Understanding Gender Dysphoria
A person’s gender is often assigned at birth—either male or female. It's based on the sex organs a baby is born with. You may not agree with the gender you were given at birth. You may instead feel like you are a different gender. If this mismatch between your own gender identity and that assigned at birth seriously upsets you, you may have gender dysphoria.
Gender dysphoria or gender incongruence occurs when a person feels strong emotional distress because of the difference between their own gender identity and their sex assigned at birth. Not all transgender or nonbinary people have these feelings. People who are transgender identify with a gender that is different from what they were assigned at birth. People who are nonbinary don't identify as strictly male or female.
Gender words are used here to talk about anatomy and health risk. Please use this information in a way that works best for you and your health care provider as you talk about your care.
What causes gender dysphoria?
The exact cause of gender dysphoria is unknown. Experts think a combination of things cause it, such as:
Gender dysphoria often starts in childhood or the teen years. But it can start later in life. It tends to get worse during puberty.
Symptoms of gender dysphoria
The symptoms of gender dysphoria can vary from person to person. To be diagnosed with it, you must have two or more symptoms for at least 6 months. The strong distress you feel about your gender must also impair your daily life. That means it causes problems with your relationships, social life, work, or school.
The symptoms of gender dysphoria are:
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Being very upset about the mismatch between your gender identity and the gender you were assigned at birth.
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Wanting to change your body, maybe even your sex organs, so it matches your gender identity.
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Wanting the physical traits of the gender you identify with.
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Wanting to be a different gender.
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Wanting to be treated as a different gender.
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Believing that your feelings and reactions are more in line with a different gender.
You may also strongly prefer the hairstyles, clothing, or activities of a different gender. You may prefer to be around people who are the gender you identify with.
Gender dysphoria may look like other health problems. It’s vital to talk with a health care provider and a mental health expert for a diagnosis. Choose providers who know how to care for transgender or nonbinary people. They can help you deal with your feelings.
Treatment for gender dysphoria or gender incongruence
When deciding on treatment, look for health care providers who are skilled in treating gender dysphoria. You will need a care team, including an endocrinologist and a mental health expert. Your team will work with you to help ease the distress you feel.
Treatment for gender dysphoria depends on your overall health. It also depends on what you are comfortable with. Care may include:
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Counseling. Before starting any other treatments, your provider will advise you to talk with a mental health expert. This provider can help you cope with your feelings about your gender identity. They can also help you better handle your relationships with family, friends, and others. They can connect you with resources like support groups. You’ll also learn what to expect from other treatments.
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Hormone therapy. You may choose to take hormones. These come in many forms, such as pills, patches, gels, or shots. These medicines change your body so that it looks more like the gender you identify with. Transgender men (assigned female at birth transitioning to male) often take testosterone. This hormone can cause facial hair growth, deepen the voice, and add more muscle mass. It can also reduce breast size and stop periods. Transgender women (assigned male at birth transitioning to female) may take estrogen and other medicines that stop the body from making male hormones. These increase breast size and change the shape of the body. When on hormones, you will need to see your health care provider often for checkups.
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Gender-affirming surgery. This treatment is often called top or bottom surgery. It involves procedures that change the size of the breasts or the look of the face. Surgery may also be done on the sex organs. To have this type of surgery, you need to be on hormones and live as your desired gender for at least 1 year. Many of the changes these surgeries make can’t be reversed.
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Other treatments. Transgender or nonbinary people may look for other ways to help express their gender identity. Two of these are hair removal and speech therapy.
Treatment can greatly improve your quality of life. But it’s important to talk with your care team about all the benefits and risks.
Possible complications of gender dysphoria
Gender dysphoria causes intense emotional distress. As a result, people with gender dysphoria are more likely to suffer from:
The treatments for gender dysphoria can also cause health problems. These include:
When to contact your doctor
Contact your health care provider if you have:
When you need help right away
People with gender dysphoria are at risk for self-harm and suicide. If you are thinking about harming yourself or others, help is available. Call or text 988 right away. You will be connected to trained crisis counselors at the National Suicide Prevention Lifeline. An online chat option is also available at 988lifeline.org. You can also call Lifeline at 800-273-TALK (800-273-8255). Lifeline is free and available 24/7.
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