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KJ Gormley
November 29, 2018 7:00 am

It’s a good thing that transgender people are more widely seen in media and acknowledged in general these days, but you may have questions about some of the terms trans people use. It can be hard to ask because while you want to be respectful and learn more about trans people’s experiences, going up to a transgender person and interrogating them about their identity is rude. “Gender dysphoria” may be an example of unfamiliar vocabulary.

It’s an important aspect of identity to many (but not all) transgender people, and can also be confusing. Gender, sure, that’s mostly easy. Dysphoria? That’s probably not a word you use every day.

We reached out to clinical counselor Alex Roan, Ph.D., who specializes in working with trans and non-binary clients in Portland, Maine, to ask about the term. This conversation might not answer every question you have about gender dysphoria, but it’s a good start. If you think you might be experiencing gender dysphoria, we encourage you to reach out to a professional with a background in gender dysphoria and/or working with transgender patients. For more answers to your questions about transgender people or transitioning, the National Center for Transgender Equality has a good FAQ page.

What is gender dysphoria? What are some symptoms?

“Gender dysphoria is a sense of incongruence between a person’s experience of gender and their gender assigned at birth. Symptoms may include feeling strong discomfort about primary and/or secondary sex characteristics, and/or a desire to be perceived by others as a different gender than the one you were assigned. According to the DSM-V, two of the following six criteria must be met for a diagnosis of gender dysphoria in adolescents and adults:

1. A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics

2. A strong desire to be rid of one’s primary and/or 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 of the other gender

5. A strong desire to be treated as the other gender

6. A strong conviction that one has the typical feelings and reactions of the other gender.”

If I only feel like I qualify for a few of the symptoms, might I still have gender dysphoria?

“You are the only person who gets to decide if you are experiencing gender dysphoria or not. It can often be difficult to determine if a sense of discomfort about gender is due to dysphoria or due to the problematic stereotypes and assumptions that are often associated with gender labels. Gender is deeper and more complex than the type of clothes you wear, the interests you have, or the way you interact with others. Many people do not conform to gender stereotypes, but do not experience gender dysphoria. However, if your sense of who you are as a person feels incongruent with the gender label you’ve been assigned, this is likely gender dysphoria.”

Does having gender dysphoria mean I’m transgender? Do I need to have gender dysphoria to qualify for transgender-related health care (hormone replacement therapy (HRT), surgeries, etc)?

“As with any label, you get to pick the ones that apply to you, and only you can do this. Most—but not all—transgender people experience some form of gender dysphoria. Likewise, many people who experience gender dysphoria are transgender. However, because humans are complex creatures and these terms can be interpreted in different ways, it’s rarely useful (or accurate) to claim that ‘all people who [A] are [B].’ In terms of accessing trans-related health care, it is typically the case that people who take steps to alter their bodies do so in order to reduce feelings of intense discomfort (gender dysphoria) and/or to increase feelings of gender congruence.”

What are first steps to take when you figure out you have gender dysphoria?

“Determine how gender dysphoria is impacting your life. If you feel terrible about your body and/or being perceived as a gender that doesn’t feel right to you, it may be worth learning about what options are available to help you feel better about yourself. This may mean dressing or behaving in ways that feel more natural, reducing time spent with people who have a narrow and rigid view of how people are ‘supposed to look/act’ based on their gender, taking steps to change your appearance in a way that feels good to you, or pursuing various medical interventions to help your body better align with how you see yourself. The most important thing to keep in mind is that there is no ‘right way’ to have a gender, and that you are the only person who decides who you are and how you want to present yourself in the world. Seek out as much information as possible about the various paths you have to choose from and talk to other supportive people you relate to.”

What are some coping mechanisms you can suggest for someone with gender dysphoria?

“Make connections with others who share similar experiences. Knowing that you’re not alone makes a big difference. Remind yourself that there are infinite ways to experience and express gender and that you are okay just the way you are. Learn about the lives of trans and non-binary people and what steps they took to be their authentic selves—note what you do and don’t relate to. Give yourself permission to let go of gender stereotypes you’ve been taught if they don’t apply to you. Spend time with people who are accepting and affirming of who you are. Identify what options you have to help you feel better about yourself and take one small step towards one of your goals.”

Some days I feel these symptoms and other days I don’t have any. Do I really have ‘enough’ gender dysphoria?

“Sometimes the way we feel about ourselves can change day-to-day, depending on what we’re focused on or what thoughts we tell ourselves. The most important step is to figure out how gender dysphoria is negatively impacting your life and identifying possible steps to minimize that impact. Each person’s experience is unique and you are the one who knows you best. Oftentimes, talking to a trusted friend or a therapist can help in further exploring these issues if you’re experiencing gender dysphoria and not sure what to do next.”

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