Gender dysphoria

The NHS (National Health Service) explains gender dysphoria in this article. September 2020.

Gender dysphoria is a term that describes a sense of unease that a person may have because of a mismatch between their biological sex and their gender identity.

This sense of unease or dissatisfaction may be so intense it can lead to depression and anxiety and have a harmful impact on daily life.

What is gender identity?

Gender identity refers to our sense of who we are and how we see and describe ourselves.

Most people identify as “male” or “female”. These are sometimes called “binary” identities.

But some people feel their gender identity is different from their biological sex.

For example, some people may have male genitals and facial hair but do not identify as a male or feel masculine.

Some may have female genitals and breasts but do not identify as a female or feel feminine.

Some people do not define themselves as having a “binary” identity. For them the concept of gender is not relevant to their identity.

They may use different terms, such as agender, gender diverse, gender non-conforming, to describe their identity. However, as a group, they are often called “non-binary”.

Gender dysphoria and gender identity

Many people with gender dysphoria have a strong, lasting desire to live a life that “matches” or expresses their gender identity. They do this by changing the way they look and behave.

Some people with gender dysphoria, but not all, may want to use hormones and sometimes surgery to express their gender identity.

Gender dysphoria is not a mental illness, but some people may develop mental health problems because of gender dysphoria.

Signs of gender dysphoria

People with gender dysphoria may have changed their appearance, their behaviour or their interests.

They may also show signs of discomfort or distress, including:

  • low self-esteem
  • becoming withdrawn or socially isolated
  • depression or anxiety
  • taking unnecessary risks
  • neglecting themselves

Read more about the signs of gender dysphoria.

Children and gender identity

Children may show an interest in clothes or toys that society tells us are more often associated with the opposite gender. They may be unhappy with their physical sex characteristics.

However, this type of behaviour is reasonably common in childhood and is part of growing up. It does not mean that all children behaving this way have gender dysphoria or other gender identity issues.

A small number of children may feel lasting and severe distress, which gets worse as they get older. This often happens around puberty, when young people might feel that their physical appearance does not match their gender identity.

This feeling can continue into adulthood with some people having a strong desire to change parts of their physical appearance, such as facial hair or breasts.

Find out more information if you think your child might have gender dysphoria.

What causes gender dysphoria?

The exact cause of gender dysphoria is unclear.

Gender development is complex and there are still things that are not known or fully understood.

Gender dysphoria is not related to sexual orientation. People with gender dysphoria may identify as straight, gay, lesbian or bisexual.

How common is gender dysphoria?

No one really knows because not all people who have a sense of unease about their identity, or already identify as gender diverse, need or ask for support from the NHS.

The number of people being referred and diagnosed with the condition has increased a lot over the last decade. In 2018/19 around 8,000 people were referred to adult gender dysphoria services in England.

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