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Help With Gender Dysphoria

Curated and updated for the community by APA

Topic Information

The term “transgender” refers to a person whose sex assigned at birth (i.e. the sex assigned by a physician at birth, usually based on external genitalia) does not match their gender identity (i.e., one’s psychological sense of their gender). Some people who are transgender will experience “gender dysphoria,” which refers to psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity. Though gender dysphoria often begins in childhood, some people may not experience it until after puberty or much later.

People who are transgender may pursue multiple domains of gender affirmation, including social affirmation (e.g., changing one’s name and pronouns), legal affirmation (e.g., changing gender markers on one’s government-issued documents), medical affirmation (e.g., pubertal suppression or gender-affirming hormones), and/or surgical affirmation (e.g., vaginoplasty, facial feminization surgery, breast augmentation, masculine chest reconstruction, etc.). Of note, not all people who are transgender will desire all domains of gender affirmation, as these are highly personal and individual decisions.

See more on symptoms, & treatment

  • Dec 11, 2019
The ‘Q’ in LGBTQ: Queer/Questioning

Most people are familiar with the term LGBT—lesbian, gay, bisexual, and transgender. The acronym increasingly includes the letter Q, LGBTQ, referring to queer and/or questioning individuals. The terms queer and questioning are important because they encompass a larger number of individuals who identify as having same-sex attraction and behaviors.

  • Nov 30, 2017
Direct-to-Consumer Advertising Linked to Changes in Medication Use Among People with Serious Mental Illness

People with serious mental illness exposed to direct-to-consumer advertising (DTCA) of medications are more likely to stop taking their medications than those not exposed to the advertising, according to new research published in Psychiatric Services in Advance.

  • Nov 15, 2017
Effective Messages to Fight Stigma

Despite increasing public awareness and discussion about mental illness and substance use disorders, stigma is still a major barrier to many people seeking treatment. New research has identified communication strategies that are effective in reducing stigma and increasing public support for policies and programs benefitting people with behavioral health conditions.

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. ome people who use this term do not consider themselves as matching a binary gender category of either strictly male or female. In addition, new terms such as gender non-conforming, 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 affirmation or confirmation (historically referred to as sex reassignment). Some transsexual individuals may identify as transgender, although many 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 Gender Dysphoria 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. ... More

About the Experts:

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Jack Drescher, M.D.
Clinical Professor of Psychiatry, Columbia University
Adjunct Professor, New York University
Training & Supervising Analyst, W.A. White Institute

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

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Eric J. Yarbrough, M.D.
Psychiatrist in private practice in New York City

Patient Story

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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Editor's Choice

JAN 6, 2021

Early care leads to better mental health for transgender youths, study finds
Upworthy

Transgender rights are some of the most controversial issues of the day. It's reasonable to believe that we could make more progress on these issues if people understood the experiences of transgendered people. In the end, empathy is the key to understanding. By finding more effective ways to present the experiences of marginalized groups, we can bridge the gap between these communities and those who deny them their rights. Or, in other words, teach them what it's like to walk a mile in their shoes.  

 JAN 4, 2020

California commissioner: Trans youths cannot be denied insurance for surgery 
Metro Weekly

Legal opinion says insurers must consider individual care assessments when determining medical necessity.  California’s Department of Insurance has issued an opinion clarifying that, under existing law, health insurance companies operating in the state may not deny coverage for male chest reconstruction surgery for transgender patients undergoing care for gender dysphoria based solely upon their age. 

DEC 18, 2020

Gender Dysphoria: What Is It, and How Do I Cope? What is gender dysphoria?
The Good Men Project

Gender dysphoria refers to the discomfort and distress in individuals whose gender identity is different from their sex at birth. Transgender, as well as gender-nonconforming people, can experience gender dysphoria during their lives. Gender dysphoria doesn’t affect every person whose gender identity differs from their assigned sex at birth. In some instances, transgender and gender-nonconforming people feel comfortable in their bodies and don’t need medical intervention. If you’re experiencing gender dysphoria, know that you’re not alone. Many people have gone through these issues, and they’ve gotten the support they needed to feel comfortable in their bodies.