Gender dysphoria refers to a condition in which an individual experiences discomfort or distress due to a conflict between their biological sex and gender identity.
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This may involve feeling like their gender identity does not align with the gender they were assigned at birth. The symptoms can vary widely, including depression, anxiety, social isolation, and a desire to alter one’s physical appearance to align with gender identity.
Those with gender dysphoria may feel uncomfortable and/or distressed over the conflict between their physical and sexual characteristics and how they feel and think about themselves.
This contrasts with cisgender individuals – those whose gender identity aligns traditionally with the gender or sex assigned to them at birth.
Many people experiencing gender dysphoria may identify as transgender, which is an umbrella term describing individuals whose gender identity or gender expression differs from the sex or gender they were assigned at birth.
Gender identity and expression differ from sexual orientation (the type of people one is sexually attracted to). Sexual orientation is just as diverse for those who are transgender and gender non-conforming as it is for cisgender individuals.
What are gender norms?
Those experiencing gender dysphoria may also experience distress over traditional gender norms. Gender norms can be psychosocial factors such as verbal labeling (e.g., using terms ‘boy’ or ‘girl’), non-verbal gender-cuing (e.g., gender-specific clothing and hairstyles), and gender role expectations (e.g., getting pregnant).
‘Masculine’ and ‘feminine’ gender norms are culturally defined and vary across time and cultures. Although these gender norms may be imposed on people from a young age, it has been found that these factors are not determinative for those with gender dysphoria.
For instance, if a child has been encouraged to play with traditionally ‘boys’ toys throughout childhood, they may still experience a desire to identify as female.
Is the term ‘gender dysphoria’ problematic?
Some experts and advocates argue that the term “gender dysphoria” can be stigmatizing. Here’s why:
1. It Medicalizes Trans Identity
- The term frames being transgender as a mental health condition.
- This can imply that being trans is a disorder or something “abnormal.”
- It overlooks that gender identity is a natural and diverse aspect of human experience.
2. It Reinforces Pathology
- Using gender dysphoria as a diagnosis can suggest that being trans needs to be “treated” or “fixed.”
- This framing can marginalize people whose identities don’t fit medicalized definitions.
3. It’s Tied to Healthcare Access
- The diagnosis is often a gateway to gender-affirming care (e.g., hormones or surgery).
- As a result, some people feel pressured to present their identity in a way that meets clinical criteria.
4. It Can Limit How We Understand Gender
- Focusing solely on distress may obscure the broader reality of gender diversity.
- It risks defining trans lives only in terms of suffering, rather than identity, agency, and joy.
⚠️ While this article refers to gender dysphoria in line with the DSM-5, it’s important to be aware of the ongoing debate around the term—and the need to view gender diversity as valid and non-pathological.
Signs of gender dysphoria
People experiencing gender dysphoria often show one or more of the following signs:
- A strong dislike of their sex characteristics, along with a desire to have the physical traits of another gender.
- A deep longing to be recognized and treated as a different gender than the one assigned at birth.
- A preference for clothing, hairstyles, or other forms of self-expression that align with their gender identity rather than societal expectations.
- Rejection of gender-stereotypical toys, roles, or activities commonly associated with their assigned gender.
- Emotional discomfort or distress when addressed or treated as their assigned gender.
- A desire to be called by a name that better reflects their gender identity.
- Choosing pronouns that match their true gender identity, which may differ from what others assume.
- Resistance to conforming with traditional gender norms and expectations.
What does gender dysphoria feel like?
Below are some other experiences that trans individuals have shared about how gender dysphoria feels:
“Before I knew I was trans, it was easy to ignore and think I was just dissatisfied with my appearance. What was harder to ignore was the gnawing pit in my chest. Every time I looked at a girl or thought about being one, I’d get this deep feeling of yearning for some missing essential part of myself. It feels a bit like nostalgia, but for a past that never existed.”
“Looking in the mirror and just feeling off, like in some way your body is a (sometimes disturbing) object decorating your bathroom and not a representation of you. Certain parts or aspects of you feel more like that than others. Despair and nonrecognition upon seeing your shadow. Staring at yourself for ages waiting for your real reflection to come into view.”
Challenges faced by People who Experience Gender Dysphoria
Many individuals throughout history would have been considered transgender today.
