Gender dysphoria 

Introduction 

Transgender: Ruth's story

Ruth was born in a male body but knew from the age of 16 that she wanted to be a woman. Learn about her hormone treatment and surgery, and how she feels now.

Gender terminology

Gender dysphoria is a complex condition that can be difficult to understand. Therefore, it helps to distinguish between the meaning of a number of different gender-related terms:

  • Gender dysphoria is a condition that describes the feeling of being trapped in a body of the wrong sex.
  • Gender identity is the gender that you feel you should be.
  • Transsexual is someone with an extreme and long-term case of gender dysphoria, who seeks to alter their biological sex to match their gender identity.

See Gender dysphoria - definition for more information.

Gender can be defined using very narrow medical terms such as what types of chromosomes you have or what types of genitals you were born with. But many transsexuals (and also many experts in the treatment of gender dysphoria) find this type of narrow definition both unhelpful and offensive.

Their response is that gender is a matter of personal preference. If you regard yourself as a man, or a woman, then you have the right to be treated as one.

Gender dysphoria is a condition where a person feels that they are trapped within a body of the wrong sex. The condition is also sometimes known as:

  • gender identity disorder
  • gender incongruence
  • transgenderism

People who have long-lasting and extreme gender dysphoria are known as transsexuals.

A person with gender dysphoria may:

  • experience anxiety, uncertainty and persistently uncomfortable feelings about the gender that they were born with
  • believe that their gender identity is different from their anatomical sex (for example, a man with gender dysphoria will feel that he is a female even though he was born with a male body)

Early symptoms

The symptoms of gender dysphoria usually begin to appear at a very young age. For example, a child may refuse to wear typical boys' or girls' clothes, or dislike taking part in typical boys' or girls' games and activities.

In most cases, this type of behaviour is just a normal part of growing up, but in cases of gender dysphoria, it persists into later childhood and through to adulthood.

The exact cause of gender dysphoria is unknown. It is currently classed as a psychiatric condition (relating to the mind), but many recent studies have suggested that it is more to do with biological development (relating to the body). Research into what causes gender dysphoria is ongoing.

How common is gender dysphoria?

Gender dysphoria is rare, but the number of people being diagnosed with it is increasing due to growing public awareness about the condition.

However, although awareness has increased over recent years, many people with gender dysphoria still face prejudice and misunderstanding about their condition.
 
In the UK, it is estimated that 1 in 4,000 people is receiving medical help for gender dysphoria. However, there may be many more people with the condition who have yet to seek help. On average, men are diagnosed with gender dysphoria five times more often than women.

Outlook

Treatment for gender dysphoria aims to help people become content with their gender identity. This can mean different things for different people. For example, for some people it can mean dressing and living as their preferred gender. For others it can mean taking hormones that change their physical appearance. Most transsexuals seek to have surgery to permanently alter their biological sex.

In 2004, the Gender Recognition Act was passed. It states that transsexuals and people with gender dysphoria can:

  • marry in their preferred gender
  • obtain legal documentation stating their preferred gender, including a new birth certificate and passport

Last reviewed: 28/04/2010

Next review due: 28/04/2012

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13 Comments

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Comments are personal views. Any information they give has not been checked and may not be accurate.

mollymay1984 said on 11 January 2012

I must say my doctor was and is very understanding and helpful i wish all of you could have had him i am so sorry for all your upset and anguish he has helped me deal with alot of things that i didnt even know were going to be an issue for me the NHS are fantastic

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bambi43 said on 10 January 2012

I have found out my dad wants to be a woman since last april, i was so angry and tearful, i just want to know on here is there a site or counselling service for people like myself and the families effect by it, at the moment i cant accept it.

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Freeatlast said on 26 December 2011

I am amazed that the NHS can culturally and objectively get away with the way it treats (or does not treat) transsexuals.
Two years ago, in desperation, having read much on the internet, I plucked up courage and went to see my to my GP in Kent. She did not know how to deal with me and focused our discussion entirely on the potenntial effects on my wife. She told me to think about it some more. I told my wife. She was amazingly very sympathetic and very sorry for me having had to live life since early childhood with dysphoria. Over the last two year she has been very supportive as has our family. I decided to go privately as it was my only real choice. At 63 I could not risk delaying any surgery (and the constructive 5-year delaying tactics of the NHS) in case my health deteriorated. In the meantime I had facial feminisation and gender reassignment surgery at a total cost of £40,000. Having completed all my surgeries over 2 years, I approached my new GP on the Wirral, and asked for the NHS to provide me with maintenance hormones. She said that the local PCT did not treat transsexual people and I would have to pay for my hormones for the rest of my life. I challenged this with the PCT who agreed eventually to prescribe. What and absolute disgraceful performance of the NHS despite national and inernational legislation and numerous guidance documents. It is about time individuals in the NHS are made answerable for what is constructive ignorance (to save costs) or worse, bigotry.

