Gender Dysphoria: Signs, Causes, and Treatment

Gender dysphoria (GD),previously referred to as gender identity disorder (GID),is the term used to describe a persistent sense of discomfort, dissatisfaction, unease, and frustration about the future experienced by people who feel their gender identity is different from their sex assigned at birth (which is usually based on psychical characteristics such as external genitalia). In this article, we will dig into possible causes of gender dysphoria, explore the best ways to treat the condition and explain some gender-related terms.

Some people start experiencing GD in childhood (at ages 5-7),while others might develop it during puberty or even later. Some people have periods in which they do not experience this disorder. According to several studies, gender dysphoria has a higher prevalence in individuals with schizophrenia, bipolar disorder, and/or some other mental conditions.

In many cases, the psychological distress caused by the condition is so intense that it can lead to anxiety and depression. It can also have a harmful impact it can have on an individual’s daily life, including school or work performance and interpersonal interactions.

If you or someone you know have been experiencing similar feelings, we suggest you or they take this reliable Gender Dysphoria Test.

Gender identity is a person’s conception of themselves as female, male, both, or neither. Up until recently, people usually identified as female or male. Society also tended to recognize only these two gender identities known as binary.

However, some individuals discover at some point in their lives that their gender identity does not match their sex assigned at birth. Some of these people feel they do not have a binary identity. They may be agender, gender nonconforming, gender diverse, genderqueer, or use some other terms to describe their gender identity. These identities are called non-binary.

Transgender (often abbreviated as trans) people are also individuals whose birth sex does not match their gender identity. Yet, most transgender people define themselves as binary - either female or male.

Non-binary individuals may pursue social, legal, medical affirmation, and/or surgical affirmation of their gender identities. Not all non-binary people desire all domains of gender affirmation. The decision of whether to undergo medical procedures or sex reassignment surgeries (SRS) to make the body more congruent with one’s identity is deeply personal. Some trans and gender nonconforming individuals feel at ease with their bodies, regardless of whether they have undergone medical intervention.

The gender dysphoria diagnosis was created to help individuals suffering from this condition get access to the health care they need and be effectively treated.

To diagnose an individual with GD, a health provider usually evaluates their behavioral health first to confirm the presence of the disorder. A health specialist also documents how discrimination due to the patient’s gender identity impacts their mental health. Your mental health professional may use the criteria for GD listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association in which this diagnosis is included.

Gender Dysphoria Symptoms

As mentioned before, adolescents and adults with GD tend to experience a mismatch between their inner identity and the gender assigned at birth. For an individual to be diagnosed with gender dysphoria, the symptoms must last for at least six months.

Symptoms in Children and Teens

GD symptoms in children and young adolescents usually include at least two of the following:

• A mismatch between the child’s inner sense of gender and anticipated secondary sex characteristics, such as voice, breasts, hips, and facial hair;
• An intense desire to prevent the development of their secondary sex characteristics;
• An intense desire to have the genitals and/or secondary sex characteristics of another gender;
• A strong desire to participate in the stereotypical activities/games of another gender;
• An intense desire to be an individual of another gender, look like one, and/or be treated as one.

Symptoms in Adults

GD symptoms in adults typically include at least two of the following:

• A mismatch between the person’s inner gender identity and genitals or secondary sex characteristics;
• An intense desire to get rid of their genitals or secondary sex characteristics;
• An intense desire to have the genitals and/or secondary sex characteristics of another gender;
• A strong belief of an individual that they have the typical reactions and emotions of another gender;
• An intense desire to be an individual of another gender, look like one, and/or be treated as one.

In some cases, despite manifesting symptoms of gender dysphoria, an individual may experience another disorder. Some of the conditions or circumstances that might be mistaken for GD include:

• Autogynephilia: a situation where a male becomes sexually interested in himself as a female;
• Transvestic disorder (as a form of paraphilia): intense and recurrent sexual arousal from cross-dressing (typically, in males who dress in women’s clothing). This is not interchangeable with GD or being transgender.
• Gynandromorphophilia: a sexual attraction to gynandromorphs (colloquially, shemales) - males who possess a combination of female and male sex characteristics, usually female breasts and a penis.

While the exact causes of the disorder are still unknown, numerous studies have proven that the psychological well-being of gender-nonconforming individuals largely depends on family acceptance and support.

According to some researchers, gender dysphoria might be the result of a complex interaction between various genetic and environmental factors. For instance, individuals who went through a set of experiences of prolonged traumatic events (often involving their primary caregivers) in early childhood or adolescence, are more likely to develop gender dysphoria. Parents’ confusion about their own gender identity might also be the cause of the development of GD in their children.

