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Gender dysphoria

A person with gender dysphoria feels they belong to the wrong gender. This can cause distress or discomfort. Dysphoria means ‘unhappiness..

While biological or physical gender is determined by having male or female sex organs, gender identity is the sex the person feels they are.

What causes gender dysphoria?

The exact cause of gender dysphoria is not known. However, there are theories that suggest the condition may be caused by genetic (chromosomal) abnormalities, hormone imbalances during foetal and childhood development, or a combination of these factors.

How common is gender dysphoria?

More people than ever are being diagnosed with gender dysphoria due to a growing awareness of the condition.

However, it is rare and complex. It can be evident in early childhood and most people recognise that they have a gender identity problem before they reach adolescence. The condition occurs more often in males than females.

A survey in 2012 by the Equality and Human Rights Commission found that 1% of the population was gender variant to some extent.

What are the symptoms of gender dysphoria?

There are no physical symptoms of gender dysphoria but children often display the following behaviours:

  • A desire to be the opposite sex (including giving themselves an opposite sex name and dressing and behaving as the opposite sex)
  • Belief they will grow up to become the opposite sex
  • Disgust with their own genitals - for example boys may pretend not to have a penis and girls may refuse to sit on the toilet when urinating
  • Withdrawal from social interaction and activity
  • Feelings of isolation, depression and anxiety
  • Feeling extremely distressed by the onset of puberty.

Adults with gender dysphoria often display the following behaviours:

  • A strong desire to live as a person of the opposite sex
  • A strong desire to be rid of their own genitals
  • Dressing and behaving like the opposite sex
  • Withdrawal from social interaction and activity
  • Feelings of isolation, depression and anxiety.

How is gender dysphoria diagnosed?

First stop, as so often is the case, is your GP who can then make a referral to a Gender Identity Clinic.

Gender dysphoria is usually diagnosed by a trained mental health professional such as a psychiatrist or psychologist. A thorough medical history and a psychological examination are carried out to rule out other possible causes for the symptoms, such as depression, anxiety or psychosis. A gender dysphoria diagnosis will confirm the person's continuing and persistent desire to be the opposite sex.

How is gender dysphoria treated?

Individual and family counselling is usually recommended to treat children with gender dysphoria. Counselling focuses on treating the associated problems of depression and anxiety, and on improving self-esteem. Therapy also aims to help the individual function as well as possible within his or her biological gender.

Puberty for children with gender dysphoria can be especially distressing because of the physical changes associated with it. Hormone blockers can be prescribed to put puberty on hold.

Counselling is also recommended for adults, along with involvement in a support group.

Some people with gender dysphoria will be happy with dressing and living as their preferred gender, others will seek hormone or surgical treatments. The surgery (sometimes referred to as a sex change) is called gender reassignment surgery. Because it is major and irreversible, candidates undergo extensive evaluation and a transition period beforehand. This is available for people of 17 years and older.

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