There are also cultures around the world that recognize more than two genders. Therefore, people who do not identify as a different gender from their assigned gender have always existed throughout time and places.
However, there is often still a stigma attached to individuals who do not conform to their assigned gender at birth, especially in Western cultures.
Healthcare challenges
Depending on the country they live in, those with gender dysphoria may have difficulty accessing appropriate healthcare or insurance to cover their medical costs. There may also be a long waiting list, or they may not be able to afford the treatment in general.
19th and 20th century takes on gender variance, and views of appropriate treatment were pathologizing and highly stigmatizing to trans people.
While mainstream psychiatry is typically more affirming of gender variance today, trans people may still experience health professionals who adhere to outdated and stigmatizing theories and approaches to treatment.
Individuals may feel like they have to present as meeting all the criteria of gender dysphoria to their healthcare provider in order to receive the support they need:
“[I] feel very, like, trapped by my doctor into presenting a certain way and if I even deviate from that a little bit then I won’t have my options…Like, If I don’t do this the right way my doctor’s going to take away what I need, which is not a very nice way to have to interact with your doctor”
Interview extract from Brooker & Loshak (2020).
Discrimination
As there still exists a stigma associated with trans people or anyone experiencing gender dysphoria, this can provide many challenges for these individuals. There is often an increased risk of bullying, violence, and discrimination.
People with gender dysphoria may be faced with offensive comments and language from those with outdated views, which could be damaging to the mental health of these individuals.
Those of school age may refuse to attend school for fear of bullying from other students or being discriminated against by teachers, whereas adults may not attend their jobs for fear of comments from co-workers.
Lack of support
Some people who experience gender dysphoria may also lack social support from their family or peers. Some may be too afraid to discuss their discomfort with members of their household for fear of losing those relationships.
Family members or friends may not accept the individual or be reluctant to believe that gender dysphoria is real. Some individuals, especially those who are younger, may find themselves stuck in a household where they do not feel accepted or that they cannot be their real selves.
“Having gender dysphoria can be crippling at times, especially when you might not have the most supportive people around you. Trust me, I know what it’s like to be misgendered and dead-named by people who know that I’m non-binary and trans.”
Lynn
Mental health challenges
Due to all the challenges that may be experienced, it is not uncommon for those with gender dysphoria to have accompanying mental health issues such as anxiety disorders, depression, or substance misuse disorders.
They may also have a negative self-image and feel uncomfortable about their appearance if what they see about themselves does not match their gender identity.
There is also a higher risk of suicide and self-harm for those who experience gender dysphoria. One study found that 48.3% of these individuals had experienced suicidal thoughts, and 23.8% had attempted suicide at least once (Garcia-Vega et al., 2018).
Experiencing mental health issues may also make it more difficult for those experiencing gender dysphoria to access the gender-affirming support they need, as described by one individual:
“When I first stated transitioning, I was experiencing a lot of issues with …mainly depression and a lot of thoughts of suicide…I didn’t want to say anything that would potentially be a barrier to me starting hormones…So I remember at the time thinking, how do I convey to the doctor…that I identify with these symptoms [of gender dysphoria] without appearing…mentally unhealthy”
Interview extract from Brooker & Loshak (2020).
Coping With and Treating Gender Dysphoria
There’s no one-size-fits-all approach to managing gender dysphoria. Effective support depends on the individual’s needs, goals, and level of distress.
Some people find relief through social changes, while others explore medical or psychological treatments—or a combination of all three.
Exploring Gender Identity and Expression
For some, expressing their gender identity more authentically—through clothing, hairstyles, or changing their name or pronouns—can significantly ease dysphoria.
This process might also involve rejecting traditional gender roles or experimenting with different aspects of gender expression until something feels right.
Support from family, friends, and peers plays a key role. Simply being addressed by the correct name and pronouns can improve mental well-being.
Conversations with loved ones about identity and preferences can foster understanding and reduce feelings of isolation.
Many also benefit from joining support groups, where they can connect with others navigating similar experiences. These communities provide space for validation, advice, and shared coping strategies.
Psychological Support
Behavioral therapy can help individuals explore their identity in a safe, affirming space. The goal isn’t to change one’s gender identity, but to reduce distress and improve quality of life.
