Gender Dysphoria

Diagnosis

A diagnosis of gender dysphoria is made when a person experiences significant distress or discomfort because their gender identity differs from the sex assigned at birth. This condition must persist for at least six months and include two or more of the following:

• A difference between gender identity and physical characteristics such as genitals or secondary sex traits like breasts or facial hair.

• A strong desire to be rid of genitals or secondary sex characteristics or to prevent their development.

• A strong desire to have the genitals or secondary sex characteristics of another gender.

• A strong desire to be or to be treated as another gender.

• A strong belief that one has the typical feelings and behaviors of another gender.

Gender dysphoria is also characterized by emotional distress or difficulties functioning in daily life, such as challenges at work, in school, or in social settings.

Treatment

The main goal of treatment for gender dysphoria is to ease distress and support well-being. Treatment options depend on individual goals and may include gender expression changes, medical interventions, and behavioral health therapy.

Changes in gender expression
Gender expression refers to how someone presents their gender to others through appearance and behavior. This can include clothing, hairstyle, mannerisms, communication, and interests. Adjusting gender expression to better match gender identity often helps relieve feelings of dysphoria.

Medical treatment
Medical care for gender dysphoria may include:

• Gender-affirming hormone therapy to align physical traits with gender identity.

• Gender-affirming surgeries, such as chest reconstruction, genital surgery, or facial feminization or masculinization procedures.

Specific treatments depend on personal goals, health conditions, and social or economic factors. Before hormone therapy or surgery, healthcare professionals perform a full medical evaluation, which may include:

• A review of personal and family medical history

• A physical exam

• Laboratory testing

• A review of vaccinations

• Screenings for certain conditions and infections

• An assessment of lifestyle factors such as smoking, alcohol use, or drug use

• Fertility counseling and options for fertility preservation

A behavioral health evaluation may also be recommended to explore:

• Gender health goals and expectations

• Mental and emotional well-being

• Sexual health and relationships

• Effects of gender dysphoria at work, home, and in social life

• Substance use or unsupervised hormone use

• Available social and family support

Behavioral health therapy
Behavioral health therapy aims to improve mental health and quality of life. It is not designed to change gender identity but rather to help people explore their gender experience and develop coping strategies.

Therapy may help individuals:

• Manage the stress of prejudice or discrimination (gender minority stress)

• Build emotional and social support systems

• Create a plan for coming out to family, friends, or colleagues

• Feel comfortable expressing gender identity

• Explore healthy sexuality

• Make informed decisions about medical treatments

Counseling may include individual, couples, family, or group therapy depending on a person’s needs.

Other supportive steps
Additional ways to reduce gender dysphoria and support gender affirmation may include:

• Using affirming names and pronouns

• Voice and communication therapy

• Hair removal, hair transplants, or other aesthetic procedures

• Chest binding, breast padding, genital tucking, or packing

• Legal services for updating names and gender markers

• Guidance on clothing, makeup, and personal appearance

• Community and social support services for issues related to work, family, or parenting

Working closely with an experienced healthcare professional can help create a treatment plan that supports both physical and emotional well-being while affirming gender identity.