Table of ContentsView AllTable of ContentsSymptomsDiagnosisCausesTreatmentChallengesHow to CopeImportant Terms to Know

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Symptoms

Diagnosis

Causes

Treatment

Challenges

How to Cope

Important Terms to Know

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Gender dysphoria refers to feelings of distress and discomfort that a person experiences when their assigned gender does not match their gender identity. People who experience gender dysphoria may feel uncomfortable with and distressed over the conflict between the sexual characteristics of their physical body and how they feel and think about themselves.

They may also experience feelings of distress or discomfort over the traditional gender roles expected of their assigned gender.

Children who experience gender dysphoria may express their wish to be the opposite gender and insist on toys, hairstyles, and clothing typically associated with the opposite gender.

Not everyone who has gender dysphoria identifies astransgender, but many peoplediagnosedwith gender dysphoria do identify as transgender,gender fluid, orgender non-conforming.

Symptoms of Gender Dysphoria

Symptoms of gender dysphoria can include feeling a strong sense of distress or discomfort with one’s assigned gender. Some signs that someone is experiencing gender dysphoria include:

People who experience gender dysphoria may frequently express that they want to be the opposite gender. They often feel uncomfortable with the gender roles and gender expressions of their birth-assigned sex. This might manifest in behaviors such as dressing as their preferred gender, playing with toys typically associated with the opposite gender and rejecting many gender-stereotypical behaviors.

Gender dysphoria is not related to an individual’s sexual orientation. People who experience gender dysphoria may be straight, gay, lesbian, or bisexual. People who feel gender dysphoria may also be gender-nonconforming or transgender. However, it is important to recognize that not everyone who istransgenderor gender nonconforming experiences gender dysphoria.

Gender Identity vs. Sexual OrientationIt is also important to note the distinction between gender identity and sexual identity.Gender identity refers to a person’s internal sense of gender, whether male, female, or outside of thegender binary. Sexual orientation refers to a person’s physical, emotional, or romantic attraction to other people.Where gender involves who you are, sexuality is about who you are attracted to. Some people with gender dysphoria are part of theLGBTQ+community, but experiencing gender dysphoria does not mean that a person is gay, lesbian, or bisexual.

Gender Identity vs. Sexual Orientation

It is also important to note the distinction between gender identity and sexual identity.Gender identity refers to a person’s internal sense of gender, whether male, female, or outside of thegender binary. Sexual orientation refers to a person’s physical, emotional, or romantic attraction to other people.Where gender involves who you are, sexuality is about who you are attracted to. Some people with gender dysphoria are part of theLGBTQ+community, but experiencing gender dysphoria does not mean that a person is gay, lesbian, or bisexual.

It is also important to note the distinction between gender identity and sexual identity.

Gender identity refers to a person’s internal sense of gender, whether male, female, or outside of thegender binary. Sexual orientation refers to a person’s physical, emotional, or romantic attraction to other people.

Where gender involves who you are, sexuality is about who you are attracted to. Some people with gender dysphoria are part of theLGBTQ+community, but experiencing gender dysphoria does not mean that a person is gay, lesbian, or bisexual.

Diagnosis of Gender Dysphoria

Gender dysphoria is listed in theDiagnostic and Statistical Manual of Mental Disorders(DSM-5). In the previous edition of the DSM, it was known as gender identity disorder. This was changed in 2013 to remove thestigmaassociated with calling it a disorder. Where it was previously presented as a disorder related to identity, the DSM-5 takes a more descriptive approach that is focused on the discomfort and distress that dysphoria causes.

The 2022 publication of the DSM-5-TR (text revision), gender dysphoria terminology was updated to help ensure the use of less stigmatizing and more culturally-sensitive language. The DSM now uses the terms “experienced gender,” “gender-affirming hormone treatment,” “individual assigned male at birth,” and “individual assigned female at birth.”

PrevalenceThe DSM-5 estimates that around 0.005% and 0.014% of people assigned male at birth and 0.002% and 0.003% of people assigned female at birth have gender dysphoria.While not all transgender people experience gender dysphoria, research suggests it is more common among people are transgender.

Prevalence

The DSM-5 estimates that around 0.005% and 0.014% of people assigned male at birth and 0.002% and 0.003% of people assigned female at birth have gender dysphoria.While not all transgender people experience gender dysphoria, research suggests it is more common among people are transgender.

In Adolescents and Adults

In Children

Children can also experience gender dysphoria. It is not uncommon for kids to exhibit gender non-conforming behaviors. Therefore, it’s important to distinguish between typical childhood behaviors and true gender dysphoria.

