What is gender dysphoria?

What you need to know about this commonly-misunderstood condition.
What is gender dysphoria
Edward Berthelot

Gender dysphoria is a term to describe the “sense of unease” experienced by some individuals that their biological sex does not match their gender identity, according to the definition on the NHS website.

Celebrities such as Elliot Page (who announced his transition from female to male in late 2020) and Caitlyn Jenner have spoken openly about struggling with gender dysphoria. And as we, as a society, seek to understand more about gender identity, it's important that we get to grips with these important terms and what they mean.

How does gender dysphoria relate to gender identity?

Gender identity is, put simply, our individual sense of who we are and how we want to be described in relation to the concepts of gender. By definition, everyone has a gender identity.

This can mean being cis-gender (conforming to the biological sex you were born with, such as having male genitals and identifying as male), which typically means having what's called a “binary” male or female identity. Or else it can mean being transgender (identifying with a gender you were not assigned at birth). It is also possible that you do not conform to any gender (described as gender-non-binary, or more rarely agender or gender non-conforming).

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Dr Elena Touroni, a consultant psychologist and co-founder of The Chelsea Psychology Clinic, has provided some important background.

Does gender dysphoria develop as you age?

“In most cases, someone becomes aware from an early age that their assigned gender doesn’t align with their psychological experience,” says Touroni. This can often happen around puberty, explains the NHS website.

“It tends to be a persistent experience that is deeply ingrained in one’s identity, making it unlikely to change over time. It’s very unusual for gender dysphoria to diminish with age,” she adds.

Is gender dysphoria a mental health condition? What is its link with mental health?

Gender dysphoria is not a mental health condition, stresses Touroni. However, the challenges of questioning one's identity can often lead to “psychological distress” such as “symptoms of anxiety, depression and difficulties in interpersonal relationships”, which Touroni says may be more common in those experiencing gender dysphoria.

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Sleep therapist Dr Kat Lederle has also noted that gender dysphoria can be associated with sleep difficulties, quoting a study by Auer et al. which showed “79.2% of trans women and 81.2% of trans men report poor quality sleep.” She adds: “While there was no difference between the genders, this rate is higher than for cisgender people.”

What kind of treatments are there to support patients with gender dysphoria?

In England, adults can be referred to one of the country's NHS gender dysphoria clinics (of which there are currently eight sites) from the age of 17. Treatment options tend to be based on whether an individual chooses to have gender reassignment surgery, Touroni explains.

"While surgery can address the core issues, it may also bring about psychological challenges that require some form of psychological therapy for adjustment. For those who decide against surgery, various coping mechanisms can be employed to manage the emotional distress caused by the incongruence. Either way, some form of therapy is generally recommended to support the individual’s mental wellbeing.”