Gender Dysphoria Basics

Gender dysphoria affects children who identify as "transgender," a term that describes someone who does not identify with the sex characteristics he or she was born with. Being transgendered is not a psychiatric disorder. Gender dysphoria is diagnosed only if a child experiences severe distress due to being transgender.

Gender Dysphoria: What Is It?

Not all children and adolescents fully identify with the sex characteristics they were born with. Some girls subjectively feel as though they are actually boys, and some boys subjectively feel as though they are actually girls. This phenomenon, commonly referred to as being “transgender,” is not a psychiatric disorder, but when children experience significant distress as a result of being transgender, they may have the disorder called gender dysphoria. A child with gender dysphoria is one who experiences great anguish as a result of feeling “trapped” inside a body that does not match the gender he feels himself to be internally. The creation of gender dysphoria as a distinct disorder was meant to remove the stigma from being transgender, and to shift the concern of mental health professionals to assisting those for whom the experience of being transgender has resulted in significant distress and impaired functioning.

Gender Dysphoria: What to Look For

Children who have gender dysphoria have a marked incongruence between the gender they have been assigned (i.e. assumed by others to be, based on sex characteristics), and their experienced gender. In childhood this takes the form of a strong preference for dress, toys, and activities associated with the other gender. They may assert that they are the other gender, will grow up to be the other gender. As they reach adolescence they may express a strong dislike of their own sexual anatomy and a strong desire to have sex characteristics of their experienced gender. It’s not gender dysphoria unless the incongruity causes the person significant distress or impairment in important areas of functioning.

Gender Dysphoria: Risk Factors

Though there is debate over what might cause gender incongruence, the causes of distress involved in gender dysphoria are largely sociological: in a society that still views transgenderism as outside of the norm, it is understandable that children and adolescents may experience significant distress as the result not only of struggling to make sense of their own gender identity, but of being stigmatized, ostracized, and bullied.

Gender Dysphoria: Diagnosis

If a young person has experienced acute distress or discomfort as a result of his or her assigned gender or accompanying gender roles for at least six months, he or she may have gender dysphoria. To be diagnosed with the disorder, a young person must have “feelings of incongruence” between his assigned gender and his experienced gender and a wish to be, and be treated as, the other gender. In addition, a young person must be distressed to the point of impaired ability to function at school, at home, or in social settings. In diagnosing gender dysphoria, a doctor will rule out a physical intersex or sexual development condition.

Gender Dysphoria: Treatment

Psychotherapy, talk therapy in particular, can help a young person understand and manage the distress he is experiencing as a result of gender dysphoria.

Gender Dysphoria: Risk For Other Disorders

An adolescent who is experiencing distress as a result of his gender identity, especially if he is bullied or ostracized, is at heightened risk for anxiety, depression and substance abuse.