Written by Alice Broster
Gender identity is connected with how you experience your gender inside. You might identify as a woman, man, be fluid, or fall somewhere in between.
For some people, their gender identity matches the sex they were assigned at birth but for others, it doesn’t — and that’s completely normal.
While some people sit within the strict classification of man or woman (known as the “gender binary”), others identify as transgender or non-binary. It’s all about how you see yourself and being who you are. And society’s reactions to this can impact how you feel, especially if the sex you were assigned at birth and your gender identity don’t align, triggering gender dysphoria for some.
Imagine, for example, being assigned male at birth but knowing you are a woman. You might feel uneasy, stressed, and anxious about what this means and how you are perceived, especially because society often expects us to conform to stereotypes of what constitutes femininity or masculinity, such as subservience in women and leadership in men. These feelings of unease are what’s known as gender dysphoria.
“Over the last five years, there’s been a massive step forward in trans communities gaining a platform,” Dr. Helen Webberley, a gender dysphoria expert at Gender GP, tells Flo.
“However, that has also led to a lot of political emotion and hatred. Just because someone’s sex that they were assigned at birth doesn’t match their gender doesn’t necessarily have to be distressing. It should just be something that we note and move on from. Dysphoria and deep unhappiness comes from society’s reaction to trans or gender non-conforming identities.”
In fact “gender dysphoria” is a relatively new term in medical texts, first appearing as “transsexualism” in American Psychiatry in 1980, although it may have been used within the community much earlier.
In 1994, in a bid to reduce the stigma attached to the diagnosis, transsexualism was replaced by “gender identity disorder in adults and adolescence.” Then, in 2013, “there was a move away from the diagnosis ‘gender identity disorder,’ which was affirmed not to be a mental illness,” Michael Beattie, a psychologist at Chartered Counselling, explains. “‘Gender identity disorder’ was then replaced by the term ‘gender dysphoria,’ which is no longer recognized as a sexual and gender identity disorder. It’s a diagnostic category that people can work through in order to access health care.”
Often, the way you feel about different aspects of your identity are rooted in what is seen as “normal” or “good.” If you’re told repeatedly growing up that only women have periods; a man and a woman is the ideal relationship foundation; and cervical screening is a women’s health issue, it’s hard to unlearn those teachings.
Words have immeasurable power over the way you perceive yourself — and Dr. Webberley explains that this is where gender dysphoria can take root. “If you look at resources on offer about menopause, it’s all about women,” she says. “The language is explicitly aimed at women, and women do experience menopause, but so do other people, [so] it’s important to start changing the language that we use. All that will do is inform all identities that it’s okay to be trans; it’s okay to be a man who has a cervix or womb; and it’s okay to be a man [or a non-binary person] who gets pregnant.”
Exclusive language that rejects and ignores trans and gender non-conforming identities can have very real health impacts on the communities that are being erased. For example, almost half of 28,000 people questioned by the 2015 US Transgender Survey said they had been verbally harassed in the year prior to the survey taking place. Ten percent had been physically assaulted.
Similarly, the Youth Chances Survey 2014 that looked at the experiences of young trans people in the U.K. found that 83 percent have experienced name-calling or verbal abuse. The LGBT in Britain: Trans report conducted by Stonewall also found that 48 percent of trans people don’t feel comfortable using public toilets through fear of discrimination or harassment and 44 percent avoid certain streets because they don’t feel safe there as an LGBTQ+ person.
Feeling rejection or a lack of safety in medical settings and beyond can increase dysphoria and lead to people feeling further isolated.
“If you’re a man who has a uterus and you’re going through menopause, for example, what message does it give when all it talks about is women? It denies your whole identity,” Dr. Webberley explains. “Are we celebrating that trans identities do exist, and we should validate them as just as ordinary as anyone else? Or are we saying that they should have separate websites and services? This is what leads to minority stress and discrimination.
“When we talk to young people about periods and contraception it’s not going to apply to everyone in the same way based on the sex they were assigned at birth. We need to start getting the language right.”
Understanding gender dysphoria can be extremely difficult if it’s something you’ve never experienced before. However, the NHS explains that there are some key signs to look for.
- A strong desire to hide any tell-tale signs of the sex you were assigned at birth, such as binding your chest
- Sensing or feeling sure that your gender identity and the sex you were assigned at birth are not the same
- Not feeling like yourself when adhering to the gender roles of the sex you were assigned at birth, e.g., being forced to dress a certain way
- A strong dislike for the genitals you were born with
- Becoming withdrawn or socially isolated
- Experiencing anxiety or depression
- Having low self-esteem
Many of these symptoms stem from feeling pressure to present a certain way or like you have to hide who you truly are.
The NHS notes that a diagnosis of gender dysphoria in children is rare. However, if they express that they’re feeling confused or unsettled about their gender identity then you can seek advice from an LGBTQ+-inclusive doctor or therapist.
Some people who experience gender dysphoria may take action to affirm their gender identity. They might do this by dressing in clothes that more closely align with their gender identity; changing their name and pronouns; or seeking medical intervention in their transition.
Shea is a 27-year-old trans man from London. Over the last decade, he has medically transitioned and legally changed his names and pronouns. Shea may have started transitioning in his teens, but he can pinpoint experiencing feelings of gender dysphoria from a young age.
“I remember my aunt asking me to be her bridesmaid. I must have been about 11 years old, and I was sitting in the changing rooms looking at this dress that I just couldn’t put on,” he says. “It highlighted every part of my body that felt so completely alien to me. I couldn’t understand why my parents couldn’t see that I was a boy. It had been obvious to me for as long as I could remember.”
Shea received messages of what a girl should be, at home and at school. “I became dissociative with my own body. I sat through sex education lessons and learned how exciting it is to get your period,” he says. “My mum picked up some tampons covered in pink branding from the women’s health section. It was as if life was happening to me and I was looking in from the ceiling, paralyzed with fear almost constantly.”
Shea explains that the isolation caused by repeated rejections that he is male led to a series of depressive episodes where he started to self-harm. “I’ve spoken to my parents about this time and looking back, none of us had the language to explain what I was experiencing,” he says. “They couldn’t help me, and I was pretty convinced that the only plausible outcome was for me to die.”
Shea was put in contact with a counseling service that eventually introduced him to resources like Mermaids UK, Stonewall, and Gendered Intelligence. The Trevor Project and Trans Equality in the U.S. provide similar support. There’s also a list of other helpful services below.
“Finding out that I’m not alone quite literally saved my life,” Shea says. “Learning how to manage my periods and intimate health as a man has been invaluable and connecting with other people who have felt so dysphoric about their gender too has given me a tool kit and coping mechanisms I never received growing up.”
There are a number of platforms and advocacy groups that share resources, support, and information for people experiencing gender dysphoria and their loved ones. You can find links to them below. We’ve also pulled together a guide to finding an LGBTQ+-inclusive doctor or therapist here.
Dr. Webberley has this helpful advice if someone you know has told you they’re experiencing feelings of gender dysphoria: “Believe them. People don’t make this up. This isn’t a ‘cool’ thing to do. They’ve probably thought about this for years. You just have to support them, help them, and do your best to understand what they’re feeling.”
Please note these resources are just for reference and are in no way associated with Flo
If you’ve been affected by anything in this piece or are struggling with your mental health and would like to speak to someone, Flo has gathered links to support services that might be helpful. Please visit this page for helplines in different countries.