relationship of gender dysphoria with mental illness

Relationship of Gender Dysphoria with Mental Illness

Dysphoria usually refers to a disturbance in mood, accompanied by anxiety, discomfort, and even angry reactions. On the other hand, gender dysphoria is a medical term used to describe the distress of the transgender person, faced with a mismatch between their assigned sex and their gender identity.

What is gender dysphoria?

The term dysphoria, in its original sense, can refer to a mental disorder, characterized by a mood oscillating between sadness and excitement. This state often proves to be lasting.

Gender dysphoria actually describes the distress experienced by a person that is, having the physical attributes of a person, girl but feeling like a boy, or vice versa. 

It means that a person experiences, at all times and often from an early age, very significant discomfort, both physical and mental, concerning their assigned gender. While his body is that of a boy, for example, his head and heart say the opposite. It’s as if his body and his brain are constantly sending him contradictory and difficult to reconcile messages.

Some transgender people remember feeling like they didn’t belong to the “right” gender when they were very young. For others, the process is more confusing, and these people will spend many years figuring out what is wrong before they figure it out and take action.

Some people have described it as the equivalent of “being in a place where you know you really don’t belong, and our only thought is to get out of it as soon as possible. Except there’s nowhere else to go; no door, no exit, no refuge.”

This permanent discomfort not only causes great suffering but can also affect the functioning of the person at all levels: personal, social and professional.

How to recognize gender dysphoria?

The word sex refers to differences biological between males and females; to the visible difference between their genitals and the correlative difference between their procreative functions. Gender is a question of culture: it refers to the social classification into male and female.

Biological sex refers to the reproductive organs, gender identity, the inner feeling of being male or female. It is generally accepted that babies born with the female sex will later see themselves as female and that babies born with the male sex will develop into men, dressing in this way.

But ultimately, sex and gender tend more, more than a clear and frank dichotomy of these two categories, to represent a sort of continuum. The variation in how people position themselves on this continuum depends on factors such as stage of development, past and present environment and lived experience, as well as the nature of relationships to self and others.

Symptoms of gender dysphoria.

Symptoms of gender dysphoria appear at different stages of development but become more severe with the onset of secondary sex characteristics during puberty.

  • A significant difference between their own gender experience and their secondary sex characteristics.
  • A strong desire to get rid of their secondary sex characteristics or prevent their development.
  • A desire for secondary sex characteristics of the opposite gender.
  • Willingness to be treated like the other gender.
  • Strong belief in having feelings and reactions of the opposite gender.

Men are more affected by gender dysphoria than women. It is, therefore, more frequent in heterosexual or bisexual biological men (male to a female) can be preceded by a more or less lasting phase of cross-dressing, gradually evolving towards a desire to get rid of its secondary sexual characteristics and a compelling desire to live fully under a female gender identity.

Gender dysphoria and an increased risk of mental illness.

Mental illness is more common in the transgender population. The prevalence of depression in transgender is double compared to the general population.

The discrepancy that a person perceives between their biological sex and their gender identity often goes along with great distress. Because of their suffering as well as because of their isolation and the gaze of others, people with gender dysphoria are more at risk than the general population of experiencing mental disorders: anxiety, depression, mutilation, psychological distress. 

One-third of transgender youth have attempted suicide. It is therefore essential to support and understand them.

A social rejection, a rejection of the family.

This distress that grips some transgender people have been studied. These researchers seem to show that in reality, the distress encountered by some transgender people is not an inherent characteristic of their identity, but is much more due to the experience of social rejection and violence. The rejection of the family is moreover the most influential factor in this disarray.

Anguish, disgust, even mutilation.

On the other hand, the feelings of these people regarding their own secondary sex characteristics and those of the opposite gender are very marked. For many, the bodily maturation and growth of their discordant sexual aspects is a potent source of anxiety, a cause of disgust, which can even lead to mutilation.


In addition, abuse, harassment, discrimination, isolation, and suicidal ideation are significantly higher in individuals identified as transgender.

Treatment and prevention of gender dysphoria.

Being a person who identifies as transgender is not inherently pathological. Investigations are essential, in particular, to know the patients who would like to benefit from hormonal therapies. 

The attending physician must have a good understanding of gender dysphoria, as they will often be the first point of contact for these patients. More often isolated, they also have higher rates of depression and suicide. The consulting doctor should therefore show them the right path with kindness.

Because taken care of appropriately, the prognosis of gender dysphoria is generally favorable: its treatment allows real improvements. It can include the combination of psychotherapy, management via hormone therapy, and sometimes surgery. These treatments are secure and effective in the long term.

What to do with gender dysphoria?

The key to understanding different people better is always empathy. Those around a child or someone living with gender dysphoria or in transition can choose to be allies, treating these people just like everyone else, simply explaining to the children what is going on in order to de-dramatize the situation, by advocating respect and diversity on a daily basis, etc. 

What people affected by this disorder want is to be able to be themselves; the more experience they have in school, with peers, at work and in the community, the less difficult their journey will be.

As a parent or as a relative of a child who frequently and repeatedly expresses his discomfort with his biological sex, it is crucial not to make him feel that what he is experiencing (and which is anchored deep within him) is shameful! It is best to refer to a doctor as soon as possible to obtain follow-up, support and better see the next steps.

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