Many of us have felt uncomfortable with some aspect of our bodies at one point or another. And for some, that discomfort may have even turned into a certain level of distress.
But gender dysphoria is something more. It goes beyond feeling upset with or not liking something about your body.
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Here's what gender dysphoria is, what it feels like and how to cope with it.
What Is Gender Dysphoria?
Gender dysphoria is when someone experiences psychological distress because of a disconnect between the sex one was assigned at birth and their gender identity, according to the American Psychiatric Association.
However, this definition leaves out a lot of the nuances that can come with gender dysphoria.
"Not all transgender or nonbinary people have gender dysphoria, nor are all people with gender dysphoria transgender or nonbinary," says Cadyn Cathers, PsyD, a transgender man and psychologist who specializes in working with transgender communities. "It can be any gap within any layer of identity within the realms of sex or gender."
In other words, gender dysphoria can happen when a person's internal sense of gender and their socially designated gender aren't aligned, Cathers says. It can also apply to a mismatch between gender identity and gender expression, or gender identity and how one relates to others in terms of their relational gender.
Dysphoria can cause the following, Cathers says:
- Excessive exercise
- Feeling shame about one's body
- Low distress tolerance
- Low self-esteem
- Overeating or binging
- Restricting eating
- Sleeping too much
- Social isolation
- Substance use
- Thoughts of suicide
- Various forms of numbing
"Gender dysphoria can range from mildly disruptive social anxiety to a debilitating sense of hopelessness," says Tammy Plunkett, author of the book Beyond Pronouns: The Essential Guide for Parents of Trans Children.
When someone feels gender dysphoria, she says, they might avoid public places for fear of having to use a gendered bathroom, or they may fast or dehydrate themselves when they do have to be out. They may also avoid showering because they don't want to see or touch their body when it doesn't align with their internal gender.
What Gender Dysphoria Can Feel Like
Gender dysphoria varies depending on each individual. Some only experience it to a small degree, while others feel it so strongly that the condition is debilitating for them.
"Gender dysphoria can show up as no longer wanting to participate in their usual hobbies and activities, missing school and affecting their grades, and in some cases, a serious mental health crisis," Plunkett says.
"Children will typically insist they are a different gender from what was assigned to them at birth and choose different clothing, toys and activities. Teens will also choose to express their gender differently and might have anxiety around puberty and secondary sex characteristics that don't match their gender identity," she adds. "Underneath these behaviors is an undercurrent of discomfort and distress."
Jenn Kennedy, PhD, LMFT, a queer therapist who specializes in offering treatment for couples, sex, addiction and LGBTQ+ concerns at Riviera Therapy in Santa Barbara, California, says gender dysphoria can present in myriad ways.
"For some folks, it looks like 'not passing' in the world for their true gender," she says. They may feel self-conscious when they're misgendered in small ways (say, when the barista at Starbucks uses the wrong pronouns) and in larger moments (at family gatherings, for example).
"For others, it is about the discomfort they feel in their own body," Kennedy says. "They don't even want to see themselves naked because their body does not match how they see themselves. This affects how they dress, how visible they are in the world and often how they feel about intimacy with others."
How to Deal With Dysphoria
There are dozens of ways you can choose to deal with gender dysphoria. Depending on exactly how your dysphoria manifests, some methods may be more effective than others. Don't hesitate to try a few techniques and see what works best for you.
"Coping mechanisms can range from grounding techniques, deep breathing, meditation, connecting with friends and other support systems, social transition and medical transition," Cathers says.
"It's important to remember that some strategies may not work all the time, even if they did before, so try out different strategies at different times to find what is helpful for that moment," says Jennifer Vincent, LMHC, a therapist and gender specialist at The Brave Life Therapy, who specializes in supporting transgender patients and those who have experienced trauma.
Here are a few specific techniques you can try the next time your gender dysphoria gets to be too much.
1. Seek Gender-Affirming Care
Gender-affirming care is a broad term for a wide array of health care services meant to ease or eliminate feelings of gender dysphoria. It may include mental health help as well as medical interventions like hormone therapy, where a person takes certain prescribed hormones in order to change their physical characteristics to be more in line with their internal gender.
"Treatment is focused on integration of self," Kennedy says. "They must first acknowledge their inner conflict and the negative self-talk. They should present how they feel comfortable and choose their own path of transition, which may include no changes, hormones, social transitions and/or surgery."
2. Talk to a Doctor About Gender-Affirming Surgeries
While it's not right for everyone, "gender-confirming surgery can be a huge relief for some people," Cathers says. "However, it can take a long time due to waitlists of surgeons."
Depending on what state you live in and if you're using insurance, some surgeries can require that you have taken other steps in your transition first. These can include things like going on hormones, seeing a therapist and living publicly as your gender identity for a specific amount of time before you can qualify.
Some transgender and gender non-conforming individuals can feel a sense of ease in preparing for surgery. Others can feel anxious or scared despite wanting to change.
3. Make Use of Mindfulness Tools
Mindfulness tools can help in accepting the situation as it is instead of feeling the need to change or avoid it.
"Increasing one's ability to tolerate distress — any sort of distress — can be helpful," Cathers says. "Often people just want to get rid of anything uncomfortable or painful. However, the reality is that life is often uncomfortable and sometimes even painful. Learning how to tolerate distress without falling apart is an important life skill."
One of the best ways to tolerate distress is by practicing mindfulness. Being mindful in distressing situations can help increase distress tolerance by helping you learn to accept the situation without feeling the need to judge or attach to it, says Jessica Kowalski, a licensed clinical mental health counselor who works with transgender and non-binary clients at Thriveworks in Charlotte, North Carolina.
"One of my favorites is the five senses grounding technique, where you look around you and name five things you can see, four things you can hear, three things you can feel and two things you can smell," Kowalski says. "And then for the last one, I do one thing you like about yourself."
This kind of exercise can help get you "out of your head" and bring you back to the present moment, she notes.
4. Seek Support From People You Trust
One of the best ways to deal with gender dysphoria is to find acceptance and support from people you trust.
"Talk to someone who gets it, or at least someone supportive who validates your gender," says Jo Eckler, PsyD, a psychologist who treats transgender and non-binary clients. "When gender dysphoria hits, it can have us feeling really alone. Connecting with someone else, whether it's for validation or distraction, can counter that lonely feeling."
If you can't find someone in person, consider calling the Trans Lifeline at 877-565-8860. Or consider joining a support group, many of which meet virtually.
"Many local cities have trans or gender-variant support groups," Vincent says. "Or watch a YouTuber who has been through similar experiences."
Kowalski highly recommends virtual support groups, especially if you feel like you can't come out to people around you or leave your house in a ways that feels safe.
"I know some of my clients have even found support groups on Discord," she says. "Having a group of like-minded people and people who get you and understand you, outside of just your therapist, is super important. Because you don't feel so alone."
5. Find Tangible Ways to Affirm Your Identity
There are countless ways you can affirm your identity. Socially transitioning, or living outwardly as your gender identity, is different for everyone. Many people find that changing how they dress or groom themselves helps them more closely feel like they are living in line with their gender identity.
"Do little or big things that affirm your identity," Vincent says. "For you, maybe it's small accessories that are affirmative for you, wearing items that make you feel good or telling supportive people in your life your preferred name and pronouns."
Some people live in unsafe situations where they can't live as themselves. However, even having one person in your life with whom you can safely be yourself can make all the difference.
"If you want to start going by a different name, or want to start using different pronouns, let's do that," Kowalski says. "Even if it's just in this therapy session, we're gonna do that. I had a teenage client, who was not out to their parents. But in our therapy session, we used the name that they wanted to go by, and we had pronouns that they wanted to use."
James T. Prince is a transgender editor and talked to LIVESTRONG.com about one unique way he deals with gender dysphoria.
"Because so much of my work is through email or other forms of written communication, it was really important to me to be perceived as more masculine/neutral than feminine, especially early in my transition," Prince says. "Having a more distinctly masculine voice in writing (using fewer tone indicators and more statement-driven sentences) allowed me to cope with the real-world discrepancy between my internal and perceived gender."
Kowalski helps her patients on an individualized level to find how they can live a gender-congruent life in ways that are currently available to them, whether that be through binding, padding, voice and communication therapy or something else. "I challenge them to think about what that looks like for them."
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