Learn about the treatments that can help alleviate discomfort that can arise when there's a difference between gender identity and sex assigned at birth.
Gender dysphoria is the feeling of discomfort or distress that might occur in people whose gender identity differs from their sex assigned at birth or sex-related physical characteristics.
Transgender and gender-diverse people might experience gender dysphoria at some point in their lives. However, some transgender and gender-diverse people feel at ease with their bodies, with or without medical intervention.
A diagnosis for gender dysphoria is included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a manual published by the American Psychiatric Association. The diagnosis was created to help people with gender dysphoria get access to necessary health care and effective treatment. The term focuses on discomfort as the problem, rather than identity.
Gender dysphoria might cause adolescents and adults to experience a marked difference between inner gender identity and assigned gender that lasts for at least six months. The difference is shown by at least two of the following:
Gender dysphoria may also cause significant distress that affects how you function in social situations, at work or school, and in other areas of life.
Gender dysphoria might start in childhood and continue into adolescence and adulthood. Or you might have periods in which you no longer experience gender dysphoria. You might also experience gender dysphoria around the time of puberty or much later in life.
Gender dysphoria can affect many aspects of life, including daily activities. People experiencing gender dysphoria might have difficulty in school due to pressure to dress in a way that's associated with their sex assigned at birth or out of fear of being harassed or teased.
If gender dysphoria impairs the ability to function at school or at work, the result may be school dropout or unemployment. Relationship difficulties are common. Anxiety, depression, self-harm, eating disorders, substance misuse and other problems can occur.
People who have gender dysphoria also often experience discrimination, resulting in stress. Accessing health services and mental health services can be difficult due to fear of stigma and a lack of experienced care providers.
Adolescents and adults with gender dysphoria without gender-affirming treatment might be at risk of thinking about or attempting suicide.
Your health care provider might make a diagnosis of gender dysphoria based on:
Gender dysphoria is different from simply not conforming to stereotypical gender role behavior. It involves feelings of distress due to a strong, pervasive desire to be another gender.
Some adolescents might express their feelings of gender dysphoria to their parents or a health care provider. Others might instead show symptoms of a mood disorder, anxiety or depression. Or they might experience social or academic problems.
Treatment can help people who have gender dysphoria explore their gender identity and find the gender role that feels comfortable for them, easing distress. However, treatment should be individualized. What might help one person might not help another.
Treatment options might include changes in gender expression and role, hormone therapy, surgery, and behavioral therapy.
If you have gender dysphoria, seek help from a doctor who has expertise in the care of gender-diverse people.
When coming up with a treatment plan, your provider will screen you for mental health concerns that might need to be addressed, such as depression or anxiety. Failing to treat these concerns can make it more difficult to explore your gender identity and ease gender dysphoria.
This might involve living part time or full time in another gender role that is consistent with your gender identity.
Medical treatment of gender dysphoria might include:
Some people use hormone therapy to seek maximum feminization or masculinization. Others might find relief from gender dysphoria by using hormones to minimize secondary sex characteristics, such as breasts and facial hair.
Treatments are based on your goals and an evaluation of the risks and benefits of medication use. Treatments may also be based on the presence of any other conditions and consideration of your social and economic issues. Many people also find that surgery is necessary to relieve their gender dysphoria.
The World Professional Association for Transgender Health provides the following criteria for hormonal and surgical treatment of gender dysphoria:
Additional criteria apply to some surgical procedures.
A pre-treatment medical evaluation is done by a doctor with experience and expertise in transgender care before hormonal and surgical treatment of gender dysphoria. This can help rule out or address medical conditions that might affect these treatments This evaluation may include:
This treatment aims to improve your psychological well-being, quality of life and self-fulfillment. Behavioral therapy isn't intended to alter your gender identity. Instead, therapy can help you explore gender concerns and find ways to lessen gender dysphoria.
The goal of behavioral health treatment is to help you feel comfortable with how you express your gender identity, enabling success in relationships, education and work. Therapy can also address any other mental health concerns.
Therapy might include individual, couples, family and group counseling to help you:
Therapy might be helpful during many stages of your life.
A behavioral health evaluation may not be required before receiving hormonal and surgical treatment of gender dysphoria, but it can play an important role when making decisions about treatment options. This evaluation might assess:
Other ways to ease gender dysphoria might include use of:
Gender dysphoria can be lessened by supportive environments and knowledge about treatment to reduce the difference between your inner gender identity and sex assigned at birth.
Social support from family, friends and peers can be a protective factor against developing depression, suicidal thoughts, suicide attempts, anxiety or high-risk behaviors.
Other options for support include:
You may start by seeing your primary care provider. Or you may be referred to a behavioral health professional.
Here's some information to help you get ready for your appointment.
Before your appointment, make a list of: