Gender dysphoria

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Gender dysphoria (GD) is the distress a person experiences due to a mismatch between their gender identity—their personal sense of their own gender—and their sex assigned at birth.


  • First, one of the most important – and, for many, confusing – questions: why do some trans people need medical intervention at all? Dysphoria, the antonym of ‘euphoria’, is the clinical term now used to describe the intense feeling of anxiety, distress or unhappiness some trans people feel in relation to their primary sex characteristics (genitals), their secondary sex characteristics (breasts, facial hair, menstruation, face shape, voice) or how these physical traits cause society to interact with them, by perceiving them as a male or female. Previously called 'gender identity disorder' and, before that, 'transsexualism', gender dysphoria is the name given to an experience many trans people struggle with, which can be helped by medical intervention. Although the term is widely used within the community, different trans people can experience dysphoria in very different ways, and so might have different clinical needs.
  • Gender dysphoria is a rare experience in society as a whole, affecting about 0.4 per cent of the population, which can make it hard to explain to the vast majority of people, who have not experienced it. To get around this, we often rely on metaphors. The clumsy phrase ‘born in the wrong body’ has become the favoured soundbite in popular media. Clumsy because – and this must be stressed – many trans people do not think this describes dysphoria at all well. To my mind, the trans writer Andrea Long Chu expresses it more accurately: "Dysphoria," she says, "can feel like heartbreak." Heartbreak, its incapacitating grief and the sense of absence and loss which activate the same parts of the brain as physical pain, can be so all-consuming it interferes with your everyday life. So, too, dysphoria. For me, at least, this is a much richer way of describing how many trans people experience distress with their bodies – indeed, how I felt until I medically transitioned.
  • Dysphoria, it should be said, is not a precondition of being trans. According to some research, as many as 10 per cent of those who positively identify as trans men, trans women, non-binary people and various other terms do so without any feelings of dysphoria. It is sometimes incorrectly assumed that trans men and women experience dysphoria and non-binary people do not, when in fact some non-binary people feel themselves to be in great need of medical assistance, and some trans men and women seek none at all. Nevertheless, most trans people experience dysphoria to some degree.
  • It is the "battle of the beliefs": hanging on to your belief that you are who you are despite how others may define you, while also challenging yourself not to compare your insides to other people’s outsides. It's a constant effort to align yourself externally with how you feel internally.

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