Blog – What Does Gender Dysphoria Look Like?



What is gender dysphoria?

For people with gender dysphoria, there is a significant mismatch between the sex they were assigned at birth and the gender identity they experience.

While not all people with gender dysphoria experience distress, many do. The gap between their experienced and assigned gender can be overwhelming and uncomfortable.

According to Caitlin Lawrence, a psychotherapist at Main Line Health’s Women’s Emotional Wellness Center, gender dysphoria occurs in people of all ages, sometimes as young as toddlers through to the geriatric years. While it may appear that gender dysphoria is more and more common, the medical condition has always existed – the difference is that now more people have the space and security to explore their gender.

There are many gender-affirming medications and surgical options available to help people with gender dysphoria bridge the disconnect between their assigned gender and their lived gender. At Main Line Health, the goal is to help patients with gender dysphoria access the resources and care they deserve so they can comfortably and confidently embody the gender they know they are.

What does gender dysphoria look like?

Gender dysphoria is a lived experience in which the gender assigned to a person does not match their lived gender. Someone, for example, may feel masculine or masculine despite being born with breasts and a vagina. People with gender dysphoria may feel like they’re not the kind their body or paperwork says they are.

Symptoms of gender dysphoria can occur in people of all ages. It has been observed in toddlers as well as in geriatric patients, Lawrence says. Often, gender dysphoria appears in adolescence when children become individualized and become aware of their identity. Gender dysphoria may seem more common now, but it’s always been around – now there is more space and safety for people to recognize and explore their gender and seek affirmative care. “We see it throughout life up to geriatric age,” says Lawrence.

In the medical field, since insurance companies require a diagnosis to cover care, gender dysphoria is clinically defined as the distress experienced by individuals, caused by a discrepancy between a person’s experienced gender and gender assigned to it. Not all people of variable gender suffer from psychological distress, but in order to access care, a diagnosis is currently required for people of variable gender.

“It’s a medical condition,” Lawrence said. “It is not a pathological disorder of the mind.”

How can gender dysphoria cause psychological distress?

As stated earlier, gender dysphoria is not a mental illness. According to Lawrence, not all people with gender dysphoria are distressed, but many people find it stressful to feel a strong disconnect between their assigned sex and the sex they see in the mirror. For teens, developing secondary sex characteristics that don’t match a person’s lived gender can be overwhelming and traumatic.

Almost 47 percent of people of varying sex have considered or attempted suicide. People with gender dysphoria are also at greater risk of experiencing discrimination at home or at work, homelessness, a higher rate of sexually transmitted infections, depression, and greater barriers to healthcare.

Many experience tensions in their interpersonal and family relationships and may face rejection, violence and bullying. There is a lot of stigma surrounding gender variance which can be a major barrier to obtaining care. The transition can also be stressful, as there is a lot of societal pressure for all genders over what it might mean to pass as their experienced gender, or to be female or male.

What type of gender affirming interventions are there?

There are several options for people with symptoms of gender dysphoria, including medications and surgeries that can help minimize the gap between the gender people experience and the gender assigned to them.

Behavioral health: For those experiencing psychological distress, mental health professionals can work with patients to help them feel comfortable with gender ambiguity and diversity. Mental health professionals can also help patients deal with and unbox gender incongruity and learn to accept and celebrate who they are.

Puberty blockers: These are given to young people who are prepubescent. Puberty blockers, according to Lawrence, essentially put a pause button on puberty so people don’t develop characteristics that could put them at high risk for pathological gender dysphoria. “You can put a pause button on it and say, ‘Okay, let’s let your teenage years go by for a bit, let’s think about it, plan and see how you really feel and what to expect and what you really want to do.’ , Lawrence said.

Affirm hormones: Affirmative hormones can be given to people who have already gone through puberty. Gender-affirming hormones are more aligned with the experienced gender of the person, explains Lawrence. Affirmative hormones retract some secondary characteristics such as breast hair, menstruation, erections, deepening of the voice, and breast development.

Gender affirming surgeries: There are many different gender affirmation surgical procedures. Some people may choose to continue with breast augmentation or thoracic masculinization / subcutaneous mastectomy surgery (removal of breast tissue, commonly called upper surgery). There is a wide range of facial feminization surgical procedures, including Adam’s apple reduction and reshaping of the nose, cheekbones, jaw, and other facial features that develop during male puberty. There are also many procedures that modify the genitals to reflect their gender expression. Some of the masculinization procedures include hysterectomy and phalloplasty (in which a phallus is created); Feminization procedures include removal of the testicles and vaginoplasty, in which a vaginal canal is created and the penis and testes are removed. Consulting a surgeon who performs gender-affirming surgeries can help you navigate gender dysphoria and your options.

What resources are there for gender dysphoria?

If you or a loved one has gender dysphoria, Lawrence recommends finding a primary care physician who provides affirmative care first. Look for gender-specific signals on the provider’s website or office, such as rainbow flags or non-sexist language.

The Global Professional Association for Transgender Health is a great resource to educate people about gender diversity and improve access to care for non-compliant people.

Lawrence also recommends contacting a local gender clinic or inclusive care facility, such as the Main Line Health sites in Bryn Mawr, Media and Paoli or the new Main Line Health Comprehensive Gender Care program under the leadership of Dr. Katerine Rose. Call them up and talk to them about how you explore your genre and want to tell someone about it, advises Lawrence. Mental health professionals, such as Main Line Health Women’s Emotional Center, can also provide valuable emotional support and resources related to affirmation of housing, gender-neutral health care, finance and social support.

At Main Line Health King of Prussia, Lawrence offers free monthly support groups for parents of transgender children. For people who experience a disconnect with their gender, the goal is to “engage them in a medical and behavioral health intervention so that we can provide them with the resources they need,” says Lawrence.

Main Line Health serves patients in hospitals and health centers in the western suburbs of Philadelphia. To make an appointment with a specialist at the Women’s Emotional Wellness Center, call 1.888.CARE.898 (227.3898) and follow the instructions provided.

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