Like adults, children must experience impairments in functioning or significant distress lasting a minimum of six months. They must also experience at least six of the following symptoms:

Signs of gender dysphoria in children can be present as early as age 4. These symptoms often grow more severe as children get older, particularly once they experience the physical changes associated with puberty.

Gender Dysphoria vs. Gender NonconformityIt is important to note that gender dysphoria andgender nonconformityare not the same. Gender nonconformity involves behaviors and gender expressions that do not correspond to the stereotypical norms associated with a person’s birth-assigned gender. Gender nonconformity is not considered a mental disorder.

Gender Dysphoria vs. Gender Nonconformity

It is important to note that gender dysphoria andgender nonconformityare not the same. Gender nonconformity involves behaviors and gender expressions that do not correspond to the stereotypical norms associated with a person’s birth-assigned gender. Gender nonconformity is not considered a mental disorder.

Causes of Gender Dysphoria

The exact causes of gender dysphoria are not entirely understood, but several factors may play a role. Genetics, hormonal influences during prenatal development, and environmental factors may be involved.

For example, prenatal exposure to certain chemicals has been associated with disruptions in the normal development of sex determination before birth. Research also points to a genetic link since there is a higher shared prevalence between identical twins than fraternal twins.

The onset of gender dysphoria is often during early childhood. While the exact mechanisms are unclear, we know that when children are born, they are assigned a sex based upon their physical anatomy. The sex that a child is assigned at birth often determines how they are raised and how others interact with them. As they grow older, they may begin to feel a mismatch between their gender identity and their assigned sex. In some cases, this mismatch can lead to feelings of gender dysphoria.

Treatment of Gender Dysphoria

In addition to counseling, treatment for gender dysphoria may involve hormones and gender reassignment surgery.

Medical Options

Some people with gender dysphoria may prefer more extensive treatment involving gender-affirming hormone treatment and gender-affirming medical procedures. Treatment may also involve body modifications that help align a person’s outward presentation with their internal gender identity.

Hormone therapy and surgery are two ways to accomplish this. But again, treatment needs to be adapted to the needs and goals of the individual. Some people may want to achieve a full transition to the gender with which they identify. Others may wish only to minimize the secondary sex characteristics, such as facial hair or breasts, that do not align with their gender identity.

Masculinizing and feminizing hormones can sometimes help lessen or resolve feelings of gender dysphoria. Such hormones can have side effects, including changes in libido and the potential for manic, hypomanic, or psychotic symptoms in people with an underlying psychiatric condition.

However, people who cannot take any of these steps may begin to experience increased psychological distress, including feelings of anxiety and depression. In such cases, psychotherapy may help people feel more comfortable expressing their internal sense of gender and improve mental well-being.

Psychotherapy

Some individuals may wish to have counseling to help them feel more comfortable with their feelings, affirm their identity, and help them cope or reduce any feelings of distress.Relationship or family counseling can help partners, parents, and other family members better understand what their loved one is experiencing. This can help the individual gain social and peer support, providing a more affirming environment.

Psychotherapeutic treatments for gender dysphoria do not try to change an individual’s gender identification. Instead, psychotherapy focuses on helping people feel more comfortable in their identity and expression of their gender.

Therapy can help people reduce feelings of dysphoria, but it can also help people at any phase of the process improve their quality of life and well-being.

People who are gender nonconforming and their families are often at an increased risk of exposure tostigmaand discrimination because of their gender identity. People with gender dysphoria who are transgender or gender nonconforming also have a higher risk of being the victims of violence or bullying.

Those who do pursue medical treatments such as hormones or surgical procedures may also face difficulties in accessing appropriate healthcare and insurance coverage for their treatment.

Feelings of dysphoria combined with a lack of social support can often contribute to mental distress and other issues. Some disorders associated with gender dysphoria include depression, anxiety, substance misuse, self-harm, and other mental health problems.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

Coping With Gender Dysphoria

Coping with feelings of gender dysphoria typically involves treatment that focuses on helping people feel more comfortable with their gender identity. Some other strategies that can help people manage with feelings of gender dysphoria include:

PronounsSome people with gender dysphoria may prefer to use pronouns corresponding to their gender identity. Or they may prefer the use of the gender-neutral, singular “they,” “them,” “their” pronouns.

Pronouns

Some people with gender dysphoria may prefer to use pronouns corresponding to their gender identity. Or they may prefer the use of the gender-neutral, singular “they,” “them,” “their” pronouns.

As you work toward your long-term goals, look for solutions that will also help you cope with your feelings of dysphoria in the short term. This might involve covering or minimizing your contact with the primary or secondary sex characteristics that cause feelings of distress. Spend time exploring your identity and the ways of expressing it that feel right for you.

