6 Ways to Deal With Gender Dysphoria—From a Therapist Who Can RelateIt doesn’t always feel like being “trapped in the wrong body.”
When I was a kid, I would rip bows out of my hair and throw them across the room, and I would panic if I had to wear a dress. Everyone told me that made me a tomboy, so I believed them. I mean, What else would I be?, I remember thinking.
It was middle school when I started to become incredibly uncomfortable with questions from my friends and classmates about why I wouldn’t wear “girl jeans” and why I didn’t want to carry a purse. Apparently, I was supposed to shave my legs. And, apparently, getting my period for the first time was supposed to feel like I was “becoming a woman”...and not like my life was ending. As I got older, everything always felt wrong in a way I didn’t know how to describe.
I didn’t know there was a thing called “gender dysphoria” at that point, and it wasn’t until college that I saw the phrase online for the first time. But even then, I didn’t think what I was experiencing counted as dysphoria. Those articles always defined dysphoria as being “trapped in the wrong body” or like you were born the wrong gender, which didn’t fully align with how I felt. For some people, that is what it feels like, but that’s not all it can feel like.
What is gender dysphoria?
Gender dysphoria refers to the experience in which your gender expression doesn't match the gender you were assigned at birth and is often experienced by transgender and nonbinary people (or people who don’t identify with the two options of man or woman).
As of 2013, it’s appeared as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), replacing an old diagnosis called gender identity disorder. According to the latest edition of the DSM, the criteria for a gender dysphoria diagnosis (which some therapists believe is imperfect) includes experiencing at least two of the following symptoms consistently for at least six months:
- A significant difference between your gender expression/experience and your biological sex
- A strong desire to not have the primary and/or secondary sex characteristics of the gender you were assigned at birth
- A strong desire to be a different gender
- A strong desire to be treated as that other gender
- A strong belief that you have feelings and reactions that are stereotypically associated with another gender
FWIW there is a separate (again, imperfect) criteria for diagnosing gender dysphoria in children, since this can be felt at any age. That said, even if your symptoms don’t quite align with what the DSM-5-TR lays out, and even if they don’t lead to severe distress or impairment in your daily life (which is also listed in the diagnostic criteria), you can still label that sense of unease about your gender identity as gender dysphoria. Just like you don’t need to be diagnosed with an anxiety disorder to feel anxious, you don’t need a gender dysphoria diagnosis to feel dysphoric.
What are the symptoms of gender dysphoria?
Gender dysphoria symptoms generally fall into two buckets: social dysphoria and physical dysphoria. The first time I started to notice that my depressed mood and distress was about gender at all was in college when people would include me in the category of “ladies,” which I now know is a form of social dysphoria. Physical dysphoria can be discomfort or unhappiness with physical characteristics, like facial hair, breasts, height, and even hand size. It took years for me to notice the physical dysphoria I was also experiencing.
The intensity of gender dysphoria can also vary a lot. Some people experience it as a very mild feeling, like preferring to dress in more masculine or feminine clothing. On the other end of the spectrum, some can feel overwhelmed and debilitated by this experience. For example, if someone feels insecure that their voice doesn’t match their identity, they could get anxious when talking or even decide not to go for a cool promotion at work that requires public speaking. And because of how varied and unique the experience can be, it’s sometimes hard for people dealing with these symptoms to identify that they’re struggling with gender dysphoria.
Here’s how to manage your gender dysphoria.
Whether you have a diagnosis or not, figuring out what’ll make you feel at home in your body takes time and work. So, if you need a little assist on that journey, here are a few things that’ve helped my clients.
1. Acknowledge and honor what you’re feeling.
Gender dysphoria can go away, but it almost never fades when you ignore it. I often tell my clients who might be struggling with dysphoria that finding clothes and hairstyles that feel aligned with your sense of self, using different pronouns, changing your name, or undergoing a medical transition like taking hormones or having surgery can really help ease those dysphoric symptoms. It’s not required that you do any or all of these things, but you’ve got to address the discomfort you’re feeling.
2. Remember what you do like about your body.
When you’re in a dysphoric spiral, it can be very difficult to focus on the good things you’ve got going on, but focusing on something you’re proud of can help you avoid getting too overwhelmed by what feels wrong or off. Take some time to identify parts of you that you appreciate—even if it’s small. Do you like your eyebrows? Your tattoos? The great hugs you give? Your dancing skills? How your hands look with nail polish? Your singing voice? How your hair does that cool swoopy thing?
3. Set up a buddy system that works for you.
Intimacy can be a double-edged sword: We want connection and the comfort it brings, but that can also leave us feeling exposed and vulnerable. Even if you’re not ready to share any of your thoughts or feelings with everyone, you’ll need support as you figure out how to become your true self. Find someone you feel comfortable talking about this with and let them be there for you.
That can be asking your long-distance friend to refer to you online by some of the new names you’ve been considering so you can figure out which name you like best in real life. It could be asking your cousin to correct people when they misgender you out in public. It could be asking a classmate to accompany you to the restroom that feels most comfortable for you. By letting them know what’s most helpful for you in advance, it takes some of the burden off you. Your friends want to support you! (If they don’t then they aren’t really your friends.)
4. Think about your boundaries and triggers, then communicate them.
Sometimes the words or actions of the people we are closest to can make our dysphoria worse. In order to avoid this as much as possible, it’s important to pay attention to the types of things that trigger your dysphoria. Think about if there is a specific word or a category of words that make you uncomfortable. Are there specific experiences or types of physical intimacy that feel overwhelming or gender role expectations that come up in your relationships that feel distressing to you?
Once you have that information, you can start to communicate it to your loved ones and decide what to do next. Sometimes the solution is avoiding the words or actions entirely, but they may just need to be adjusted slightly so that everyone involved feels safe, comfortable, and respected. So if your work bestie keeps saying “Girl, listen…” every time they come to you with office gossip, try telling them, “I don’t like how it makes me feel when you use gendered words like that. Could you try not to say that ‘girl’ part going forward and just use my name instead? Also, please keep sharing all these juicy updates with me!”
5. Go easy on yourself when you need a break.
OK, I know I said you need to face your dysphoria, but if you’re in the process of addressing it and having a dumpster fire of a day, there’s nothing wrong with playing a video game and hiding under the covers. We can’t do emotional heavy lifting all the time, so give yourself a break when things get overwhelming. Progress can be slow, and even when you are working through your dysphoria, there will be many times when you are forced to wait to feel like your true self. That’s especially true if you’re planning on going through a medical transition but can’t get an appointment for a while.
Some days it might be especially hard to look in the mirror or be out in public, and when that happens, take care of yourself the same way you would if you were sick. Let yourself rest, hydrate, eat some nutritious food, and do a low-energy hobby you enjoy, like watching a movie or crafting.
6. Get connected with people who understand.
Having a community is the #1 most important thing when it comes to protecting your mental health (particularly in this time of so much political turmoil). And that doesn’t just mean using the buddy system. As you work through gender dysphoria, make sure you’re talking to people experiencing the same things as you. Trust me, you’ll appreciate those who really understand what you are going through and people you don’t have to educate all the time.
Your community will become the people who celebrate your wins with you, they will be there for you if you have a tough conversation with your family, they will be the people who help you crowd-fund if you need financial support, and they may even be the people who give you a couch to crash on if you need it. Your community can easily become your chosen family.
If it’s possible to find your community and safe spaces in person, then that’s great (and you have even more buddies who can be a part of your buddy system). But if not, try to find your people online by joining certain platforms (like TrevorSpace, where young LGBTQ+ people can virtually gather) or by following people who are talking about the same things you’re going through and consider starting a convo with them if it feels safe.
The bottom line: Dealing with gender dysphoria is painful and exhausting, but I want you to know that you are not doomed to feel this way forever. You are already doing the work to take care of yourself, and that is a huge step. Take a moment to give yourself credit for that.
If you’re looking for more resources and info on gender dysphoria, consider reaching out to The Trans Lifeline and The Trevor Project. You might also want to check out Am I Trans Enough?: How to Overcome Your Doubts and Find Your Authentic Self (written by yours truly) and How to Understand Your Gender by Alex Iantaffi and Meg-John Barker.
Wondermind does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a replacement for medical advice. Always consult a qualified health or mental health professional with any questions or concerns about your mental health.