Therapy may involve:
- Exploring and affirming one’s gender identity
- Building a support network
- Addressing anxiety, depression, or other co-occurring issues
- Developing strategies to come out safely
- Making informed decisions about any medical treatments
Therapy can be offered individually or in group, couple, or family formats, depending on a person’s situation.
Medical Treatment Options
Medical options are available to those who want to align their body more closely with their gender identity. These may include:
- Hormone therapy (testosterone or estrogen) to develop desired secondary sex characteristics and reduce unwanted ones (e.g., facial hair, breast tissue).
- Benefits include relief from dysphoria and improved self-image.
- Side effects can include changes in libido or, in rare cases, psychiatric symptoms—particularly for those with pre-existing mental health conditions.
- Surgery, such as top surgery, bottom surgery, or facial feminization/masculinization, may be an option for some but is not necessary for everyone. Some only pursue changes to certain physical features, while others opt for full medical transition.
Access to these treatments often involves assessments from healthcare providers to ensure the individual can give informed consent and that gender dysphoria is well-documented.
Requirements and processes vary by country and healthcare system.
Additional Ways to Alleviate Dysphoria
Alongside therapy and medical care, many individuals find relief through personal strategies, including:
- Voice training
- Breast binding or chest padding
- Hair removal or hair transplants
- Genital tucking or packing
- Makeup, styling, and other aesthetic choices that align with one’s gender identity
Each person’s journey is different. Some may combine several of these approaches; others may pursue only one. What matters most is finding a path that affirms their identity and reduces distress.
Advice from trans voices
Below are some quotes from trans individuals who have shared their tips for how they cope with their own gender dysphoria:
“I do have a board full of inspiring ladies and messages, like from magazines, attitudes I feel and want to practice. I try to avoid women I would compare myself to, just ones who inspire or comfort me.”
“Reading up on other trans identities’ experiences with dysphoria helps me self-reflect and engage with the broader community without exacerbating my own feelings. And it’s great for general awareness as well.”
“Journal writing, even if I don’t intend on retaining my writings just vocalising my feelings into words and concrete thoughts helps me deal with them better than just letting them float around my head in an undefined and unspecific manner.”
“The biggest thing that really helped me with my gender dysphoria is realizing that I’m my gender no matter what anyone else perceives me as. That realization was so powerful because no matter what anyone else sees me as I know that they’re looking at a non-binary person.”
Lynn
Further Information
American Psychiatric Association. Expert Q & A: gender dysphoria.
References
American Psychological Association. (2015). Guidelines for psychological practice with transgender and gender nonconforming people . American Psychologist, 70(9), 832-864.
Brooker, A. S., & Loshak, H. (2020). Gender affirming therapy for gender dysphoria: a rapid qualitative review.
Craig, S. L., Austin, A., Levenson, J., Leung, V. W., Eaton, A. D., & D’Souza, S. A. (2020). Frequencies and patterns of adverse childhood events in LGBTQ+ youth. Child abuse & neglect, 107, 104623.
Jacobson, R., Cohen, H., & Diamond, G. M. (2016). Gender atypicality and anxiety response to social interaction stress in homosexual and heterosexual men. Archives of sexual behavior, 45(3), 713-723.
MacMullin, L. N., Bokeloh, L. M., Nabbijohn, A. N., Santarossa, A., van der Miesen, A. I., Peragine, D. E., & VanderLaan, D. P. (2021). Examining the Relation Between Gender Nonconformity and Psychological Well-Being in Children: The Roles of Peers and Parents. Archives of Sexual Behavior, 50(3), 823-841.
Roberts, A. L., Rosario, M., Corliss, H. L., Koenen, K. C., & Austin, S. B. (2012). Childhood gender nonconformity: A risk indicator for childhood abuse and posttraumatic stress in youth. Pediatrics, 129(3), 410-417.
Spivey, L. A., & Prinstein, M. J. (2019). A preliminary examination of the association between adolescent gender nonconformity and suicidal thoughts and behaviors. Journal of abnormal child psychology, 47(4), 707-716.
Toomey, R. B., Ryan, C., Diaz, R. M., Card, N. A., & Russell, S. T. (2013). Gender-nonconforming lesbian, gay, bisexual, and transgender youth: school victimization and young adult psychosocial adjustment.