Treatment can help individuals experiencing GD significantly ease the distress caused by their condition. However, what is effective for one individual might not work for another. That is why treatment for gender dysphoria should be individualized.

Remember that treatment options are different for children/young adolescents and adults.

Options for children and teens usually include individual child psychotherapy, family therapy, and parental counseling. Regular reviews to monitor the child’s gender identity development are also recommended. At puberty, a referral to a specialized hormone clinic for hormone blockers for adolescents who meet specific criteria might also be necessary. Puberty blockers are gonadotrophin-releasing hormone analogs that pause the physical changes occuring in the body during puberty, such as facial hair growth or breast development.

A health professional may prescribe adolescents aged 16 or older who have been on hormone blockers for at least 12 months gender-affirming hormones, also known as cross-sex hormones. These hormones cause some irreversible changes, for example, estrogen causes changes in breast development, and testosterone causes the deepening or breaking of the voice.

Treatment options for adults may include some or all of the following:

• Psychological support;
• Behavioral therapy;
• Changes in gender expression (living part-time or full-time in another gender role);
• Voice therapy to help an individual sound more typical of their gender identity;
• Cross-sex (feminizing or masculinizing) hormone therapy;
• Sex reassignment surgery.

Whether a person has had only hormone therapy or has also undergone surgery, the aim is that they no longer experience GD and feel at ease with their gender identity.

In most Western countries, the majority of patients diagnosed with gender dysphoria who request hormone therapy or gender affirmation surgery are individuals who were assigned as males at birth and who feel internally that their gender identity is female. After gender-affirming care, most patients report significant improvement in gender dysphoria symptoms, sexual function, and overall quality of life. However, people considering surgery should bear in mind that as with any surgical procedure, gender affirmation surgery might lead to certain complications. All surgeons should discuss the risks of surgery with patients before they consent to the procedure.

Many individuals experiencing gender dysphoria may have difficulty in school or at work. It might be, among other things, due to pressure to dress in clothing associated with their socially approved birth sex or fear of being teased, bullied, harassed, and stigmatized. Besides, if a person with GD refuses to abide by the requirements imposed on them, they might be dropped out of school or fired, especially in areas where stigma against gender nonconforming people is a norm. Gender dysphoric individuals may also have difficulties accessing mental health services in such areas of the world. Relationship problems, extreme stress, anxiety, depression, eating disorders, substance abuse, self-harm, or even suicide can occur in people experiencing gender dysphoria.

Here are some relevant gender-related terms that everyone needs to know in order to better understand GD:

• Gender: according to the World Health Organization (WHO),the term describes the socially constructed characteristics of boys and girls, men and women, such as roles and norms for groups of men and women and relationships between them. In other words, gender determines what society expects from a woman or a man in a given context; this varies from culture to culture. “Sex” and “gender” are often used interchangeably, but they are distinct entities. Gender interacts with but is not the same as sex. Gender, sex, gender identity, and gender expression are different terms.
• Sex: according to WHO, the term sex describes the different biological and physiological characteristics of females and males, such as reproductive organs, hormones, chromosomes, etc.
• Gender identity: an individual’s inner sense of being a boy/man, girl/woman, a combination of both, no gender at all, or something else. This may or may not match a person's sex assigned at birth.
• Sex/gender assigned at birth: a traditional designation of an infant as male, female, or intersex based on their anatomy (usually, external genitalia and/ or internal reproductive organs) and/or other biological factors(for example, sex chromosomes). Sex assigned at birth is marked on people’s birth records. It is usually abbreviated as AMAB (assigned male at birth) or AFAB (assigned female at birth).
• Gender diverse: an umbrella term that describes people whose gender identities and/or expressions do not conform to the gender binary framework; it includes individuals who are agender or, on the contrary, have multiple gender identities.
• Agender: a term used to describe people who have no gender or a “lack of gender”.
• Nonbinary/genderqueer: an umbrella term used by people whose gender identity is neither female nor male, or not solely female or male.
• Sexual orientation: a term used to describe an enduring pattern of emotional, romantic, and physical attraction to people of a specific gender.
• Gender expression (or presentation): a term used to describe the way an individual’ outwardly expresses their gender identity. Gender expression may or may not reflect a person's inner gender identity based on traditional societal expectations. Gender expression includes how an individual carries themselves, their dress, make-up (or its lack),conversational mannerisms, and/or voice/speech patterns.
• Transgender (trans) is a term that refers to individuals whose gender identity does not align in a traditional sense with their birth sex. Being transgender includes but is not limited to people who identify as a trans man (female-to-male FTM),trans woman (male-to-female MTF),transsexual, cross-dressers, or gender variant.

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