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7 questions you should ask about gender dysphoria

By: Aleena Ortiz (he/she/they)

What does gender dysphoria feel like? Some people say it’s like wearing a mask. Others say it’s like wearing clothes that don’t fit, that you can never take off. Some people notice their gender dysphoria only after they have started their gender transition, while others feel dysphoria long before they even know they’re trans.

Gender dysphoria may make you feel like your body doesn’t match your true gender identity. This can lead to feelings of sadness, isolation, and confusion. The experience of gender dysphoria can be emotionally and physically exhausting. It can cause you to feel disconnected from your body and out of touch with your true self. 

For some trans people, it can be difficult to express your gender identity openly due to fear of judgment or rejection. Feeling like you can’t be open can make gender dysphoria worse. Three common signs of gender dysphoria may include:

  1. Strong desire to be treated like a different gender
  2. Strong preference for clothing or that is not typically associated with your assigned sex at birth
  3. Feeling more comfortable when called by a different chosen name or different pronouns

The signs and symptoms of gender dysphoria can vary from person to person, but many trans and nonbinary people share the same experiences. Gender dysphoria can include strong feelings of discomfort with physical traits that are associated with your assigned sex. For example, you might dislike having facial hair or a particular body shape, such as having breasts. If it’s left untreated or ignored, gender dysphoria can lead to feelings of depression, anxiety, self-harm, and even suicidal thoughts.

How early do people experience gender dysphoria?

Psychology professor Kristina Olson (she/her) started TransYouth Project to study how gender identity develops. The project has run for more than 20 years and worked with more than 800 children and their families. Olson said some parents reported that children could identify their gender identity as early as 18 months or 2 years (when they started talking). This means they might experience gender dysphoria as well as a sense of wholeness when their gender is affirmed.

Puberty is an especially sensitive time for many trans people. These challenging years can reveal how we truly feel about our bodies. Gendered changes might cause gender dysphoria to become more obvious. One example might be wanting to speak less as your voice becomes lower, because you don’t like sounding “male.” Another example might be struggling with developing curves, breasts, and/or chest and wanting those changes to stop or go away.

For myself, puberty highlighted my gender dysphoria. I felt distress at sensitivity developing in my genital area and other parts of my body. I experienced for the first time a strong disconnect between my body and my mind. 

Is it gender dysphoria or mental health issues?

Sometimes, it can be hard to tell the difference between mental health issues and gender dysphoria. The two can overlap, especially if your bad mood was triggered by a situation you deal with often—such as your family asking about marriage, being misgendered daily, or struggling with self-image.

If this is your experience, you may question whether labeling your bad mood as “gender dysphoria” is true or worth it. The short answer is, if something is bothering you it is important to deal with it. You deserve to feel healthy and balanced within your own body.

If your mental health issues connected with your gender dysphoria are severe, you may need clinical support. Gender-affirming healthcare, including mental health medications and medications that support your gender transition may help. Know that you do not have to be alone with feelings of depression, anxiety, isolation, confusion, as well as other aches and pains.

Does everyone experience gender dysphoria?

Gender dysphoria is a very common experience in our community. It’s nothing to be ashamed of. Feeling gender dysphoria doesn’t mean you’re “doing gender wrong” or that you are failing at your transition. It simply means you feel uncomfortable and should seek support.

For the record, while gender dysphoria is one way that some people identify their  transgender or nonbinary identity, it doesn’t happen to everyone. Everyone’s experience is unique, so there are also people who don’t experience gender dysphoria at all! Instead, they only feel gender euphoria, which is the feeling of being safe and at home in your body. Many care providers, including our team at Plume, feel that gender euphoria is a much stronger indicator of someone’s need and desire to transition. For example, if you feel comfortable with your body but would be happier living as a different gender than the one assigned to you at birth—you may be transgender.

Gender euphoria and gender dysphoria may affect how you wish to be addressed or look on a specific day. For example, you may not feel uncomfortable with your body, but you would be happier being perceived as another gender.

Is it gender dysphoria or body dysmorphia?

The feeling of gender dysphoria may not be as obvious as disliking a certain aspect of your body when you look at yourself in the mirror. Gender dysphoria comes in many forms. Some of the signs are more subtle than others. More than likely, you have seen or heard stories about trans or nonbinary folks looking in the mirror and feeling unhappy with what they saw. They might wonder, “Do I dislike my body because it’s imperfect, or because it’s not aligned with my gender identity?”

Those are honest questions. Many of us do feel pain, humiliation, or shame when we see our oppositely-gendered, pre-transition appearance. It’s very common to try to hide aspects of your body, like I did. For example, if you have a large chest, perhaps you wear baggy sweatshirts and scrunch your shoulders forward to hide your chest as much as possible. This is a valid experience that many trans people go through.

However, experiences of gender dysphoria aren’t always so clear-cut for everyone. Often, those who are first questioning their gender, or who identify as nonbinary or genderfluid, may not have a specific goal or idea of what they want themselves to look or be like. The goal of your gender transition may not be to look more feminine or more masculine, but simply to feel comfortable in your own body. This may include surgeries and gender-affirming hormone therapy (GAHT, sometimes also called hormone replacement therapy or HRT), only gender-affirming surgeries, or only hormones. For some of us, it may include choosing affirming clothes and different pronouns.

