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Help With Gender Dysphoria

Curated and updated for the community by APA

Gender dysphoria involves a conflict between a person's physical or assigned gender and the gender with which he/she/they identify. People with gender dysphoria may be very uncomfortable with the gender they were assigned, sometimes described as being uncomfortable with their body (particularly developments during puberty) or being uncomfortable with the expected roles of their assigned gender.

People with gender dysphoria may often experience significant distress and/or problems functioning associated with this conflict between the way they feel and think of themselves (referred to as experienced or expressed gender) and their physical or assigned gender.

The gender conflict affects people in different ways. It can change the way a person wants to express their gender and can influence behavior, dress and self-image. Some people may cross-dress, some may want to socially transition, others may want to medically transition with sex-change surgery and/or hormone treatment. Socially transitioning primarily involves transitioning into the affirmed gender’s pronouns and bathrooms.

See more on symptoms, & treatment

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What is the difference between transgender and transsexual?

Transgender is a non-medical term that has been used increasingly since the 1990s as an umbrella term describing individuals whose gender identity (inner sense of gender) or gender expression (outward performance of gender) differs from the sex or gender to which they were assigned at birth. Some people who use this term do not consider themselves as matching a binary gender category. In addition, new terms such as genderqueer, bigendered, and agendered are increasingly in use.

Transsexual is a historic, medical term that refers to individuals who have undergone some form of medical and/or surgical treatment for gender reassignment (historically referred to as sex reassignment). Some transsexual individuals may identify as transgender, although others primarily identify as the male or female gender to which they have transitioned.

People who identify as transgender but who do not seek medical or surgical treatment are not transsexual.

Is there a general age that people realize they are transgender or experience gender dysphoria? Can it happen late in life?

Not all transgender people suffer from gender dysphoria and that distinction is important to keep in mind. Gender dysphoria and/or coming out as transgender can occur at any age.

The DSM-5 distinguishes between Gender Dysphoria in Childhood for those who experience GD before puberty. The diagnosis of Gender Dysphoria in Adolescents and Adults can occur at any age. For those who experience gender dysphoria later in life, they often report having secretly hidden their gender dysphoric feelings from others when they were younger.

About the Experts:

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Jack Drescher, M.D.
Clinical Professor of Psychiatry, New York Medical College
Adjunct Professor, New York University

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Jack Pula, M.D.
Psychiatrist in private practice in New York City

Transgender Non-Conforming Youth: One Experience of Many

My fourth child is a transgender boy, and I love him. At 2 he climbed up on the kitchen counter when his dad and I were doing the dishes.

He refused to toilet train until we bought him boxers. Desperate for him to toilet train so he could start preschool at 3, we did. We were dismayed to see him freeze when he was asked to use pink scissors or line up with the girls in PE, and mortified to overhear other parents ask each other, “What kind of parents would name a boy Samantha?”.

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