Gender dysphoria is discomfort or distress stemming from the incompatibility of one’s gender identity with their assigned sex at birth או מיחס מצד החברה שאינו תואם את התפישה המגדרית העצמית.

Dysphoria can have various forms, however the most common of them are physical dysphoria – discomfort regarding the body itself or sexual aspects of the body; and social dysphoria – discomfort with name, pronouns, clothing, or societal expectations related to the assigned sex at birth.

The opposite of gender dysphoria is gender euphoria – a feeling of joy stemming from the alignment of one’s gender identity and their body and/or societal expectations of them.

Everyone experiences gender dysphoria differently. Not all people on the trans spectrum experience gender dysphoria and some cisgender people experience gender dysphoria and euphoria at times, but that does not make them transgender.

Types of Gender Dysphoria

Physical Dysphoria

Discomfort regarding the body’s shape and physical attributes, such as:

• External sex organs (penis, testicles, vulva) and internal sex organs (ovaries, uterus, etc.)
• Fat distribution
• Muscle mass
• Height, hand and foot size
• Voice
• Facial hair and body hair
• Chest size
• Skin texture
• Facial structure

Social Dysphoria

Dysphoria regarding how gender is perceived by society. Some examples are how people perceive you, the gender roles society assigns to you (such as “mother”, “father”, “wife”, “husband”, etc.), how people address you, and how you are expected to address people in return. As part of this, dysphoria can also be related to one’s name and pronouns.

Social dysphoria can lead to a feeling of social isolation and trouble making friends. People on the trans spectrum can feel more comfortable interacting with people of the opposite sex to the sex assigned at birth.

Additionally, people on the trans spectrum may feel more comfortable when they are “excluded” from the group of their assigned sex at birth; for example, if a girl is laughed at for being “masculine” or a boy is laughed at for being “feminine”, it may not actually be insulting to them (אך לא ניתן להניח איך ירגיש בן אדם ואין להתייחס לאדם במגדר שונה ללא רשותו). Non-binary people may prefer their gender to be unclear rather than being assigned to one of the binary genders.

Sexual Dysphoria

Dysphoria related to sexual roles society assigns to certain genders, that people are exposed to through social norms and media representation (such as males on top and females on the bottom during sex). Trans people can feel dysphoria regarding the role expected of them (directly or indirectly, outwardly or inwardly), as well as euphoria when they experiment with other roles.

Presentational Dysphoria

Dysphoria related to the presentation of oneself to society. Presentation does not indicate someone’s gender, but the way we are perceived by others can lead them to conclude what our gender is.
Clothing, hair, jewelry, makeup, glasses, piercings, tattoos, and even personal hygiene such as shaving body hair or skin care can be presentational characteristics that affect how others infer gender according to social norms. Presentational dysphoria exists when one feels uncomfortable with the way they present themselves, and by extension their gender, to society.

Existential Dysphoria

Dysphoria related to life experiences that you have been through or experiences missed out on by growing up as the wrong gender.

Things such as ceremonies, memories, trips, friendships, pictures, relationships, after-school activities, or any other life experiences that you might have experienced if only you had not been designated the wrong gender. These can all cause grief and despair.
Existential dysphoria can also be related to biological dysphoria, such as despair about not having given birth or breastfed.

Biochemical Dysphoria

Dysphoria related to the brain’s structure and bodily hormones.
Biochemical dysphoria stems from the brain expecting to receive one type of sex hormone, while in practice the body excretes another type. Sex hormones that are “incompatible” with one’s gender can lead to brain fog, decreased cognitive function, and general anxiety and unrest. Additionally, in some cases, this can lead to an experience of depersonalization and derealization (DPDR).

Depersonalization is an experience of dissociation from the body or disbelief that the reflection in the mirror is you.
Derealization is an experience of dissociation from the world around you, a feeling that everything is fake.

What Does Dysphoria Feel Like?

Gender dysphoria feels different for everyone.
Some experience no gender dysphoria, while others experience dysphoria so severe that it interferes with their ability to function properly.

Gender dysphoria feels different for everyone.
Some experience no gender dysphoria, while others experience dysphoria so severe that it interferes with their ability to function properly.

Gender dysphoria can be understood through the opposite sensation – gender euphoria. A metaphor for euphoria could be, for example, life in a cave lit by candles, without sunlight. When the cave is suddenly opened to the outside, the initial encounter with sunlight is blinding and can be scary. Slowly your eyes adjust to the new light, and it becomes possible to look outside and see a different life, a world full of new shapes and colors. Sometimes this new world is scary, and at the beginning, it can be easier to return to the familiar comfort of the cave. But the opening remains there, and sunlight penetrates the darkness. With time, the light may draw you out further and further until it becomes hard to return to life in the cave. Sometimes you might return for the others living in the cave, but life outside feels more real, and life in the cave feels wrong and it is painful to return.
Gender euphoria can feel like small flashes of light that may be hard to deal with at the beginning, but with time it feels better to remain in the light, and the darkness that feels wrong is the feeling of dysphoria. Many people on the trans spectrum are unaware of the pain they are experiencing until they find the “flashes of light” of the right sensation for them.

The inverse of anything that can cause gender dysphoria can lead to gender euphoria, such as:

• Use of correct pronouns
• Use of correct name
• Wearing clothing that aligns with gender identity
• Hairstyle that aligns with gender identity
• Relevant physical changes
• Reflection in the mirror
• Societal perception that aligns with gender identity
• Sexual relations that align with gender identity and orientation

Coping with Dysphoria Before Coming Out

Sometimes, gender dysphoria is coped with subconsciously, and various steps can be taken to relieve it even before it is recognized as such.

Coping with gender dysphoria before coming out can look like:

• A preference to play as characters of the correct gender in video games and roleplaying
• A preference to consume media with characters of the correct gender, or with characters that break societal gender norms (Mulan, Little Women)
• Costumes or clothing that align with the correct gender, or drag performance
• Finding excuses to lengthen or shorten the hair
• Shaving body hair, or unwillingness to shave body hair, against societal expectations
• Wearing loose clothing that obscures body shape
• Avoiding social settings when possible, a preference to stay alone
• Curiosity about subjects related to gender, such as men’s or women’s clothing design
• Obsessive working out, trying to align the body with the gender
• Extreme feminine or masculine presentation, or adopting stereotypical gender roles or very conservative opinions about gender (by trying to conform with society’s expectations, with the claim that if you try hard enough you can make yourself conform)
• Putting large amounts of time into hobbies, work, sleep, or distractions to try and repress the gender dysphoria

Coping with Gender Dysphoria After Coming Out

There are various ways to cope with gender dysphoria. The goal of coping with gender dysphoria is to promote feelings of comfort with one’s gender and to restore normal functioning as much as possible.

Social Aspects

• Trying out names and pronouns in safe environments, or with strangers (such as a café)
• Wearing clothing that aligns with your gender identity, using makeup, changes in facial hair and body hair
• “Coming out” – telling your close environment about your gender identity, using different pronouns, or changing your name
• Surrounding yourself with people who accept your gender identity
• Workouts or exercises that can help align your body with the desired appearance (such as developing muscle or aerobic exercises)
• Sharing about dysphoria with people you trust, or with other trans people
• Changing your name or sex clause on legal documents (national ID card, passport, driver’s license, etc.)
• Using gender-affirming tools, such as binders, tucking, prosthetic breasts, or packers

Medical and Therapeutic Aspects

• Psychotherapy – therapy with a psychologist or psychotherapist who accepts your gender identity, allowing you to explore gender further. Dysphoria is often accompanied by additional mental health challenges, it is important to treat these as well (depression, anxiety, eating disorders, substance abuse, self-harm, personality disorders, and more)
• Hormone replacement therapy (HRT) with estrogen (feminizing hormone), testosterone (masculinizing hormone), or in the case of teens – puberty blockers to delay puberty.
• Gender-affirming surgeries

For Further Reading:

• That’s Gender Dysphoria, FYI