Gender Dysphoria

The experience of gender dysphoria can vary widely among transgender and gender-nonconforming individuals and may change over time. Not everyone with gender dysphoria may experience the same signs, and the intensity of symptoms² may vary. The following are common emotions and experiences associated with gender dysphoria.

Emotional and psychological signs

Emotions and psychological symptoms may involve: 

• Persistent distress or discomfort about one's assigned gender
• Strong and consistent identification with a gender other than one’s assigned gender at birth 
• Discontent or unease with one's physical characteristics, hormones, or bodily processes 
• Anxiety, depression, or emotional distress related to the inconsistency between gender identity and assigned gender at birth
• Overall challenges in daily functioning, such as heightened anxiety in social situations, difficulties in maintaining relationships, and persistent discomfort during routine activities that remind them of their gender incongruence

Behavioral signs 

Behaviors³ associated with gender dysphoria may include the following: 

• Expressing a strong desire to be treated as a gender different from the one assigned at birth
• Preferring clothing and accessories often socially associated with a different gender identity
• Seeking to participate in activities and adopt roles stereotypically aligned with the identified gender
• Social withdrawal or isolation due to fear of rejection or discrimination

Physical signs

There may be some symptoms related to physicality in gender dysphoria, including the following: 

• Having discomfort or distress with the development of physical characteristics during puberty (e.g., breast growth or facial hair)
• Expressing a strong desire to alter or hide certain physical traits to align with gender identity
• Having a sense of being incompatible with one's own physical body, often described as “being trapped in the wrong body”

Gender dysphoria is not a phase or a lifestyle choice but a real experience as some people begin to express their gender identity. If left unaddressed, distress caused by experiencing gender dysphoria can lead to mental health conditions.⁴

With appropriate support and understanding from healthcare providers, family, and society, those who experience gender dysphoria can lead fulfilling lives and embrace their authentic gender identities.

While the genetic causes of biological sex continue to be examined by experts, research published in the National Center for Biotechnology Information (NCBI) suggests that gender dysphoria involves a complex interplay of genetic, hormonal, and environmental factors. While distress related to gender dysphoria can lead to mental health challenges, it is no longer classified as a mental health condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 

Gender dysphoria is common in transgender individuals, those who identify as a gender outside of their assigned gender at birth. However, not all transgender or non-binary people experience dysphoria or wish to change their bodies. Gender identity and gender expression can be separate, and each individual's manner of expressing their gender reflects their distinct personal identity.

Treatment⁵ for gender dysphoria aims to alleviate distress by supporting individuals in exploring and affirming their gender identity, through counseling, hormone therapy, and sometimes surgery, tailored to each person’s needs and goals. Treatment for gender dysphoria is not an attempt to “cure” or change a transgender or non-binary person but is designed to support them in their mental and physical health by reducing the causes of the dysphoria. 

The treatment approach varies for each person and may involve a combination of therapies, medications, and other interventions to support gender identity and overall well-being.

Medication

For individuals seeking physical changes to align with their gender identity, hormone therapy may be an option. Estrogen, progesterone, and testosterone are the most commonly prescribed hormones for hormone replacement therapy (HRT), and several formats and treatment options are available. 

In cases where gender dysphoria leads to significant anxiety, depression, or other mental health challenges, mental health medications may be prescribed to alleviate symptoms and improve overall well-being. Consult a medical doctor before starting, changing, or stopping a medication for any condition.

Other treatment options

Below are other treatments that may reduce gender dysphoria in some people: 

• Puberty blockers: For adolescents experiencing gender dysphoria, puberty blockers may be considered to temporarily halt the development of secondary sex characteristics. Secondary sex characteristics may include facial hair, breast growth, and deepening of the voice.
• Gender-affirming surgeries: For some individuals, gender-affirming surgeries can play a crucial role in aligning their physical appearance with their gender identity.

Self-care

Self-care may help some people work through gender dysphoria alongside treatments and support. Below are some options: 

• Building a support system: Surrounding oneself with understanding and accepting friends, family, or support groups may provide valuable emotional support.
• Exploring interests and hobbies: Engaging in activities that bring joy and fulfillment may improve overall well-being and act as positive distractions from distressing thoughts or feelings.
• Educating oneself: Learning about gender identity, gender expression, and experiences of other transgender or gender-nonconforming individuals can foster self-acceptance and resilience.
• Setting boundaries: Establishing and enforcing boundaries in personal relationships may protect one's mental and emotional well-being.

Treatment for gender dysphoria is individualized, and not all individuals pursue the same interventions. The approach can be based on individual needs, preferences, and goals. Healthcare providers, mental health professionals, and supportive communities can play pivotal roles in helping individuals navigate their gender identity journey with dignity, understanding, and respect. Early intervention can improve quality of life and reduce long-term distress.

The treatment of gender dysphoria requires a sensitive and supportive approach from healthcare professionals, family, friends, and society. Seeking support from mental health professionals with expertise in gender issues may aid individuals in exploring their feelings and guide them through the process of self-discovery.

Certain online therapy platforms, such as BetterHelp, offer the ability to connect non-binary and transgender people with mental health professionals who meet their specific needs. This specialized approach can create a safe space for those experiencing gender dysphoria to explore their feelings, thoughts, and identity while receiving support and guidance from home or any location with an internet connection. 

Additional resources and support for both adolescents and adults can be found at:

• Trans Lifeline
• The Trevor Project
• GLAAD
• Transgender Law Center

If you’re an LGBTQ+ youth or young adult in crisis, reach out to The Trevor Project hotline by calling 1-866-488-7386 or texting “START” to 678-678. You can also use the organization’s online chat feature. The Trevor Project has information about gender dysphoria, gender affirmation, assigned gender, expressed gender, and sexual orientation. Help is available for those who have experienced gender dysphoria and/or discrimination based on gender identity.

If you are experiencing suicidal thoughts or urges, call the 988 Suicide & Crisis Lifeline at 988 or text 988 to talk to a crisis provider over SMS. They are available 24/7 to offer support. 988 also offers an online chat for those with an internet connection.

For those experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

A recent study published in the Journal of Adolescent Health found that many transgender and gender diverse (TGD) adults realize their gender identity is different from their assigned sex during adolescence or later. The research also revealed that TGD individuals often wait several years before sharing this realization with someone else. 

This study contradicts the "rapid onset gender dysphoria" hypothesis, which suggests that TGD identities identified in adolescence are temporary and won't persist into adulthood. Over 40% of TGD adults reported realizing their gender identity during adolescence, showing that the hypothesis is not valid. 

While additional research highlights a need for more studies on non-reassignment resolutions to gender dysphoria, studies show positive outcomes for the majority of individuals who undergo gender reassignment surgery. Factors like positive pre-reassignment psychological adjustment, family support, living as one’s desired gender for at least one year, consistent hormone therapy, psychological treatment, and successful surgery contribute to a positive outcome.

• Gender dysphoria affects approximately 0.5% to 1% of the population.
• The prevalence of gender dysphoria varies across different age groups, with some studies reporting higher rates in adolescents and young adults.
• Research indicates that transgender individuals who receive gender-affirming care and support experience improved mental health outcomes and overall well-being.
• According to a study, therapy has been shown to be an effective treatment for gender dysphoria, with many individuals reporting positive changes in distress and improved quality of life after gender-affirming therapy.