example, prenatal exposure to certain chemicals or the way your hormones develop before birth may increase your chances of developing the condition.
Gender dysphoria can begin at any time, but many transgender people first experience symptoms in childhood, often around age 7. Symptoms vary by gender and age, but here are some of the most common signs of gender dysphoria in children and adults.
Symptoms of gender dysphoria in children include:
- Dressing in clothes associated with a different gender
- Preferring toys, games, and activities typically associated with a different gender
- Preferring to play the role of a different gender during make-believe and fantasy play
- Preferring to play with children of a different gender
- Expressing discomfort with their bodies
- Wishing they had physical characteristics of a different gender
- Insisting that they’re a different gender
Symptoms of gender dysphoria in adolescents and adults include:
- Having a strong desire to be a different gender than the one they were assigned at birth
- Wanting to be treated as a different gender
- Wanting to be addressed with a different gender’s pronouns
- Feeling, thinking, and reacting in ways associated with a different gender
- Expressing a desire to change their bodies
- Wanting the physical and sexual characteristics of a different gender
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Do all transgender people have gender dysphoria?
Transgender is a term that describes people who don’t identify with the gender they were assigned at birth. For example, someone who was assigned female at birth but identifies as a man is a transgender man.
While most people who experience gender dysphoria are transgender, nonbinary people can also experience gender dysphoria. In fact, some nonbinary people also identify as trans. Not all transgender people experience gender dysphoria, and it’s a deeply personal experience for each individual.
Is gender dysphoria a medical or mental health condition?
Gender dysphoria is listed as a mental health condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM). But it’s important to understand that the condition refers specifically to the distress some people experience due to a mismatch between their gender identity and the gender they were assigned at birth.
To be clear, being transgender is not considered a mental health condition. Rather, gender dysphoria refers to the emotional or psychological distress that may arise when a lack of gender alignment impacts a person’s daily life and functioning.
To be diagnosed with gender dysphoria, a person must experience symptoms that are severe enough to impact social, occupational, or other areas of functioning for at least six months.
Gender dysphoria is associated with other mental health conditions, like anxiety, depression, and substance use disorder. It’s also been linked to an increased risk of suicidal thoughts and behaviors, with some studies showing that nearly half of participants with gender dysphoria experienced suicidal ideation. Without a strong support network, gender dysphoria may also contribute to other issues, like loneliness and isolation.
Support for people with gender dysphoria
If you’re experiencing gender dysphoria, consider seeking professional support. There are multiple treatment approaches that can help you manage your distress and express yourself in ways that align with your gender identity.
1. Talk therapy
Therapy is a great place to start your healing journey. Working with a therapist can help you understand your feelings, build self-confidence, and develop healthier coping strategies for managing distressing thoughts and emotions. Family therapy is another effective treatment option — especially for children and teens — that helps family members navigate major changes and provide emotional support.
Your therapist may also suggest group therapy sessions. Connecting with other people who understand your experience may empower you to feel more comfortable expressing your gender identity.
2. Gender-affirming medical treatments
Although gender dysphoria is classified as a mental health condition, some people may prefer medical solutions. This could include gender-affirming hormone therapy or surgery to help align their physical appearance with their gender identity.
Hormone therapy involves taking hormones like estrogen and testosterone to develop physical traits that match your gender identity. This is generally considered a safe and effective solution for reducing unwanted physical characteristics, like facial hair and breast tissue. Still, it’s always important to discuss the potential benefits and risks with your provider. For example, certain masculinizing hormones may trigger anxiety or psychotic symptoms in people with an underlying mental health condition.
Gender-affirming surgery is another option to help you align your body with your gender identity. Common gender-affirming surgeries in the U.S. include breast and chest procedures, genital reconstruction, and facial surgeries. Although people aren’t required to see a therapist prior to gender-affirming procedures, experts recommend consulting with a therapist beforehand to ensure informed decision making and emotional support.
3. Social affirmations
Social affirmations — such as choosing your name and pronouns — are important ways to express and communicate your gender identity. Other ways to socially transition include:
- Gender-affirming clothing and hairstyles
- Hair removal
- Genital tucking
- Genital packing
- Chest binding
- Breast padding
Regardless of how you treat your gender dysphoria, remember to make time for activities that help you feel good about yourself. Practicing regular self-care can reduce stress, increase happiness, and enhance self-confidence.
If you're feeling distressed about your gender not aligning with the one you were assigned at birth, it could be gender dysphoria. A good first step is to speak with a therapist who specializes in gender identity to help you understand and explore your feelings. You might also try keeping a journal to track your thoughts or connecting with LGBTQ+ support groups for guidance.
Find care with Rula
Living with gender dysphoria can cause significant emotional discomfort and distress, but you don’t have to navigate those feelings alone. At Rula, we believe that everyone deserves access to safe and supportive mental health services with a care team they trust.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 10,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.
About the author
Alex Bachert
Alex Bachert is a freelance copywriter and mental health advocate. Since earning her masters degree in public health, she has focused her career on creating informative content that empowers people to prioritize their health and well-being. Alex has partnered with organizations like Ro, WellTheory, and Firsthand, and her work has been recognized by the Digital Health Association.
When she’s not writing about mental health, Alex is usually playing pickleball, meeting with her local board of health, or enjoying time with her three kids.
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