Other times, the biggest indication that “something isn’t right” is the friction you experience socially. This is a sign of gender dysphoria, too. For example, you may not hate your appearance, but you avoid thinking about it. You might avoid mirrors and expectations around gender altogether. You may even reason that it is natural for everyone to dislike aspects of themselves and avoid engaging with your self-presentation. If this is what you are experiencing, your feelings may be related to gender dysphoria.

Is “trying too hard” a sign of gender dysphoria?

Another common sign of gender dysphoria is trying really hard to “fit in” with your gender assigned at birth. This is known as overperforming. For example, if you are assigned female at birth (AFAB, sometimes also called FTM), you might try extra hard to be even more feminine. You might take on a hyper-feminine gender presentation, even though it doesn’t feel authentic to you.

If you are assigned male at birth (AMAB, sometimes also called MTF), you might behave in a way that is ultra macho or like an alpha-male. Maybe you pursue a sport like football, try to achieve the ideal gym body and act assertive because you want to be seen as a “man’s man.”

Perhaps you try to avoid your assigned sex completely. This is surprisingly common, especially with nonbinary, agender, and genderfluid folks! We might experience gender dysphoria as avoiding feminine and/or masculine clothing in an attempt to conceal our bodies from others (and ourselves). 

Gender identity is innate and natural. It’s nothing to hide, although it is common to want to hide from something that causes you pain. Gender dysphoria can be alleviated by honoring your true gender identity and taking steps to feel affirmed.

If you feel you are overperforming or underperforming gender roles to make others see you a certain way, you may be transgender, nonbinary, and/or gender non-conforming. And that’s great to know about yourself! It is very common for those of us who experience gender dysphoria to blame ourselves for not being “male” or “female” enough in the body we’re born with. Many of us double down on our assigned gender and try to force ourselves to accept it. If this is where you are in your journey, know that you’re not alone—and you don’t have to fake anything to fit in or belong.

How can gender dysphoria affect my sex life?

When you don’t feel attractive or balanced, it’s very hard to have fulfilling relationships. Before transitioning, a combination of low self-confidence, gender dysmorphia, and confusion about sexuality sometimes makes relationships challenging. Many transgender people say they also noticed changes in their sexual and/or romantic orientation throughout their gender transition. 

Gender dysphoria can impact your sexuality and self-esteem. This might make you feel like it’s hard to be fully present in your romantic relationships. It may also feel like something is “wrong” with you or the other person. If you are experiencing complicated sexual and/or romantic feelings in your dating life (such as not knowing which gender you are most attracted to or feeling like you have difficulty connecting with your body in sexual situations), then you may be experiencing gender dysphoria.

If you have been dealing with gender dysphoria for a long time, its effects may not be obvious to you. Gender dysphoria can feel like a ton of bricks sometimes. Other times, it is more subtle and difficult to understand. You might wonder whether it is natural for you to feel this way. It is also possible that your gender dysphoria may change over time, feeling loud some days and nonexistent the next.

Often, trans and nonbinary people find that pursuing gender-affirming health care options can have a positive impact on their self-esteem (and their sex lives, as a result). For some folks, a change in gender presentation is helpful, too. Feeling seen and accepted by your partner is a powerful experience and can bring you closer.

What should I do about my gender dysphoria?

Above all, it is important to remember that your gender dysphoria is not a choice. It is not something that can be “fixed” with willpower. Instead, it requires understanding and compassion from your chosen family, friends, and health care providers. If you or someone you know is experiencing gender dysphoria, it is important to seek out professional help. A mental health provider can offer support and resources to help you explore your gender identity and find ways to cope with the distress associated with gender dysphoria. 

If you are questioning whether you are experiencing gender dysphoria, a transgender and/or gender-questioning support group may help you understand your own gender feelings. Plume offers support groups for our Members that can help.

Especially if your gender dysphoria depends largely on your social context, it can be difficult to designate those feelings as “gender dysphoria” in the moment. Gender dysphoria often has physical symptoms too, resulting in fatigue, insomnia, changes in appetite, and changes in skin tone. People may also experience physical discomfort such as muscle tension, headaches, and stomach aches. Be gentle with yourself and nurture the parts of you that are hurting. 

Instead of sitting alone with this pain, allow yourself to reflect the gender dysphoria, if you can. You might journal about how gender dysphoria affects your life physically, socially, and emotionally. If you are constantly struggling to fit in everyday or feel like your true gender identity is not accepted, this can lead to unexplainable feelings of depression and anxiety. Rather than isolate and shut out others, try to connect with your community and loved ones. Although it might seem difficult to communicate your feelings around gender dysphoria, allowing others to love you can be profoundly healing.

The experience of gender dysphoria can be a difficult one, so it is important to recognize the signs and symptoms of this condition. It is also important to remember that there is help available. Plume can help you find support and resources to help manage gender dysphoria and to help you cope with the distress that it can cause—and hopefully, move past it. You deserve to experience life beyond gender dysphoria and enjoy the sense of self-acceptance and alignment we call gender euphoria.

Aleena Ortiz (he/she/they) is an independent world traveler, freelance writer, and contract book reviewer at Foreword Magazine. They obtained a Bachelor of Arts in Religion with a focus on Buddhism, Daoism, and Shintō at Reed College in May 2021. Eager to explore fictive worlds with respect to cultural sensitivity and the complexities of human emotion, he has published over 1 million words online over the last decade. Aleena strives to create space for nuanced understanding of historically underrepresented groups through her analyses of media and in fiction writing. 

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