What is Gender Dysphoria? (with pictures)

Mary McMahon
Mary McMahon
When someone identifies as a gender other than the one they were physically born as, talking to a psychologist can help them decide how to confront the issue.
When someone identifies as a gender other than the one they were physically born as, talking to a psychologist can help them decide how to confront the issue.

Gender dysphoria is a condition characterized by a disconnection between someone's assigned and perceived genders. Individuals with this issue usually identify themselves as transgender or transsexual, depending on their ideological feelings about sex and gender. Some transgender individuals also disagree with the categorization of it, or more specifically, gender identity disorder, as a medical condition, as part of a larger exploration of gender identity and what “normal” gender is. It is also important to note that this is different from being a transvestite; technically, a transvestite is someone who wears clothing belonging to the opposite gender, but he or she is usually both happy and secure with his or her gender identity.

Transgender people identify themselves as the sex opposite the one they were born as.
Transgender people identify themselves as the sex opposite the one they were born as.

People of all ages can experience gender dysphoria, although most patients experience a sense of disconnection from a very young age. A child who experiences gender dysphoria may not seek treatment until he or she is much older, but the underlying feelings are still there. Adolescence is also a common time period for the emergence of symptoms, while, more rarely, some individuals only start to question their gender when they are much older. The acceptance of this issue as a condition requiring compassionate treatment, rather than an abnormality, began in the mid-20th century, but was not widespread until the 1980s.

Individuals with gender identity issues who seek treatment usually start by seeing a psychologist to discuss their feelings. Working together with a psychologist, the patient decides the extent of gender dysphoria, and whether steps should be taken to bring his or her physical gender into alignment with the perceived gender. In most nations, a patient must be seeing a psychologist about the problem for a minimum of one year before taking the next step in treatment, to ensure that the patient truly has gender dysphoria, rather than a passing phase. In most cases, the next step begins with living life in the other gender part time. A man transitioning to a woman, for example, may start going to the store in dresses and will also begin discussing the transition with the people in her life.

There are a number of treatments that can be used to transition between genders. The first is hormone treatment, which will physically alter the body. After a set period of hormone treatment, the patient may consider surgery to modify his or her genitalia and the chest region. During hormone treatment, the patient usually begins to transition full time, dressing and behaving in ways that match his or her perceived gender, and sometimes taking voice training and other lessons to learn how to walk, talk, and “pass” as the new gender. At the end of the treatment, the transgender individual will have fully transitioned into a new gender.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

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Discussion Comments


It's the worst feeling ever! It's frustrating having a voice and body of a girl. There's only so much hiding behind baggy clothes I can do by myself and there's no escaping my voice or face.


My 15 year-old step daughter has recently identified himself as transgender. He took a masculine name, requested to be referred to with masculine pronouns, and announced a desire to seek SRS.

However, he has not expressed or shown signs of the kind of mental anguish (the intrusive thoughts, etc.) that many, more mature, gender dysphoria sufferers describe. It raises the question of whether the dissonance that people feel about this is rooted in the condition itself or in the social stigma that has been attached to it in the past. In other words, should we expect to see him really wrestling with this if she has received almost entirely positive support and adulation for coming out?

He is self-absorbed and seeks attention in other ways, and he has recently started a long-distance correspondence with a gay-identifying male on whom he clearly has a crush. It seems to us that his declaration of transgender identity may be related to shock value and/or a desire to become a person in which this friend would be sexually interested. The only real opposition he has faced is from his mother, who is really struggling with it, and he seems to relish "sticking it" to her (typical teenage rebellion).

While my husband and I are aware of the complexities of gender and are open-minded and supportive of what he is going through, it doesn't seem certain to us that this is permanent. Obviously, he is working through some gender issues, but there is a large spectrum of options that isn't as severe as SRS, and isn't gender dysphoria.

My question, I guess, is this: how do psychiatrists determine if a person is genuinely dysphoric? What should we look for? And, in the meantime, does anyone have advice on how to by supportive without locking him into a choice with no face-saving way out, should he decide later that he is not transgender?


