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Gender Dysphoria:

Overview

Gender Dysphoria (GD) is a clinical term used to describe the distress that can occur when a person’s gender identity—their internal sense of being male, female, both, neither, or something else—does not align with the sex they were assigned at birth.

What is Gender Dysphoria:

  • A recognized medical condition in the DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders) and the ICD-11 (International Classification of Diseases).

  • Defined by significant distress or impairment in areas such as social life, school, work, or daily functioning.

  • Experienced by some, but not all, transgender or gender-diverse people. Being transgender is not a disorder—only the distress is treated as one.

How It’s Diagnosed1

Trained professionals—often psychologists, psychiatrists, or gender specialists—evaluate:

  • Duration (DSM requires at least 6 months)

  • Intensity of dysphoria

  • Impact on functioning

  • Co-occurring conditions

  • Personal goals for gender expression, social transition, or medical care

What Helps

Treatment is individualized, not one-size-fits-all, and may include:

  • Social transition (name, pronouns, clothing)

  • Puberty blockers (for eligible youth)

  • Gender-affirming hormone therapy

  • Gender-affirming surgeries (for adults, and in rare cases older adolescents)

  • Supportive psychotherapy

  • Family support and social affirmation

Evidence consistently shows that gender-affirming care reduces dysphoria, depression, anxiety, and suicidality.

Core Features

Symptoms can vary by age, but often include:

In Adolescents and Adults:

  • A strong desire to be another gender or be treated as another gender

  • Incongruence between experienced gender and physical body

  • Discomfort with secondary sex characteristics (e.g., breasts, facial hair)

  • Strong desire for characteristics of another gender

  • Distress, anxiety, or depression related to the mismatch

In Children:

Behavioral signs may show up, such as:

  • Insistence that they are another gender

  • Preference for roles, clothing, and peers of another gender*

  • Discomfort with their anatomy

  • Distress at anticipated puberty changes

(Note: Children’s gender exploration alone is not dysphoria; the key factor is distress and persistence.)

* Preference for roles, clothing, and peers of another gender does not, by itself, indicate an experience of gender dysphoria.

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1. “Diagnostic nomenclature has long played an important role in private and public health care systems alike. When used ethically, diagnostic systems, including mental health nosology, can

define the medical necessity of specific treatments and facilitate access to care. However, these systems can also be subject to cultural and social bias. They carry a dark history of punitive, political psychopathologization that discards scientific and ethical standards and delegitimizes entire marginalized communities.”

Winters, K. (2025) Private correspondence.

Important Distinctions

  • Being transgender does not indicate the experience of having gender dysphoria.
    Many trans people do not experience clinically significant distress. This is particularly true of youth affirmed early in life.
  • Dysphoria isn’t caused by stereotypes.

  • It’s a deep internal experience, not a preference for hobbies or clothes.

  • The goal of care is to reduce distress, not to make someone fit a preconceived gender role.