What Is Gender Dysphoria (And How Is It Different From Simply Being Transgender)?

Photo: getty
What is Gender Dysphoria, different from transgender

Turns out, it's not a mental illness at all.

When people see or hear the diagnosis "gender dysphoria", they assume this means that the person is ‘crazy’ or mentally ill in some way. 

This couldn’t be further from the truth. So, what is gender dysphoria?

Gender dysphoria is a diagnosis that highlights the way the person feels about the gender he or she was born into. It provides a category so that the person can gain access to the services he or she needs to resolve the dysphoria and become comfortable with their gender.

Dysphoria is defined as "a state of unease or general dissatisfaction with life". When it is applied to gender it is literally unease or general dissatisfaction with your gender.   

Gender is not the same as your biological sex —  though many of us identify as the gender that matches our biological sex.  

RELATED: 5 Things You Don't Know About Transgender People But Should

There are two biological sexes: male and female. Some people are also born intersex which is being born with anatomy that doesn’t fit the typical for male or female bodies. Some people have both male and female anatomy for example. 

Gender is socially constructed. 

Gender is how we feel and see ourselves. For many years, male and female were the only genders recognized. Now, we know that gender falls on a spectrum and that even people who are happy with their assigned gender at birth matching their biological sex can move along the spectrum at different parts in their lives. 

I am a biological female and I see my gender as being a woman and I have always identified as a woman (or a girl). However, at some points in my life, I have felt very feminine and at others, I have felt much more masculine.  

Gender can be fluid. Some people identify as female sometimes and male at other times. They do not see themselves as transgender necessarily because the way they identify moves along the spectrum between male and female.   

Some people feel they are neither male nor female and others feel they are both male and female. Some of these people use the label genderqueer to refer to themselves. Within the medical and psychological communities, these people are often called gender non-conforming. This term also includes people who are transgender and gender fluid.

People who identify as transgender are the people who are most likely to be identified as gender dysphoric. They often feel they were born into the wrong body. 

Some of them choose to go through the process to change biological sex fully. Others take hormones and change some of their sexual and gender characteristics.  Others choose to stay in the body they were born into despite feeling that it isn’t the right sex.

People who have gender dysphoria feel very strongly that their gender does not match their biology. This is not a mental illness. When someone experiences this dysphoria, it causes stress, anxiety, and depression. In some cases, people feel suicidal as a result of the mismatch between gender and biology.  

Gender is not sexual orientation. Sex orientation describes who you are attracted to an what types of sexual activities bring you pleasure. 

Now that we have gone over the major definitions — why is this important to understand? Gender is one of the central features of self-image, self-understanding and impacts intensely on how we relate to others.   

Feeling as though your body is wrong is an awful feeling, distressing on so many levels. When others mislabel a person’s gender, it is jarring and the person feels invisible and not understood. It impacts on every aspect of life. 

RELATED: 8 Unexpected Confessions Of A Transgender Man

People who have gender dysphoria have higher rates of substance abuse, depression, suicide attempts, eating disorders and anxiety. Research suggests that 71 percent of people who have gender dysphoria have some form of mental health diagnosis during their lifetime.

People often are aware that their body doesn’t correspond to the gender they feel when they are quite young. Children who have gender dysphoria will consistently tell people that they really are the opposite biological sex. They will tell people that when they grow up they will become the other sex. 

Many talk about removing the genitalia that doesn’t match their internal gender. They will reject clothing, toys, and activities associated with their biological sex. They will often have friends of the gender they see themselves as. They will often insist on urinating as the opposite gender so girls who identify as boys will pee standing up.

Tweens and teenagers will become very distressed by the biological changes that come when they hit puberty. This is often a time that suicide risk increases. They often express disgust at their genitals and secondary sex characteristics. 

So biological girls who are developing breasts but identify as boys will do anything to flatten their breasts and become very distressed at the development. Some will seek surgery. They will often dress as the gender they identify as rather than according to biological sex.

As gender fluidity exists, it is important to support children and adolescents where they are at any given time and not assume where they will end up when they reach adulthood.  The goal of any talking therapy or counseling is to support the person, not to try to change their gender identification. There is nothing wrong with their gender identification. 

The dysphoria diagnosis is a description of the distress this mismatch causes not a description of a mental illness. Many people choose to do things to get their bodies to conform more to their identified gender. This may include taking hormones or medication to block certain hormones or having surgery.

One of the main reasons for the diagnosis is the access it gives people to appropriate health care, especially in the United States where a diagnosis is necessary for insurance coverage. 

Some people who identify as transgender do not have dysphoria related to this identification. They don’t feel upset that they are identifying as the gender opposite their biological sex. In this case, a diagnosis would not be appropriate. There must be distress about the mismatch between biology and gender in order to gain a diagnosis.

In Europe, current statistics are that 1 in 30,000 biological males seek gender reassignment surgery and 1 in 100,000 women seek surgery. 

What do you do if someone you love is gender dysphoric? 

If it is a child, be supportive. Don’t contradict the child’s view of themselves. Don’t try to change the child to be the gender of their biological sex. If you find this difficult to manage, get some therapy or coaching to sort your emotional issues and to support you in how best to support the child.  

Call the person by the pronouns they wish. Some choose to simply use ‘he’ or ‘she’. Others who are gender fluid are more comfortable with ‘they’. Others use new pronouns like ‘zi’.  Help the person to gain the support that they need.  

If you believe you have gender dysphoria, what can you do? There are a lot of places to get help. Make sure to approach specialist clinics, doctors, and mental health professionals so that you will be supported and not told that you have a mental illness or told that you need to change to be as your biological gender.

Make sure that you come out to people who are not going to judge you or damn you. Educate yourself on all of your medical, surgical and psychological options. 

RELATED: Exactly What To Do If Your Kid Comes Out As Transgender

Dr. Lori Beth is a sex & intimacy coach and psychologist who works with individuals, couples and polyamorous groups, parents, children, and families. She hosts two podcasts: The A to Z of SexÒ and Sex Spoken Here every week. Book a discovery session to see how she can help you.