Gender Dysphoria

Gender Dysphoria Defined

Gender dysphoria involves a conflict between a person’s physical or assigned gender and the gender with which he/she/they identify. People with gender dysphoria may be very uncomfortable with the gender they were assigned, sometimes described as being uncomfortable with their body (particularly developments during puberty) or being uncomfortable with the expected roles of their assigned gender. People with gender dysphoria may often experience significant distress and/or problems functioning associated with this conflict between the way they feel and think of themselves (referred to as experienced or expressed gender) and their physical or assigned gender. Gender conflict affects people in different ways. It can change the way a person wants to express their gender and can influence behavior, dress, and self-image.

Gender Dysphoria Causes

There is no known direct cause of gender dysphoria, but genes, hormonal influences in the womb, and environmental factors are all suspected to be involved. 

Gender Dysphoria Symptoms

To be diagnosed with general Gender dysphoria in children, according to the Diagnostic and Statistical Manual of Mental Disorders, the following criteria must be met:

A. A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months duration, as manifested by at least six of the following (one of which must be Criterion A1):

1. 1. A strong desire to be of the other gender or an insistence that one is the other gender (or some alternative gender different from one’s assigned gender).
   2. In boys (assigned gender), a strong preference for cross-dressing or simulating female attire; or in girls (assigned gender), a strong preference for wearing only typical masculine clothing and strong resistance to the wearing of typical feminine clothing.
   3. A strong preference for cross-gender roles in make-believe play or fantasy play.
   4. A strong preference for the toys, games, or activities stereotypically used or engaged in by the other gender.
   5. A strong preference for playmates of the other gender.
   6. In boys (assigned gender), a strong rejection of typically masculine toys, games, and activities and a strong avoidance of rough-and-tumble play; or in girls (assigned gender), a strong rejection of typically feminine toys, games, and activities.
   7. A strong dislike of one’s sexual anatomy.
   8. A strong desire for the primary and/or secondary sex characteristics that match one’s experienced gender.

B. The condition is associated with clinically significant distress or impairment in social, school, or other important areas of functioning.     

To be diagnosed with general Gender dysphoria in adolescents and adults, according to the Diagnostic and Statistical Manual of Mental Disorders, the following criteria must be met:

A. A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months duration, as manifested by at least six of the following:

1. 1. A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics).
   2. A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics).
   3. A strong desire for the primary and/or secondary sex characteristics of the other gender.
   4. A strong desire to be the other gender (or some alternative gender different from one’s assigned gender)
   5. A strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender).
   6. A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender).

B. The condition is associated with clinically significant distress or impairment in social, school, or other important areas of functioning.

How to Approach a Loved One:

There is no perfect way to approach a loved one that is assumed or known to have gender dysphoria. In children and adolescents, it is important to take the lead from the individual, allow them to be who they feel they are, and get help if they need it.  A study of transgender teens found that more than 50 percent of transgender males and almost 30 percent of transgender females reported attempting suicide. It is important to provide support to a loved one that is experiencing gender dysphoria and continue to be informed on the best ways to support them.

Types of Gender Dysphoria Treatment

The focus of treatment for gender dysphoria focuses on alleviating a person’s distress that surrounds their gender identity. It can be common for this distress to lead to anxiety and/or depression which may also need to be treated. A child’s treatment typically involves a multi-disciplinary team of health care professionals, which may include a pediatrician, a psychiatrist, other mental health professionals, a pediatric endocrinologist (specialists in hormone conditions in children), and an advocate.

Psychotherapy

In individual therapy, a person experiencing gender dysphoria can explore these feelings and distress and learn the tools to cope with it. The goal of therapy is not to change how an individual feels about their gender. Through therapy, individuals can also work with their families or significant others, to help them determine the best way to shape their gender expression for the healthiest outcome. Some people choose to take steps to bring their physical appearance in line with their gender and they may change the way they dress or go by a different name. These changes in an individual’s life are also topics that can be discussed in therapy. Parents of children with gender dysphoria may also benefit from counseling. Peer support groups for adolescents and adults and parent/family support groups can also be helpful.

Medication  

Medication may be used to treat other related disorders that can be accompanied by gender dysphoria like anxiety and depression which can include antidepressants and anti-anxiety medication. These medications may have side effects and taking them can lead to tolerance, withdrawal symptoms, and dependence, so you must consult with a physician before starting or stopping these medications.

Resources

• American Psychiatric Association. (2019). Diagnostic and statistical manual of mental disorders. (5th ed.) Arlington, VA: American Psychiatric Association.
• American Psychiatric Association. (2019). 
• Child Mind Institute. (2019). 
• Psychology Today. (2019). 
• WebMD. (2019). When You Don’t Feel at Home With Your Gender.