So, what people are saying is that they are born this way. That's not possible. Children are molded, very easily I might add, by their surroundings. If you must insist that people are born gay or whatever, I have only this to say.

If you say that they are born this way, I contend that there must then be three genders. Since there are not three genders, they are turned by some twisted person in their lives. People, leave the children alone.


Well, first of all, I'm actually kind of surprised at how strongly some people can hold to traditional gender roles. In part, yes, I do feel society should strive to be less uptight about it, and accept people as they are rather than trying to fit everyone into one box or another. Another part is if this is something someone feels that they need and want and can afford it and will do no harm to anyone (except well potentially themselves if botched surgery, etc) then why the hell not? They owe nothing to you. Just because you have your own preconceived notions, what right do you have to tell someone, particularly a stranger, how they can or cannot live their lives?

For people like screenwriter. You are taxed because you live in benefit from your existing government. You were likely put into public education, had your higher education at least somewhat subsidized by the government, use public roads and services, are protected from foreign invaders and have a police system to report crimes to, have a court system and a working legal system for litigation, eat food that's been inspected and approved by government standards, live in some kind of housing that had a government official inspect it and make sure it won't collapse on you, etc. Not to mention your kids, grandkids, and so forth will also be guaranteed these privileges by right of being a citizen.

So yeah, if you don't want to be taxed, try buying some unclaimed land, start your own country, and then you can live however you want. Good luck with the foreign invaders part, though.

Comparing taxes to experiencing anxiety which can be helped with the modern conveniences of science and medicine is silly.


I am a transsexual who is transitioning from male to female. I can only describe the whole process as something my brain "needs" to do. I spent years and years hating myself, hating how my body was masculinising and living on an ever increasing cocktail of antidepressants because I knew I had to start the process and now that transition is underway, I feel much better.

My only regrets are that I don't have a clearly defined role in society and that any future parental role I have will be best ill-defined and worse, potentially confusing and socially disrupting to my kids. If I could avoid transition, I would, but when you have true gender dysphoria, you must act to resolve it or risk going insane - or committing suicide.

For all those who are interested, I had a fairly happy and normal "boy" childhood but I had gender issues from before puberty. Some days I hate myself for what I am having to do, but if I stop now and attempt to go back, what would I return to? More gender dysphoria and more problems with social and gender adjustment.

Gender dysphoria comes in "waves." Some days it is barely there, and others it is so intense you can't block it out. Sometimes just a comment or the sight of yourself in the mirror is enough to bring it on. I couldn't live like that anymore, hence I began my transition journey.


How can you possibly compare the two? You can pull your finger out and do your taxes and the problem goes away. What are those of us stuck in the middle of the spectrum of gender identity meant to do to make the problem go away?


Transgender is an unchanging adjective. People who experience the gender dysphoria don't necessarily have to be transgender or transexual. They may be something else within the trans* spectrum, such as: agender, bigender, two-spirit, genderqueer, genderfluid and pangender. Not all trans* people are within the gender-binary.

Being trans* is not a choice that you make; it's a part of who you are, just like sexuality or non-sexuality is a part of who you are. You cannot agree nor disagree on someone else's gender. If that would be possible, you'd be able to agree/disagree on someone else's ethnicity. And that doesn't seem so likely, does it?


I want to be a boy and I haven't told anyone besides my childhood friend who recently died as a result of a medical problem she has had her entire life.

I can't tell my family because I feel as though I would be looked down upon because I am the only "girl" grandchild. My parents noticed my preference for boy clothes and actions and insisted I have "girl" clothes/haircuts/toys, etc. The worst part was trying to explain that I like women, and my step father being a devout Catholic made everything harder.

I hated them for a long time but as I come close to reaching 18 and see my little brother playing with barbies and pink, I go out of my way to give him whatever I didn't have. I even bought him the pink real running kids car that runs on a battery because that was the one he wanted.

