Gender Dysphoria

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KEY POINTS

• Gender dysphoria is distress caused by feeling a mismatch between your physical gender at birth and who you feel you are inside. For example, a male feels that he is a female trapped in a male body, and a female feels she is a male trapped in a female body.
• Treatment helps you resolve the feeling of a mismatch between your physical gender and your identity. This can mean different things for different people. If you have a lot of distress every day, and it has lasted for many years, you may wish to physically change your sex.

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What is gender dysphoria?

Your biologic gender is determined by the appearance of your genitals at birth. Gender identity is the gender you feel that you are. Gender dysphoria (GD) is distress caused by feeling a mismatch between your physical gender at birth and who you feel you are inside. For example, a male feels that he is a woman trapped in a man’s body, and a woman feels she is a man trapped in a woman’s body. GD is not a mental illness. Dysphoria means that the gender mismatch causes distress. This may be due to the feeling of “not fitting in” with other people, because you’re “not normal”, or because others bully or reject you. It may lead to a poor self-image and sense of hopelessness.

What is the cause?

The exact cause of GD is not known. It may be caused by hormones before birth. Different hormones control the development of sex and gender. The hormones may cause the genitals to be one gender, but the brain to identify with the other gender.

What are the symptoms?

Symptoms may include:

• Wanting to live as or be a person of the opposite sex
• Wanting to hide of the physical signs of your sex or be rid of your own genitals and physically change your sex
• Dressing and acting like a member of the opposite sex
• Feeling and reacting like a person of the opposite sex
• Feeling depressed, anxious, and that no one understands you

How is it diagnosed?

A healthcare provider or therapist will ask about your symptoms and how long you have had them. He or she will ask how they affect your daily life.

How is it treated?

Therapy can be helpful to clarify if you have true gender dysphoria. Therapy also can help you and your family understand your choices and figure out the changes you want to make. It helps to work with a specialist or a clinic experienced with GD.

Treatment for GD helps you resolve the feeling of a mismatch between your physical gender and your identity. This can mean different things for different people. You may find that dressing and living as your preferred gender is all that you need. If you have a lot of distress every day, and it has lasted for many years, you may wish to physically change your sex.

A sex change is usually a step-by-step process that involves:

• Dressing and behaving as the desired sex for 1 or 2 years.
• Taking hormonal treatment to change physical sex characteristics. For example, men's breasts grow fuller while women develop facial hair and bigger muscles. Most men have electrolysis at this stage to remove facial hair.
• Having surgery to change your body to the gender that you feel that you are, such as a female having the breasts removed to become like a male or a male having the penis and testicles removed to become like a female.

What can I do to help myself?

• Ask for patience and support from friends and family. Getting clear about gender identity is a process that takes months or years. Family therapy may be helpful for you, your parents, and other family members.
• Find a support group that meets regularly. Support groups can help you understand that you are not alone. Groups also provide a safe place to share feelings.