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deenw said on 24 December 2011

It helps to read some of these stories. Mine is a mess of 5 years fighting with the NHS. Although they diagnose me as TG and do require hormone therapy. They insist that I jump through the hoops of changing my name 'to a more female appropriate name - Dee isnt good enough'. What they fail to understand is that some of us have an emergent approach to becoming well. To force people down a road a deny treatment is, well, more than heart breaking. When yet the guidance in the wpath document is totally different to the way the nhs run things with almost a comply or die attitude. Now self medicating on 1mg to take the edge off whilst I put my life back together. Patient centred care - I dont think so.

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Rebecca1991 said on 16 November 2011

I'm transgender Myself at the age of 19 yet i must say regarding my GP's it doesnt go well i have been living in my correct gender for roghly about a year now, well i went to my gp's back in the start of Feb an first of all my gp didnt have a clue what to sugest she looked rather bewildered as of what to do so she said leave it with me so for a good month it had taken her to find out what she needed to do so she applied for funding via the primary care trust which i was fully clued up on everything before i went to my gp's regarding the process an what is required so i had to wait 3 months for the primary care trust meeting regarding funding to be told that it was inconclusive as i hadnt been to see the physiatrist to show that i am medically sane to go ahead with this i then got refered to the wrong person an had to wait for yet another appointment then i was sent to the correct person who has assesed me as fine to go ahead with this they had written a report my gp who then sent this infomation to another board meeting an luckly i was told i have been awarded the funding then from september to november i had been waiting more or less 2-3 months while nothing was happening as the gp said referal had been made an to just wait for a letter to turn up my gp then relised the pct do not make automatic referals finally now refered to Leeds (GIC) apparently although they still havent received my referal! so i went to my gp to ask about getting hormones as this is Who i am an what i really want, to be told they cannot give hormones until see (GIC) although i'm sure this is incorrect? leeds are fully booked for rest of this year an possibly all next year according to what infomation leeds have given me yet my gp wont send me privately as they said it would cost more than my allicated allowance an the pct wont offer more funding due to waiting time so i'm more or less expected to go on waiting two years without any hormones or anything! :(

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jaz39 said on 11 October 2011

lets look at a child of 5 years old,what kind of a child is she or he?how do they perform?does any one know?yes we all know,we were once that age,i remember me being that age,i was happy playing with boys toys,i was happy acting as a boy,but when your child reaches such age,can you see in her or his mind to say that they are not older enough yet to decide?all my life i have worn mens clothes,for my reason are mine,if you have two woman,1 in mens clothes and the other in ladys garments,you can either see that she wont perform a male in bed,but the other might,well since i came out in my teens,i wanted to make love to a woman just as much as a man does,it connects with the way my mind has grown,how i want to be,some years ago i put my insides to the test,i put on ladys trousers,blouse,boots,jacket,walked out of my house,down the road,as i was walking down the road,i was sweating uncontrollaby,i wanted to rip the clothes of me,but i tried,i was still wanting to,why am i doing this to myself,when i was at local supermarket,i could not believe the anxsiety attack i was having,i needed to get home,i felt like a child that had no rights but to perform in that manner,ever since i have brought more mens garments,under wear,to wake up put them on,im living the truth of how my body was telling me back then,something is now,resting inside of me,relaxed,and comfortable,dont do that to me again it said,i said dont worry i wont,and i havent,but other people are really trying to put me back there because they dont want me the way i need to be,that way is me to be a man,i got away with everything to do with feminine garments,now my wardrobe is all male,my home is a bachelor pad,nothing feminine,So if any one out there feels like this,dont give up,

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Sophie8640 said on 23 September 2011

I went to my GP, and he referred me on to a psychologist.
The psychologist was 10 minutes later starting the first appointment and rushed thorough a load of questions and the second appointment lasted 10 minutes and all he gave me was the web address for a cross dressers site and told me that they would be a help! Completely clueless!

Like Sarah1944 i have looked into self medicating but the side effects scare me, with that said I feel i need to do something. Being over 40, when i was first trying to deal with my GD any male who wore a dress was gay, a freak or a joke and anyone who felt trapped in the wrong body was electrocuted as a cure! So i tried to bury the real me and now I'm suffering from that decision. It's good to hear people like Ruth and Terry don't suffer from their GD the way i do :)

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sarah1944 said on 05 September 2011

