Individuals whose mental gender does not align with the physical one they were born with experience gender dysphoria. They do not feel like their true gender identity matches their biology.

What is Gender Dysphoria?

Individuals whose mental gender does not align with the physical one they were born with experience gender dysphoria. They do not feel like their true gender identity matches their biology. These individuals desire to live as members of the opposite sex and often dress and use mannerisms associated with the other gender. For instance, a person born biologically male may feel and act like a girl. This feeling causes significant distress, anxiety and depression in both children and adults.

Types of Gender Dysphoria

Gender dysphoria covers several multiple types of the disorder. There are three subcategories of gender dysphoria including:

  • Body dysphoria
  • Social dysphoria
  • Mind dysphoria

Body Dysphoria

Body dysmorphic disorder is an anxiety disorder where individuals spend time worrying about their physical appearance. These individuals also have a distorted view of their looks. Body dysphoria may occur in individuals who already suffer from other mental health disorders, such as major depression and anxiety.  

Social Dysphoria

Social dysphoria is the distress and discomfort that occurs due to how society views the individual. A few contributing factors include when another person assumes an individual’s gender, uses incorrect pronouns or makes assumptions about social roles concerning gender.

Mind Dysphoria

Usually experienced by older patients, mind dysphoria describes an individual experiencing feelings that are related to their assigned gender or the one to which they no longer relate. An example would be an individual who identifies as a male but experiences PMS symptoms. They do not want to feel these emotions.

Symptoms of Gender Dysphoria

Gender dysphoria symptoms have a different appearance depending on the age group. Nevertheless, a person must exhibit a strong, persistent cross-gender identification. The symptoms are usually different in children than in adolescents or adults.

Gender Dysphoria in Children

Children with gender dysphoria may exhibit separation anxiety disorder, generalized anxiety disorder and symptoms of depression. The child may feel out of place between their expressed gender and the gender with which they were born. This conflict is usually present for at least six months with the following potential symptoms:

  • Desire to be of the other gender
  • In boys, a strong preference for wearing girl’s clothes
  • In girls, a strong preference for wearing only masculine clothing
  • Depression or anxiety
  • Clinically significant distress or impairment in major areas of functioning, such as social relationships, school or home life

Gender Dysphoria in Adults

Adults with gender dysphoria may display symptoms of anxiety or depression. Adult males may have abnormal sexual desires. Adults may also feel out of place in their assigned gender and the anatomy that comes with it. Symptoms in adults that differ from children include:

  • Strong desire to be rid of one’s biological gender characteristics
  • A strong desire to have the sexual attributes of the other gender
  • A strong desire to have a medical procedure to become the other gender
  • A strong desire to be treated like the other gender

Individuals with gender dysphoria may feel as if they were assigned the wrong gender at birth and may often act like their true gender identity to compensate for their bodily inconsistency. This disorder may also affect their concept of self, the way they dress, behaviors and mannerisms, and their choice of sexual partners.

Causes of Gender Dysphoria

Most professionals do not know what causes gender dysphoria. However, hormonal influences during their gestation in the womb are suspected to be involved.

Childhood onset of gender dysphoria usually occurs between ages 2 and 4. While some children may have interests in cross-gender activities and items, only a small quantity of children with gender dysphoria will continue to have symptoms in their adolescence or adulthood. Typically, by the time the child reaches adolescence, parents who have noticed continued symptoms of gender dysphoria should a professional.

The adult onset of gender dysphoria is typically in early to mid-adulthood. There are two different progressions for the development of adult gender dysphoria. First, a continuation of gender dysphoria that had an onset in childhood or early adolescence. Second, the more obvious signs of cross-gender identification appear later and more gradually, with an appearance in early to mid-adulthood.

Patients who experience a later onset of the disorder may have symptoms that include:

  • Inconsistent in the degree of cross-gender identification
  • Hesitant about sex-reassignment surgery
  • Less satisfied after sex-reassignment surgery

How is Gender Dysphoria Diagnosed?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) offers one primary diagnosis of gender dysphoria with separate criteria for children, adolescents and adults.

In children, gender dysphoria diagnosis requires significant distress or impairment in function lasting at least six months, along with some of the following symptoms:

  • Strong desire to be the opposite gender or insisting that they are the other gender
  • Preference for wearing clothes typical of the opposite gender
  • Strong preference for cross-gender roles in make-believe play
  • Rejection of toys, games and activities typical used by their assigned gender
  • Strong loathing of their sexual anatomy
  • Strong desire for the sex characteristics that match their desired gender

For children, these behaviors may become present between ages 2 and 4, when most developing children begin showing gender-based behaviors and interests. Though, unpredictable gender behavior is common among young children who are learning their interests and can be part of healthy development. Just because a child meets the criteria for gender dysphoria, this does not mean that they will continue to experience the disorder later in their life.

Diagnosing adolescents and adults with gender dysphoria involves the difference between an individual’s expressed gender and assigned gender and significant problems functioning. For diagnosis, the symptoms must last at least six months and should include at least a few of the following:

  • Feeling like they were born in the wrong body
  • Desiring to get rid of their sex characteristics (emotionally, mentally and physically)
  • Wanting to be the other gender
  • Desiring to have other people treat them as the other gender
  • Believing that one has the typical feelings and reactions of the other gender

Who Is at Risk for Gender Dysphoria Disorder?

Though there is no certainty of causes gender dysphoria, the causes of distress involved are mainly sociological. Because society views transgenderism as outside of the norm, children and adolescents may experience significant distress as they fear being denounced, ostracized and bullied.

Gender Dysphoria Statistics

According to the Journal of Adolescent Health, as much as 80 percent of mothers of individuals with gender dysphoria have a psychiatric problem, mainly one involving symptoms originating from their struggle with gender identity. Forty-five percent of fathers of people with gender dysphoria also experienced a mental problem or received gender dysmorphia treatment. Every 1 of 30,000 adult males and one out of 100,000 females seeks sexual reassignment surgery.

As much as 52 percent of children with gender dysphoria, between ages 4 and 11, have one or more diagnosed mental conditions. Adolescents and adults with gender dysphoria are at an increased risk for suicide attempts before their possible gender reassignment surgery. After gender reassignment, suicide risk may continue, depending on the mental adjustment of the individual.

If you or a loved one struggles with gender dysphoria and has become dependent on alcohol or drugs to manage depressed or anxious feelings, The Recovery Village can help. Individuals who have gender dysphoria in addition to a substance use disorder can receive help in managing the effects of their feelings at one of the facilities located in each region of the country.

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Editor – Devin Golden
Devin Golden has worked for various print and digital news organizations. Devin's family has been affected by addiction and mental health disorders, which is a large part of why he wants to help others who have either directly or indirectly been affected by these diseases. Read more
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Medically Reviewed By – Krisi Herron, LCDC
Krisi Herron is an Adjunct Psychology Professor, a Licensed Chemical Dependency Counselor and a freelance writer who contributes to several mental health blogs. Read more
Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.