Understanding Gender Dysphoria

The exact cause of gender dysphoria is unknown. Experts think a combination of things cause it, such as:

• A person’s biology
• Social views on gender
• Exposure to things in the environment
• Psychological reasons

Gender dysphoria often starts in childhood or the teen years. But it can start later in life. It tends to get worse during puberty.

The symptoms of gender dysphoria can vary from person to person. To be diagnosed with it, you must have 2 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:

• Being very upset about the mismatch between your gender identity and the gender you were assigned at birth
• Wanting to change your body, maybe even your sex organs, so it matches your gender identity
• Wanting the physical traits of the gender you identify with
• Wanting to be a different gender
• Wanting to be treated as a different gender
• 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 healthcare provider and a mental health expert for a diagnosis. Choose providers who know how to care for transgender or non-binary people. They can help you deal with your feelings.

When deciding on treatment, look for healthcare providers who are skilled in treating gender dysphoria. You will need a healthcare 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:

• Counseling. Before starting any other treatments, your healthcare 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.
• Hormone therapy. You may choose to take hormones. These come in many forms, such as pills, 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 healthcare provider often for checkups.
• 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.
• Other treatments. Transgender or non-binary 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 healthcare team about all the benefits and risks.

Gender dysphoria causes intense emotional distress. As a result, people with gender dysphoria are more likely to suffer from:

• Depression and anxiety
• Self-harm or suicide
• Social isolation
• Low self-esteem
• Substance abuse
• Verbal and physical abuse from others

The treatments for gender dysphoria can also cause health problems. These include:

• A higher risk for heart disease
• Blood clots
• Loss of fertility
• Changes in sexual function or desire

Call your healthcare provider if you have:

• Symptoms that don’t get better or get worse
• New symptoms

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 www.suicidepreventionlifeline.org. You can also call Lifeline at 800-273-TALK (800-273-8255). Lifeline is free and available 24/7.

• National Center for Transgender Equality at www.transequality.org
• GLAAD at www.glaad.org