I found this article very interesting. It was unfortunate that whilst it gave good information for young and mid aged people it made no reference to older people with GD.
I am 66 and after gender counselling and psychiatriac assessment I have been been diagnosed with GD.
I am realistic enough to realise I probably cannot undergo SRS.
My GP has my Counsellors letter and my Psychiatrists report and is to refer me to a GIC.
Until about Aprl this year and for 20 months I was taking herbs to feminise myself. I found these to affect me in a most postiive way with some slight physical changes but particularly some real psychological inprovements. I became far more relaxed and contented with myself. My anger and angst were deminished and I became a happier and more contented person.
Part of the article referred to hormones being a medication that could be taken as a way of achieving people desires to become closer to the gender they associate with without full SRS and to lead a more fulfilling and contented life.
My GP won't prescribe me hormones. I am prepared to self administer them bought off the internet and all I ask is that the NHS (my GP) should monitor my health and send off blood for testing etc.
After all, if I was depressed she would certainly prescribe me a pick me up to enhance my life so what is the difference in prescribing me hormones.
I hope someone will comment on my message and perhaps offer advice on what perhaps I can do.
Thanks for reading this.
Sarah

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terry slatcher said on 27 July 2011

My life's going great! Nice job (part time) people treat me cool.

I'll like have a month of bliss then a couple of days of hell. How do people know it's time to hate on me.?!

Dr F was nice today. Strong letter of recommendation with fast request for funding of my treatment.

She saw into my heart the subtext on WHY, the impression I got. So lovely, later on seems cereal.

Complete empathy

Since i got assertive my life's gotten better. I'm happy with my body and the emerging me.

And something good is that when I'm walking through town I'm totally different.

She was just fab I can't get over her.

I've had mental illness which I'm now over

My thing is unusual I don't cross dress although I like to. Does it make sense? I know what I mean.

Throw in a bit of negativity for good measure. People DO suck. Lower the bar (of morality).

And also my Doctor is cool too, Dr B.

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vj767 said on 25 February 2011

Today I went to GP/Doctor. After seeing the GP I asked I need help on gender issue and told themthat, from many years I’m going though gender dysporia and need help and a letter to see a psychiatric assessment... By looking at doctor they looked and was completely clueless, I think they had no experience on gender issues... they said there is no help at all. NHS can’t help or do any think. Then kept asking me question how I got trapped in man’s body and Doctor told me you can’t change your body, I never come across anything like this before. After few minutes they got up and went to see the senior nurse to ask them why they sent me to see them. Doctor came back and said ok; I will write to special psychologist to deals with your issue and the nurse will contact you in few days...
I’m a bit confused with the whole thing anyone has any idea... Please tell me

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Pauline1954 said on 08 October 2010

Transphobic attitudes will always hamper our lives and as such we should get as close to how our gender dictates us to be both with the help that the NHS can provide and by our own means with make up, feminine postureand voice therapy voice . The list is endless. There are varying degrees of what is required by each individual depending on many factors. Myself I do not want the full operation and will take all other means to get to my much needed position although this view can change as I transition. This is a personal choice and not made by many of us and will mean that I will have to try that bit more.
One interesting point was that whilst getting my log in to write this the NHS website asked for my gender....male or female.....sorry im transgendered.
So even the more well educated people on the subject can accidently miss out such an important choice.
Remember we only want to be ourselves.

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ohmygoodness! said on 21 June 2009

Emma_stbg – what on earth are you talking about? How much alleged copy & pasting of gender philosophy textbooks can one do without actually making any sense? Do you really think that “these people” as you patronisingly refer to, would under go such extreme and irreversible gender reassignment procedures to place themselves in an arguably more vulnerable position just to assuage social opinion or perceive social perceptions? By your argument, if society frowned upon people with two arms, would the others cut off one arm just to feel accepted?
Are you aware of the latest medical research which has found a common genetic denominator in sufferers of gender dysphoria? If this condition were publicised as genetic, would you then group in all other sufferers of genetic conditions with the same cut & paste attitude?
Transgender people align their bodies with their brains/gender identity. They honour their true gender whatever their sexual orientation may be. Gender identity and sexual orientation are two distinct concepts and have nothing to do with eachother. Given the amount of psychiatric assessment which “these people” undergo before they are even allowed to commence re-assignment procedures, it would be a slur on the medical profession to suggest that they would be allowed to go through with the procedures for the wrong reasons.
If you’re in the wrong room, you get out. Nobody blames you or says you’re doing it to please all the people in the other room. I think transgender people are the brave few who are actually true to themselves, whereas a lot of non-transgender people rarely are or even know themselves at all, and are the first to suffer society’s dictum of what is socially acceptable. Or are women who have boob-jobs discriminating against their own gender too? Come on!

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Kimberley Whittaker said on 20 June 2009

Nomatter how much you get rid of any transphobic attitudes there will still be the need for trans people to change their phydical appearance.

Emma stbg just does not understand, We are born in the wrong bodies and it's the body that needs rectifying to correct this defect.

It really is that simple, even in an ideal world we will still need to correct what we see as a physical deformity.

Does this Emma stbg also believe that if you remove homophobia that people will no longer need to be be homosexual or lesbian ?

surely not !

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