Gender dysphoria

About gender dysphoria

Biological sex is assigned at birth, depending on the appearance of the genitals.

Gender identity is the gender that a person feels themselves to be.

Biological sex and gender identity are the same for most people, but this isn't the case for everyone.

This mismatch between sex and gender identity can lead to distressing and uncomfortable feelings that are called gender dysphoria.

Gender dysphoria is a recognised medical condition, for which treatment is sometimes appropriate.

Signs of gender dysphoria

The first signs of gender dysphoria can appear at a very young age. For example, a child may refuse to wear typical boys' or girls' clothes, or dislike taking part in typical boys' or girls' games and activities.

In most cases, this type of behaviour will pass in time, but for those with gender dysphoria it continues through childhood and into adulthood.

Adults with gender dysphoria can feel trapped inside a body that doesn't match their gender identity. They may also want to change or get rid of physical signs of their biological sex, such as facial hair or breasts.

Getting help

See your GP if you think you or your child may have gender dysphoria. If necessary, they can refer for specialist advice and treatment. A personalised assessment is carried out and support is provided.

Treatment for gender dysphoria

If the assessment results suggest that you or your child have gender dysphoria, staff will work with you to come up with a treatment plan. This will include any psychological support you may need.

Treatment for gender dysphoria aims to help reduce the distressing feelings of a mismatch between biological sex and gender identity.

This can mean different things for different people, but can include:

• dressing and living as your preferred gender
• taking hormones or having surgery to change your physical appearance

Causes of gender dysphoria

There are many possible variations within gender development that cause a mismatch between a person’s biological sex and their gender identity, making the exact cause of gender dysphoria unclear.

Occasionally, the hormones that trigger the development of biological sex may not work properly on the brain, reproductive organs and genitals, causing differences between them.

This may be caused by:

• additional hormones in the mother’s system – possibly as a result of taking medication
• the foetus’ insensitivity to the hormones, known as androgen insensitivity syndrome (AIS) – when this happens, gender dysphoria may be caused by hormones not working properly in the womb

Gender dysphoria may also be the result of other rare conditions, such as:

• congenital adrenal hyperplasia (CAH) – where a high level of male hormones are produced in a female foetus
• intersex conditions – which cause babies to be born with the genitalia of both sexes (or ambiguous genitalia)

How common is gender dysphoria

It's not known how many people experience gender dysphoria, because many people with the condition never seek help.

While gender dysphoria appears to be rare, the number of people being diagnosed with the condition is increasing, due to growing public awareness.

Gender terminology

Gender dysphoria is a complex condition that can be hard to understand and terminology is still evolving.

It may help to distinguish between the meanings of different gender-related terms:

• gender dysphoria – discomfort or distress caused by a mismatch between a person’s gender identity and their biological sex assigned at birth
• transgender (trans) – wanting to live and be accepted as a member of the opposite sex, usually accompanied by the wish to have treatment to make their physical appearance more consistent with their gender identity
• transvestism – where a person occasionally wears clothes typically associated with the opposite gender (cross-dressing) for a variety of reasons
• non-binary – an umbrella term used to describe gender identities other than man and woman – for example, those who are both man and woman, or neither man nor woman, or moving between genders

Gender dysphoria isn't the same as transvestism or cross-dressing. It isn't related to sexual orientation.

• Gender dysphoria

More useful links

• How to use your health services