He is my life and calls me daddy, which is funny cause I feel as though deep down he knows just what I'm going through and knows that I'm trying to make his life as good as it possibly can be.


What if you're attracted to people who have undergone transformation from male to female? What category does that even fall under? I personally have no interest in changing gender, but the men who do I've then found I'm attracted to. Very confusing.


For me, gender identity, like sexual orientation, runs along a spectrum. You can fall on one side or the other, or somewhere in between. People who transition from one sex to the other are people who identify 100 percent with the gender of the opposite sex, so much so that they are willing and eager to transition in every way. Little attention is given to those people, like me, who identify with the opposite gender, but not enough to be considered transsexual. Such persons are not interested in living in the opposite gender, let alone transitioning.

For me, being an “in betweener” feels like a nightmare that I can never wake up from. When I think about it too much, my feelings can range from indifference, to anger, to self-hate, to utter despair. I feel like there is no answer to this “problem,” which means I have to just accept what is. Sometimes I can accept it, but other times it really brings me down.

I am in a long-term relationship with a really caring gay man. I have never told him about my gender identity issues, although I think on some level he can sense them. Somehow it seems to work with him, although I have a lot of trouble being labeled as a “gay” couple, because I don’t see myself as gay. Those feelings of not fitting in with the gay community keep me from committing 100 percent to the relationship. I often resent having to live a gay life, when I don’t identify myself as gay (although I sure do like the same music!). It also puts a strain on our relationship, because, for example, he doesn’t get why I don’t like to go to gay bars, take gay cruises, etc. And the sex, the rare times that it does occur, is unfulfilling. I don’t know how to tell him why I feel that I don’t fit in. I’m not ever sure there is even any point in doing so. On some levels, it doesn’t really matter.

I have often wondered how many people like me are out there and how they deal with it. I’ve never seriously contemplated suicide. I think that’s an extreme recourse. But I can’t deny that I’ve secretly hoped to develop cancer or some other terminal illness so I could be relieved of the weight that I always feel like I’m carrying around. I’m sure that sounds really ungrateful to people who get such illnesses, but let them walk in my shoes for 42 years.

I’ve considered therapy, but I’m not convinced it would make much difference to pay someone to listen to this crap, just to tell me that, well, you need to come to terms with this, blah, blah, blah . . . $5,000 later. Or someone who wants to deconstruct my relationship with my father, as if somehow he’s to blame.

I can see that I’m already moving into anger as I write this, so I better end this here.


Thanks for the comments. I have always felt extremely sad because I have always thought that I was the only one, that I am a 'freak'. I have always thought that this feeling that I just have to be a girl, that this was just my own sinful imagination and sinful thoughts.

I have not told anyone yet. In my life I have suffered lots and lots, because I have always thought that thinking this and feeling this with all my heart is a terrible sin. Do I think that all that LGBT persons should be accepted by God? No, I don't. The pain in me has led me to the hatred of myself. It is leading also to contemplating suicide.

I tell you now, if it was not for Jesus in my life, I would be dead now – dead for years, so, yeah. I now know that, well, God chose for me to be this way. God does not make mistakes. I'm still in the process of healing, and no, I have not told anyone yet, except for this anonymous post.

I do really wish I had someone to talk to, but I know Jesus is always there. So, for all of you out there who feel this way strongly, and feel like you were never meant to be born with the gender you have now. Hey, I feel you.


I have a huge amount of respect for those making the decision to remain true to their marriage vows. God bless you!


I've not wanted to be a girl as long as I can remember. For a long time I wanted to be a boy. As I grew older, I realized i did not want to be a woman or a man.

I've been married for nearly 30 years and gave birth to three sons. I now identify myself as androgynous. I'm attracted mostly to men. I maintain a masculine appearance. I'm doing whatever I can to be comfortable in my body. My husband loves me and accepts me as I am, whatever that may be at the time.


