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Gender Dysphoria

Tuesday, December 13th, 2016

"Dysphoria" is a feeling of dissatisfaction, anxiety, and restlessness. With gender dysphoria, the discomfort with your male or female body can be so intense that it can interfere with the way you function in normal life, for instance at school or work or during social activities. Gender dysphoria is a condition where a person experiences discomfort or distress because there's a mismatch between their biological sex and gender identity. It's sometimes known as gender identity disorder (GID), gender incongruence or transgenderism.

Gender dysphoria is not homosexuality.

The first signs of gender dysphoria can appear at a very young age. For example, a child may refuse to wear typical boys' or girls' clothes, or dislike taking part in typical boys' or girls' games and activities.

In most cases, this type of behavior is just a normal part of growing up and will pass in time, but for those with gender dysphoria it continues through childhood and into adulthood.

Adults with gender dysphoria can feel trapped inside a body that doesn't match their gender identity.

They may feel so unhappy about conforming to societal expectations that they live according to their anatomical sex, rather than the gender they feel themselves to be.

They may also have a strong desire to change or get rid of physical signs of their biological sex, such as facial hair or breasts.

Gender development is complex and there are many possible variations that cause a mismatch between a person’s biological sex and their gender identity, making the exact cause of gender dysphoria unclear.

Occasionally, the hormones that trigger the development of biological sex may not work properly on the brain, reproductive organs and genitals, causing differences between them. This may be caused by:

  • additional hormones in the mother’s system – possibly as a result of taking medication 
  • the foetus’ insensitivity to the hormones, known as androgen insensitivity syndrome (AIS) – when this happens, gender dysphoria may be caused by hormones not working properly in the womb

Gender dysphoria may also be the result of other rare conditions, such as:

  • congenital adrenal hyperplasia (CAH) – where a high level of male hormones are produced in a female foetus. This causes the genitals to become more male in appearance and, in some cases, the baby may be thought to be biologically male when she is born. 
  • intersex conditions – which cause babies to be born with the genitalia of both sexes (or ambiguous genitalia). Parents are recommended to wait until the child can choose their own gender identity before any surgery is carried out.

A survey of 10,000 people undertaken in 2012 by the Equality and Human Rights Commission found that 1% of the population surveyed was gender variant, to some extent.

Treatment for gender dysphoria aims to help reduce or remove the distressing feelings of a mismatch between biological sex and gender identity.

This can mean different things for different people. For some people, it can mean dressing and living as their preferred gender.

For others, it can mean taking hormones or also having surgery to change their physical appearance. Many trans people have treatment to change their body permanently, so they're more consistent with their gender identity, and the vast majority are satisfied with the eventual results.

The assessment by a specialist   will determine whether someone has gender dysphoria and what the needs are, which could include:

  • Whether there's a clear mismatch between  biological sex and gender identity 
  • Whether there is a strong desire to change physical characteristics as a result of any mismatch 
  • Coping with any difficulties of a possible mismatch 
  • New behaviours have developed over time

The assessment may also involve a more detailed assessment of your physical and psychological health before treatment is undertaken.

Dr. Monikaa Chawla

Reproductive Endocrinologist & Fertility Specialist