What Is Gender Dysphoria? Definition And Symptoms

PUBLISHED Jan 31st, 2022 & UPDATED ON Nov 8th, 2022

When you look in the mirror, do you recognize the person looking back at you as you? Do you see the clothes you’re wearing as the ones you would choose for yourself? Or on a more fundamental level, do you see the person you know yourself to be represented in your reflection?

Someone with gender dysphoria feels like the gender they were assigned at birth is at odds with the gender identity they feel best represents them. It feels like there’s a disconnect between one’s physical body and their self-image.

Gender used to be commonly interpreted as a binary: you are either male or female. But as more and more is understood about human gender, it’s clear that’s not the case… and there are many non-binary possibilities.

What Is Gender Dysphoria?

In the holy grail of mental illness information aka the Diagnostic and Statistical Manual of Mental Disorders aka the DSM-5, the American Psychiatric Association defines gender dysphoria as “a marked incongruence between one’s experienced/expressed gender and assigned gender.”

Gender dysphoria used to be known as gender identity disorder. It was renamed in 2013 to be more clear that dysphoria is the clinical problem (the pain and discomfort someone may experience) and not someone’s identity.

If you’re here because you’re wondering “do I have gender dysphoria?” — that’s ultimately a question only you can answer. Only you truly know what you’re feeling. While you don’t need to fully understand what’s happening before you get a diagnosis, you do need to recognize the symptoms enough to talk about them with a medical professional.

Symptoms of Gender Dysphoria

There are different symptoms of gender dysphoria for adults and children. As you read through the list of symptoms below, you’ll notice two scientific terms that may be confusing — let’s define them first!

Primary sex characteristics: the traits and sex organs involved directly in reproduction (for example, ovaries and testes)

Secondary sex characteristics: visible features not directly involved in reproduction (for example, voice quality, facial hair, breast size)

Symptoms in Adolescents and Adults

At least two of the following must be causing clinically-significant distress for at least six months:

A marked incongruence between one’s gender and their primary/ secondary sex characteristics
A strong desire:
- to be rid of one’s primary and/ or secondary sex characteristics because of a marked incongruence with one’s experienced gender. This can also present as a desire to prevent the development of secondary sex characteristics in puberty
- for the primary and/or secondary sex characteristics of another gender
- to be of another gender
- to be treated as another gender
A strong conviction that one has the typical feelings and reactions of another gender

Symptoms in Children Under 10

Six of the following must be present and causing distress for six months:

A strong desire to be of another gender or an insistence that one is another gender
A strong preference for:
- clothing associated with another gender
- cross-gender roles in make-believe play or fantasy play
- toys, games, or activities stereotypically used or engaged in by another gender
- playmates of another gender
A strong rejection of toys, games, and activities typically associated with their assigned gender
Strong dislike of one’s sexual anatomy
A strong desire for the physical sex characteristics that match one’s experienced gender

If you read the list of symptoms and recognized the things you’re questioning, it might be a good idea to chat with a trans/non-binary affirmng therapist. They can answer any questions you might have too or pass along awesome resources! Here’s a guide that will help you find a therapist specializing in 2SLGBTQIA+ experiences.

What Does Gender Dysphoria Feel Like?

Genderqueer activist, author, and television host Jacob Tobia (they/ them) described it as feeling like they “just had so much gender. I just had, like, gender oozing everywhere.”

Ashlee Marie Preston (she/her) described gender dysphoria as “the ‘battle of the beliefs’: hanging on to your belief that you are who you are despite how others may define you, while also challenging yourself not to compare your insides to other people’s outsides. It’s a constant effort to align yourself externally with how you feel internally.”

Beyond the internal dissonance of trying to figure out your gender identity, Tobia says societal constructs like gendered language make trans and non-binary people feel like outsiders. “Even saying ‘I am gender non-conforming is a lie.’ There’s no such thing as gender conforming. “You can’t be an outsider to human gender. If you are a human being, you are instead human gender… But, we don’t even have the language for me to describe why I struggle to be at peace with myself without singling out why I don’t belong.”

Chella Man (he/him) also believes language can help people. “I simply wish I knew the word ‘dysphoria’ existed. If I had understood the blend of intense emotions stemmed from my experience with gender identity, it would have brought me an incredible amount of comfort and relief. I would realize there must be an entire community in the same boat as me if there is a label for it.”

Transgender & Non-Binary Identities

The terms cisgender, transgender, and non-binary have become more common recently (thanks to the efforts of so many 2SLGBTQIA+ activists!). Cisgender refers to people whose gender identity coincides with their sex assigned at birth. Transgender people identify with a different gender than they were initially assigned. But there’s more than just trans and cis — there are many non-binary genders.

Third gender people do not identify with either male or female. There are many examples of this throughout the world, from two-spirit among Indigenous North Americans to the Māhū of Native Hawaiians and Tahitians.

Gender fluid is when a person’s gender identity fluctuates. These changes and shifts can occur daily, weekly, monthly, or whenever!

People can also be intersex. That’s when someone is born with a reproductive system or sexual organs that aren’t traditionally male or female. This can present in a variety of ways and each intersex person’s experience, or identity, is different. One example could be a person born with male genitalia and a female reproductive system.

There’s at least a dozen more gender identities. We have an entire article outlining what they are. Point is, gender is a social construct and there’s waaay more than two options. It’s also worth mentioning that gender identity ≠ sexual orientation. Being trans or non-binary doesn’t automatically dictate who that person will be physically or romantically attracted to.

What Causes Gender Dysphoria?

There’s no one cause of gender dysphoria. It’s most likely a mix of cultural and personal factors. Some cultures are more accepting of non-binary genders, giving people more leeway to explore their identity without fear of repercussions if they fall outside male or female.

Gender Dysphoria Treatment

First, we want to be clear that the treatment is for the dysphoria, not the gender identity. There’s nothing wrong with any gender identity; the issue being treated is the psychological distress caused by incongruences between one’s assigned gender and their gender identity.

The goal of treatment for gender dysphoria is acceptance. That can mean self-acceptance, social and legal affirmation, and/ or medical care to reduce cognitive dissonance around gender identity.

Self-acceptance is a journey of self-exploration, with or without a therapist. It’s a process of considering your true identity and becoming open to the possibility of a different gender identity than what was assigned at birth.

Social affirmation can mean changing your pronouns, appearance, and feeling accepted by your loved ones and society. Legal affirmation can include changing your name and gender on your identification. Medical treatments can include things like hormone therapy or gender-affirming surgery.

How to Support a Loved One With Gender Dysphoria

One of the biggest predictors of mental health issues related to gender dysphoria is feeling rejected by the people you care about. That means it’s very important to treat loved ones with respect and compassion if and when they open up about their dysphoria. But it also means showing respect whenever the topic comes up, regardless of whether you know someone personally affected. Elliot Page won’t read your snarky tweet about his pronouns, but a friend or family member dealing with gender dysphoria probably will. All you’re accomplishing is making it clear to the genderqueer or questioning people in your life that you’re not a safe person for them. Just don’t be disrespectful. Good advice right?