I am trying to understand gender dysphoria, but I find myself wondering: if you are born a male, how do you possibly know what it means to "feel" like a female, and vice-versa. It seems to me there is such a wide range of femaleness thinking, feeling and behaving, as well as maleness. We as a society tend to make stereotypes of the "macho" man or "girlie" girl.

Is it possible there is some problem in the person's nurture that makes them not feel appreciated for the gender with which they were born? And yes, this is not a perfect world, so there are going to be some gene and DNA mishaps.

But when I read of the extremes to which some people go for sex-change surgery/treatment, what do they really accomplish? They cannot truly experience sex with a surgical uterus or penis, or reproduce (although I did read about the possibility of transplanted uteruses). Get therapy if necessary, but all the other? It starts to seem rather self-absorbed or narcissistic.


Gender dysphoria is very real. I've been gender dysphoric since childhood and it's affected every aspect of my being. I am not a TS or a TG person. It's all in my head. I just have never been comfortable being the birth sex I am but also have no desire to be the opposite sex or dress as such. My pain is real and I cannot control it very well. Psychiatry is of some help as are some psych meds.


Gender Dysphoria is very real, and the word hardly describes how it feels. When individuals who have this transition, they may feel a lot better but in certain cases it can be impossible to change physical characteristics enough for the person to feel right.

To look in the mirror and feel betrayed by your own body or to see or develop a body that is wrong for you hurts. The pain is so bad, I know because I am transsexual myself.

And for those who don't understand, you may not understand it, you may be creeped out, you may feel that it is wrong, but you are hardly in the position to make a judgment because you do not feel what we feel and you do not understand it at all.


all right i don't know what to say other than i'm at my wits end. my boyfriend has a severe distrust when it comes to therapists because of a previous misdiagnosis. is there another way in which he can go about getting his surgery?

Brett Blatchley

Please forgive me. In realized in my last post, that I wrote of my "church leadership" in a disparaging way.

It was wrong of me to do that, and even though I feel that way and I wrote truthfully, it was unnecessary for me to inflict my pettiness and injured pride on all of you.

Jesus is not like this at all; He always did what He did out of genuine love and never out of pettiness or ego, even when He expressed His anger. Thank you.

Brett Blatchley

@Anon99894: Though I addressed my prior comment to you, please understand that I was writing to my fellow TG/TS people in general, especially with my postscript.

Since you mentioned your Baptist background, you may already know Jesus personally and have your own testimony of what he has and continues to do for you!

But I can *very much* understand the difficulties you have likely gone through with respect to your congregation. When it became clear (when I solicited prayer for TG/TS people I love) that I accept my TG-state and am convinced by God that His healing me does not involve "making me a man in a male body," then my church leadership declared me to be in sin and excommunicated me from the fellowship. They used Old Testament scripture (Deut 22:5) to justify this and rejected the clear teachings of Jesus and the apostles in the New Testament that supersede their understanding of our issue; they did this in a profound demonstration of spiritual and intellectual dishonesty clothed in "love." Nevertheless, they are not God, and He is my defender; I need no other: God has used their reaction to me to strengthen my faith and trust in him.

I am more convinced that He wishes to use this unique way He made me to help bring His love and healing to others, and to others in the "queer" community. Take care.

Brett Blatchley

Hi anon99894: I can identify with much of what you have expressed.

All of this have been a difficult and complex journey for me, one that God and I are going through together. Though some would disagree, I am convinced that God (of the Bible) is more than OK with my TG/TS-ness and that He has a good purpose for my being this way.

Poetically, I am predominately female soul clothed in a predominately male form. Bluntly, I am a male-to-female transsexual who has chosen to remain in male form out of love for my spouse and to uphold the marriage vows I made to her and God.

While I have made the incredibly difficult choice to remain in male form, as I have come to understand myself better, I am living as a "blended" person. I am God's child, through Jesus, but I am also expressed in a transgender way.