Some key terms that are related to gender dysphoria include:

Glossary of Must-Know Gender Identity Terms

10 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association.What is gender dysphoria?Byne W, Karasic DH, Coleman E, et al.Gender dysphoria in adults: an overview and primer for psychiatrists.Transgend Health. 2018;3(1):57-70. doi:10.1089/trgh.2017.0053GLAAD.How sexual orientation is different than gender identity.Davy Z, Toze M.What is gender dysphoria? a critical systematic narrative review.Transgend Health. 2018;3(1):159-169. doi:10.1089/trgh.2018.0014American Psychiatric Association.Gender dysphoria.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth edition. 2013.Zaliznyak M, Bresee C, Garcia MM.Age at first experience of gender dysphoria among transgender adults seeking gender-affirming surgery.JAMA Netw Open. 2020;3(3):e201236. doi:10.1001/jamanetworkopen.2020.1236Garg G, Elshimy G, Marwaha R.Gender dysphoria. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.American Psychiatric Association.Expert Q & A: gender dysphoria.García-Vega E, Camero A, Fernández M, Villaverde A.Suicidal ideation and suicide attempts in persons with gender dysphoria.Psicothema. 2018;30(3):283-288. doi: 10.7334/psicothema2017.438

10 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association.What is gender dysphoria?Byne W, Karasic DH, Coleman E, et al.Gender dysphoria in adults: an overview and primer for psychiatrists.Transgend Health. 2018;3(1):57-70. doi:10.1089/trgh.2017.0053GLAAD.How sexual orientation is different than gender identity.Davy Z, Toze M.What is gender dysphoria? a critical systematic narrative review.Transgend Health. 2018;3(1):159-169. doi:10.1089/trgh.2018.0014American Psychiatric Association.Gender dysphoria.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth edition. 2013.Zaliznyak M, Bresee C, Garcia MM.Age at first experience of gender dysphoria among transgender adults seeking gender-affirming surgery.JAMA Netw Open. 2020;3(3):e201236. doi:10.1001/jamanetworkopen.2020.1236Garg G, Elshimy G, Marwaha R.Gender dysphoria. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.American Psychiatric Association.Expert Q & A: gender dysphoria.García-Vega E, Camero A, Fernández M, Villaverde A.Suicidal ideation and suicide attempts in persons with gender dysphoria.Psicothema. 2018;30(3):283-288. doi: 10.7334/psicothema2017.438

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

American Psychiatric Association.What is gender dysphoria?Byne W, Karasic DH, Coleman E, et al.Gender dysphoria in adults: an overview and primer for psychiatrists.Transgend Health. 2018;3(1):57-70. doi:10.1089/trgh.2017.0053GLAAD.How sexual orientation is different than gender identity.Davy Z, Toze M.What is gender dysphoria? a critical systematic narrative review.Transgend Health. 2018;3(1):159-169. doi:10.1089/trgh.2018.0014American Psychiatric Association.Gender dysphoria.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth edition. 2013.Zaliznyak M, Bresee C, Garcia MM.Age at first experience of gender dysphoria among transgender adults seeking gender-affirming surgery.JAMA Netw Open. 2020;3(3):e201236. doi:10.1001/jamanetworkopen.2020.1236Garg G, Elshimy G, Marwaha R.Gender dysphoria. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.American Psychiatric Association.Expert Q & A: gender dysphoria.García-Vega E, Camero A, Fernández M, Villaverde A.Suicidal ideation and suicide attempts in persons with gender dysphoria.Psicothema. 2018;30(3):283-288. doi: 10.7334/psicothema2017.438

American Psychiatric Association.What is gender dysphoria?

Byne W, Karasic DH, Coleman E, et al.Gender dysphoria in adults: an overview and primer for psychiatrists.Transgend Health. 2018;3(1):57-70. doi:10.1089/trgh.2017.0053

GLAAD.How sexual orientation is different than gender identity.

Davy Z, Toze M.What is gender dysphoria? a critical systematic narrative review.Transgend Health. 2018;3(1):159-169. doi:10.1089/trgh.2018.0014

American Psychiatric Association.Gender dysphoria.

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth edition. 2013.

Zaliznyak M, Bresee C, Garcia MM.Age at first experience of gender dysphoria among transgender adults seeking gender-affirming surgery.JAMA Netw Open. 2020;3(3):e201236. doi:10.1001/jamanetworkopen.2020.1236

Garg G, Elshimy G, Marwaha R.Gender dysphoria. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.

American Psychiatric Association.Expert Q & A: gender dysphoria.

García-Vega E, Camero A, Fernández M, Villaverde A.Suicidal ideation and suicide attempts in persons with gender dysphoria.Psicothema. 2018;30(3):283-288. doi: 10.7334/psicothema2017.438

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