What is gender dysphoria?

It is often associated with transgender people and non-binary folks who may consider a gender transition to alleviate dysphoric feelings. However, cisgender people can also experience dysphoria: Amanda Bynes did, reportedly in her movie She’s The Man, where she was cross-dressing to play a man.

Identifying the ways in which gender dysphoria can appear can be life-saving information. So let’s look at naming those feelings with some terminology:‍

Physical Dysphoria‍

Physical dysphoria is a distress that is linked to outer appearance, like secondary sex characteristics. The societal belief is that biological sex and gender are congruent and live in a male or female binary. But, those biological concepts are complex and nonconformity to that strict binary exists.

This may come across as a form of dissociation: imagining your body not being your own, or seeing someone else looking back in the mirror. In the absence of a physical trait that may affirm gender, it may be a phantom limb feeling (feeling breasts for pre-transition trans woman or male-to-female, or a penis for a pre-transition trans man or female-to-male) and actively imagining/envisioning yourself with that body part. It may be more stark - repulsion or disgust at the sight, touch, mention or function of a body part that you don’t identify with. 

These feelings are generally why someone may choose gender reassignment therapy. Hormone therapy (testosterone or androgen/estrogen) and operations, such as top surgery for trans men, can frequently alleviate the discomfort of physical dysphoria. 

Social Dysphoria‍

Social dysphoria is an incongruence between how other people’s perception of us and our gender identity. It includes everyday interactions with people using names, pronouns and gendered grouping that you don’t identify with, in order to refer to you. This type of dysphoria may begin as simply noticing that being gendered a certain way feels off. It may also change your willingness to create bonds socially with groups of one gender or make you envious of gendered bonds you feel you can’t create - being one of the boys or one of the girls. For non-binary people, it can be an erasure; society has little room for gender diversity or being gender nonconforming unfortunately.

Because social dysphoria can influence physical dysphoria, this may cause someone to want to change their gender expression (hair, clothing, makeup) to more feminine or masculine, in the hopes of altering people’s perception of them. The hormonal changes of transitioning can accentuate this.

On a larger scale, social dysphoria represents ways that not conforming to your gender assigned at birth may change your vision of your gender role in society. There can be longing for a childhood as a gender you couldn’t be, or for experiences you wish you had (Boy Scouts and playing rougher sports for transmasculine people). Or hoping to incarnate a gendered role but feel that isn’t accessible: wanting to be the mother to a child, instead of a father. 

A name change can be a good first step, and even accompany a coming out. Some may also find a medical gender transition helpful. When the second puberty of hormone treatment goes into effect, it can change how others perceive you.

Sexual Dysphoria‍

In more intimate settings, there can be dysphoria as linked with your sexual orientation and sexuality in relationship dynamics. Being trans can impact how you identify to being a lesbian, gay, bisexual or heterosexual person. For instance, a transgender man wanting to be with a man, as a man, in a gay relationship. If this person were still perceived as a woman, their relationship would be considered heterosexual. That can pose an issue when constructing intimacy with others, as well as how you view your sexual orientation. Similarly, it may be difficult to align with pleasure with gender euphoria (the opposite of dysphoria) -- just because sometimes feels good, doesn’t mean it doesn’t cause dysphoria. This is a common issue for sex: a trans woman may enjoy topping with her natal genitalia, and still feel dysphoric that she is physically able to.

This can translate into preoccupations of your partner seeing you and being attracted to you as the gender you identify as. Being particular about sexual acts so they can align with gender. Or, even being disinterested in sex with anybody altogether, because of it.

It’s important to take the time and try to learn your dysphoria and what it’s signaling. It identifies the source of the pain, and help stir towards more self-understanding and potential solutions.