Through a difficult process of trial and trust, surrender, and abandonment of myself to His care, I have given my Gender Dysphoria to God for His keeping. He has not chosen to remove it from me, rather He has chosen to give me grace to endure it. (My sex and gender still do not match, but I have come to realize that that is His will for me for the time being. For others, full transition may be His path.)

I am presently in the "fun" part of this journey where I am learning how to best express myself within the limitations I have accepted (no sexual-reassignment-surgery, no more female hormones) - here is how I've expressed it to some:

I am a female soul, clothed in the form of a male. Transition to female-form and identity was my first choice, but I have accepted God's challenge to live content in this blended-form. My task now is to remain committed to this challenge, accepting it as a gift, learning to express my femininity in the context of a male body.

I want this to be a winsome and comely expression, unique to me, with the force of feminine beauty, grace and sensibility, yet not unbecoming of the male form, nor denying the masculine parts of my soul. God has promised to make me beautiful, graceful and congruent, certainly in eternity, but also (I believe) here in my life on earth as well.

May God bless each of us as we continue on the journey He has appointed to us. Take care.

P.S. I *know* this is hard, but if you're considering taking your life over this, please reconsider. You are a special person, unique and loved by God and He has a good purpose in this though it can be incredibly painful and most people will not understand you here and now.

I have self-harmed and survived and God asked me to let this body keep me until it was time for Him to give me a new one. I know that a lifetime seems too long to wait, but I trust Jesus to that at the appointed time, I will be beautiful, graceful and congruent to a degree that we could never hope to achieve here.

Please trust Jesus with your impossibilities too. And don't worry what people in the churches will say because they will mostly not understand us and may be afraid to the point of hostility, but they aren't God. He loves you, and when Jesus clothed Himself with the body of a human, He understood the horrific incongruity we feel. Imagine an infinite God, squeezing into the frail, pain ridden, limited, doomed-to-die body of a human, all so He could do for us what we can't do ourselves. Everyone is broken and only He can fix us.


I consider myself a transgender person. I wish I had been born a girl, and have always wished I was a girl since the age of six. I am now 40 and have recently over the last 10 years begun to understand my own thoughts and what they were all about through all my life.

It's not just about wanting to dress like a girl, or to have sex with guys. It is more of a need and a desire to feel right in the body and mind. My mind wants to dress one way, but then I have this body that doesn't match. Then throw in a baptist background and you have nice mental battles of self doubt in the head. Yay for religion.

All I can tell you is that it is not a choice. These thoughts come unbidden and many times unwanted. I can hardly wait to get home from work to put on my pink shorts and shirt and feel more normal. Wearing pink feels normal in my head. There is just so much you can not understand what someone is going through unless you go through it yourself.

For example, I did not believe in NDEs (Near Death Experiences), until I had two of my own. People like me just really would love to be left alone by all the homophobic gay/lesbian/ts haters out there. Even though I am not in transition I would love it if I could feel safe to wear pink clothing, shirt, shorts, shoes, nail polish etc., out while still in male mode. Until I can get the chance to have SRS.

Anyhow anon23624, you can say whatever you like but if you try to harm anyone for what they wish to do with their own body, then it is you who is creepy, not people like me. Have a good day.


Don't get so hung up on the inadequacy of the word to describe the condition that you belittle the condition.

Gender dysphoric people routinely show that their brain chemistry and neurology is, in fact, within the norms of the opposite sex and not the one their genitals would indicate. I have a friend and surgeon who is remarkably similar in appearance to, and every bit as comfortable in her femininity as Michelle Phillips. She is exceedingly comfortable in her female identity and her female body (with the aid of surgery, hormones, and other treatments).

She has been a woman for over 10 years and still finds it totally liberating after her previous life of being a woman's identity in a man's body. I don't think she has had a moment's regret, and her life today is full and rich, instead of the old depressed and insecure "living-of-a-lie" that she finally gave up.

There are so many brain studies that show that truly gender dysphoric people have the brain chemistry of one sex, with the physical appearance and genitals of the other sex to rule out the idea that this is just a psychological or anxiety-driven condition. It is a question of a truly woman's brain in a man's body or visa versa.

