Gender dysphoria is a term for extreme distress about the difference between the sex you were assigned at birth and your gender identity. There is a mismatch between that assigned sex and the gender you identify as, which is often known as your affirmed gender.

Though not all transgender and nonbinary people experience gender dysphoria, the feeling of gender dysphoria often is one of the first things that prompts a person to realize they’re trans or nonbinary.

Being transgender or nonbinary isn’t a mental health disorder. But gender dysphoria is. If you experience gender dysphoria, being diagnosed can help you get mental health support from a professional who affirms your gender identity.

Signs of gender dysphoria

The main symptom of gender dysphoria is feeling a lot of distress about the mismatch between your assigned gender and your affirmed gender. You might feel physically uncomfortable in your body or just like you really don’t belong in it. You might not want to present as your assigned gender, meaning dressing or behaving in the way that’s expected for that gender. Or you might have a super strong desire to present as your affirmed gender. Again, not all trans or nonbinary feel this way, or feel this way to the same degree.

And gender dysphoria feels different for different people. Most often, it shows up as anxiety, depression, or sometimes thoughts of suicide. Bullying, social rejection, or feeling isolated from friends, family, or your community can also have a seriously negative impact on your mental health.

Gender dysphoria is only diagnosed if your distress lasts for at least six months and makes it hard for you to function at school, at home, or in your relationships with friends and family.

It’s important to note that being trans or nonbinary doesn’t necessarily have to come with gender dysphoria.

Help for gender dysphoria

Treatment for gender dysphoria can vary a lot depending on what you need. The first step is finding a mental health professional who affirms your gender identity and who can treat the specific symptoms you’re dealing with. Often, just working with someone who validates your feelings and understands your gender identity can make a difference.

In the short term, getting help for your most intense symptoms — like anxiety or depression — is often the priority. Treatment for anxiety and depression generally includes therapy and sometimes medication. A specific kind of therapy called dialectical behavior therapy (DBT) tends to be especially helpful for people with gender dysphoria. In DBT, your therapist helps you learn skills for coping with overwhelming emotions and feeling better about yourself.

In the longer term, treatment for gender dysphoria can focus on changing the circumstances that are causing your pain in the first place. These changes can include:

• Making changes to your gender expression, like dressing differently or changing your hairstyle

• Changing the name or pronouns you use at home, at school, or on official documents like your ID cards

• Getting accommodations at school, like being allowed to use the bathroom in the nurse’s office instead of a gendered bathroom, or extra visits to the school counselor 

A mental health professional can also help you and your family consider medical interventions to make your body more closely match your gender identity. This might include puberty blockers, hormone therapy, and surgery.

There is no one way to handle gender dysphoria because everyone has different needs. But with support, you can navigate the options, take the steps that make sense for you, and feel more at home in your body and gender identity.

The Suicide and Crisis Lifeline offers specialized services for LGBTQ+ youth. To speak with a counselor specifically focused on these needs, call 988 and select option 3 or text "PRIDE" to 988.