Not every trans person experiences gender dysphoria, and not everyone who experiences gender dysphoria is trans.
The term gender dysphoria has received a lot of attention in the past decade, especially on the political stage. But gender dysphoria isn’t a new concept or experience.
There are countless instances of people experiencing dysphoria related to their gender identity and assigned sex throughout history, dating back to third-century Roman culture.
Access to gender affirming medical care, both psychological and physical, is vital for mitigating gender dysphoria, especially in children and adolescents, who are at higher risk for suicide, depression, and bullying.
Yet, the continued stigmatization of transgender, nonbinary, genderqueer, and intersex people inhibits this access, often through the implementation of draconian laws that threaten those experiencing dysphoria and their families for seeking gender affirming solutions.
While many transgender and gender nonconforming people experience dysphoria, not everyone experiences the sense of gender incongruence that defines gender dysphoria.
In many modern cultures, gender is viewed through a male/man and female/woman binary rather than a spectrum of gender identity and expression.
Because of this, a person’s sex and gender are often assigned at birth — though this determination is a point of contention.
Gender dysphoria occurs when someone assigned male/man or female/woman at birth feels out of alignment with that categorization.
Experiencing this incongruence within a culture that insists on binary gender categorization often causes mental anguish, isolation, and suicidal ideation.
Often, people experiencing gender dysphoria not only feel out of alignment with their assigned sex but are overcome by dislike for their anatomical or social sex characteristics and long to possess different sex characteristics.
This can manifest in many ways, including feeling an intense and overwhelming need to get rid of one’s breasts, to have breasts of one’s own, or to obtain or be free from certain physical characteristics culturally translated as “masculine” or “feminine.”
Sometimes these feelings are unconscious and arise as:
- a general (or extreme) sense of body discomfort
- a lack of self-recognition (for example, not feeling a connection with the person in the mirror)
- social anxiety due to other people’s perceptions and assumptions about one’s gender
- a lack of identification with the dress, mannerisms, and expectations of one’s assigned gender
- a general sense that something is missing from one’s bodily experience
These feelings can be accompanied by the following:
- an urge to isolate oneself
The effects of gender dysphoria can lead to:
- conflicts within families and social groups
- suicidal ideation or attempts
- vulnerability to violence by others
It’s important that gender affirming care (GAC) is accessible for those experiencing dysphoria and their loved ones.
Their findings are consistent with a 2018 study suggesting gender dysphoria generally develops earlier in life, though children and adolescents may not have the language to understand or describe their feelings as dysphoria.
That said, people of all ages can experience gender dysphoria. Adults may realize later in life that their adolescent feelings resulted from dysphoria, or they may find that they now have the language to describe their feelings.
There are many proposed causes of gender dysphoria, but none are proven.
Some medical professionals seek to define the cause as genealogical, neurobiological, or environmental, yet gender dysphoria wouldn’t occur were it not for the cultural rigidity surrounding the gender binary defined as male and female.
The search for a cause is linked to gender essentialism, which is the belief that gender identity and sexual orientation are biologically predetermined and inescapable. An example is the (false) belief that women are inherently weaker than men because of their biology.
Gender essentialism discounts social factors. In essence, if there wasn’t a gender binary and gender expression wasn’t violently enforced, gender dysphoria may still exist, but with arguably less potency.
Access to GAC and the absence of rigid assumptions would decrease the pain so often associated with gender dysphoria.
The term gender euphoria is often used to describe the feeling of being fully accepted within one’s gender identity and expression.
Because of the healthcare system in the United States, a diagnosis of gender dysphoria is often necessary to receive gender affirming medical care.
This diagnosis is subjective and will vary depending on the competency of individual providers, geographical location, and laws.
Furthermore, symptoms of gender dysphoria are not always in alignment with its definition parameters within the Diagnostic and Statistical Manual of Mental Disorders, which can create barriers to care.
Finding a gender affirming healthcare professional is essential to receiving proper care for gender dysphoria.
GAC is what it sounds like — care that affirms a person’s gender identity, regardless of whether it aligns with or reflects their sex assigned at birth.
- addressing a person using the correct pronouns
- using a person’s preferred name(s), which may be different from what’s on their birth certificate
- providing compassionate care
GAC for gender dysphoria also involves:
- having honest discussions regarding the experience of gender dysphoria
- providing resources for and assistance with discussing gender identity with family and social groups
- discussing and possibly prescribing puberty blockers or hormone therapy, which can help align those experiencing gender dysphoria with their gender identity
- connecting a person with healthcare professionals or organizations who can help them make physical changes in alignment with their gender identity, such as voice therapy, hair removal, and chest binding
- identifying opportunities for individual or group therapy to help mitigate the possible effects of isolation, bullying, and violence
GAC is often considered lifesaving by those who provide it and those who have access to it.
If you or someone you love is struggling, know there is a path from gender dysphoria to gender euphoria.
To find care for children and adolescents, take a look at the Human Rights Campaign’s interactive map of programs across the country.
If you’re an adult curious about care, there are a few ways to find gender affirming healthcare professionals in your area. You might try:
- searching “trans friendly doctor in [your city or state]” on Google
- reviewing the World Professional Association for Transgender Health’s online directory or Outcare’s online directory
- calling or emailing your insurance provider, if applicable, to see if they have a list of in-network professionals
- scheduling a consultation with an LGBTQ-focused telehealth service, like Folx, Plume, and Queermed
Is gender dysphoria the same as gender incongruence?
Gender incongruence is a term that evolved from gender dysphoria. The term “dysphoria” can be pathologizing, while “incongruence” is thought to more accurately describe feeling aligned with a different gender identity or expression than what was assigned at birth.
Do children, adolescents, and adults all experience gender dysphoria similarly?
Every person experiences gender dysphoria differently. Adults can often understand and verbalize the feelings of gender dysphoria more accurately than children but may feel more confined by the gender binary.
Children and teens who experience gender dysphoria may be more confused or overwhelmed by these feelings, especially with pressure from family and social groups.
Not everyone who experiences gender dysphoria as a child or adolescent will continue experiencing it into adulthood.
Is there a way to treat gender dysphoria without transitioning medically?
Yes! Social transitioning — like using a name or pronouns you feel aligned with — is always an option.
Not everyone who experiences gender dysphoria chooses to transition medically or socially, but transitioning is the best solution for some.
How old do you have to be to get gender affirming care?
There isn’t an age minimum for gender affirming care. All children, adolescents, and adults should receive affirming care at every age and stage of their lives. This is true for folks of all genders and lived experiences.
Do you have to experience gender dysphoria to socially or medically transition?
No, though a medical diagnosis is usually necessary to receive health insurance coverage for medical transition.
It can be argued that gender dysphoria wouldn’t exist without the cultural gender binary, especially because it’s primarily an issue in cultures that have rigid definitions of gender.
While medical interventions can help those experiencing gender dysphoria, it’s equally important that we all do our part in interrupting harmful cultural narratives that reinforce transphobia and gender norms.
Not every trans person experiences gender dysphoria, and not everyone who experiences gender dysphoria is trans. It’s most important that those experiencing gender dysphoria receive support and care from their family and social groups, as well as gender affirming care from a qualified healthcare professional.
Anastasia Selby is a graduate of the MFA program at Syracuse University and currently lives in Seattle, WA, where they work as a nanny and writer. Their writing has been published in High Country News, Boulevard, Vox, The New Ohio Review, Allure, and Tricycle Buddhist Review. You can find them on Instagram. They are currently working on a book.