If you keep up with current brain research on any level, one of the striking advances is to learn just how many different elements go into making up each person's sexual identity and, in some cases, how irrelevant genital structure can be.

Just for another example unrelated to dysphoria, I know a woman who was born female with a normal fully-functioning female reproductive system, lived her entire life as a female, with never a question about her identity, bearing two children who are now in college. She only discovered in her late forties, when being DNA tested for breast cancer genes, that she actually has XY (male) chromosomes (and would, ironically, flunk an Olympic gender test).

All fetuses start out developing as female for the first few weeks. It appears that the major purpose of the XY chromosome is to trigger the fetus at about six weeks to undergo a "testosterone bath," a massive increase of testosterone production that reroutes the fetus's further development onto the male development track.

Every now and then, despite the XY chromosomes, the testosterone bath never materializes (perhaps that gene is suppressed at the critical moment), and the fetus continues on the normal path of development as a female - normal in every respect except the anomalous XY chromosomes. So, which is she? Male or female? I know her answer.

So, given that we now know that each person's sexual identity is a complex mix of genes, brain characteristics, and many other elements, why do we continue to try to define everybody into the ancient pigeonholes of male/female, and treat everybody who doesn't fit the two pigeonholes as somehow abnormal?

They are all normal - just different.

Lastly, unless it is a manifestation of the poster's own deep-seated (and possibly not even consciously realized) insecurities and confusions about their maleness or femaleness, would anybody become upset by another person's sexual journey through life?


So is gender dysphoria a mental disorder? I only know of two people that have this, one girl turning into a man and is still not happy with her/him self and the other girl turning into a man and had mental disorders most her life. If this is a mental disorder, shouldn't psychiatrists try to help these people stay normal instead of going along with them changing their sex?


I can actually sum it up in 24: A lifelong battle suppressing depressing abnormal thoughts that eventually lead to one of two things: suicide from the confusion, or treatment from being strong.


The dictionary definition of dysphoria is actually very straightforward - a state of feeling unwell or unhappy. Many medical dictionaries define dysphoria simply as anxiety. But these definitions just do not describe properly the way dysphoria applies to the moods associated with various disorder cycles.

Many use dysphoria to define types of manic episodes while others associate it with depressive episodes. The truth is, it is actually quite valid as a description for either mania *or* depression.

Dysphoric mania, as described in the Merck Manual, is "prominent depressive symptoms superimposed on manic psychosis."

Thusly applied, It is neither creepy, nor "simple" anxiety. Its very real and very traumatic. But you do not have to believe me, try living it, just one week.

It is super easy to cast dispersions on things one does not understand, and easy as well to have no empathy for things one is not directly affected by.

How about a little humanity and compassion for fellow human beings to start with.

Then, try researching it, educate yourself on what it really is, and isn't.

Easy to say "bah humbug" until you really live something. I challenge you to see if you can still "bah humbug" it after you learn about it.


Do those who have surgery to become more woman-like (or woman lite) feel better about themselves? One person that I knew didn't seem to be faring very well after going from male to female status.

The recent case of a "man" being pregnant is also an illustration of a problem in the opposite direction.


I'm afraid what we have here is merely an accommodation. Dysphoria simply means anxiety, therefore in plain English a person with this condition has GENDER ANXIETY! Is this condition more worthy of a pedigree then myself who has Taxation Anxiety? Which BTW I am sure is much more common in the general population. This is a classic example of why many in the medical community believe psychiatry is more art than science!

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    • When someone identifies as a gender other than the one they were physically born as, talking to a psychologist can help them decide how to confront the issue.
      When someone identifies as a gender other than the one they were physically born as, talking to a psychologist can help them decide how to confront the issue.
    • Transgender people identify themselves as the sex opposite the one they were born as.
      Transgender people identify themselves as the sex opposite the one they were born as.