Gender Dysphoria Symptoms: Onset, in Children, and More

Signs of gender dysphoria · low-self esteem · social isolation · depression · anxiety · eating disorders · neglecting personal care. WhatAretheSignsandSymptomsofGenderDysphoria?MedicallyreviewedbyFrancisKuehnle,MSN,RN-BC—WrittenbyHilaryI.Lebow—UpdatedonJune6,2021WhatitisOnsetSignsSymptomsSymptomsinchildrenNextstepsYoumayhavegenderdysphoriaifyoufeeldistressedbecausethesexassignedtoyouatbirthdoesn’tmatchyourpersonalsenseofself.ShareonPinterestIllustrationbyBrittanyEnglandFromthenameyou’recalledathome,toshoppinginstoresforclothing,tothebathroomlineyouchoosebetweenclasses,itmayfeelasifyourgenderfollowsyoujustabouteverywhere.Forthoselivingwithgenderdysphoria,thesescenarioscanbringupallkindsoffeelings.Genderdysphoriacandisruptmultipleareasofyourlife,eventheeverydayeventsthatothersbarelynotice.Itcanalsochangethewayyoufeelaboutyourselfandrelatetoothers.IntheUnitedStates,lessthan1%ofpeoplemeetthediagnosticcriteriaforgenderdysphoria,asdefinedinthefiftheditionoftheDiagnosticandStatisticalManualofMentalDisorders(DSM-5).Thoughoftenlinkedtogether,havinggenderdysphoriaisnotthesameasbeingatransgenderorgender-nonconformingperson.Researchshowsthatnotalltransgenderpeopleexperiencegenderdysphoria.Whatisgenderdysphoria?Genderdysphoriareferstothefeelingsofdistressthatoccurwhenthesexassignedtoyoubyadoctoratbirth(usuallymaleorfemale)doesnotmatchyourgenderidentityorhowyoufeelaboutyourselfontheinside,accordingtotheAmericanPsychiatricAssociation(APA).Genderdysphoriausedtobeknownasgenderidentitydisorder.TheWorldHealthOrganizationremoveditin2019asamentaldisorderandreclassifieditasa“conditionrelatedtosexualhealth.”Thechangeacknowledgedthatbeingtransgenderisnotamentalillness.ItwasdonetoreflectamoremodernunderstandingofLGBTQIA+issuesandpreventstigma,acommonoccurrencewithtransgender,genderqueer,gender-nonconforming,andgender-diversepeople.Whendoesgenderdysphoriadevelop?Forsome,genderdysphoriacandevelopearlyinchildhood.Onestudyshowedthat,onaverage,studyparticipantsreportedtheirearliestmemoryofgenderdysphoriabetweentheagesof4and6yearsold.Bytheageof7,moststudyparticipantscouldrememberexperiencingsomefeelingsofgenderdysphoria.Forothers,symptomscanoccuraroundpubertyorevenlater,astheyrejectorfeeluncomfortablewiththechangestakingplaceintheirbody.Thefeelingsofgenderdysphoriamaybecontinuousorcomeandgowithtime.Thereissomedebateaboutgenderdysphoriathatoccurslaterinadolescence.Inonenotablestudy,256parentsreportedthattheirchildrenexperiencedsymptomsofgenderdysphoria“outoftheblue,”appearingtobeinfluencedbypeergroupsorsocialmedia.Knownas“rapid-onsetgenderdysphoria,”thisproposeddiagnosisremainsacontroversialtopicinthementalhealthandLGBTQIA+communities.Moreresearchisneededinthistopicareausingfuturestudies,asnotedintherepublishedpaperin2019.SignsofgenderdysphoriaIfyou’relivingwithgenderdysphoria,itmaypresentasarangeofsymptoms,fromthenaggingfeeling24/7thatsomethingisn’tquiterighttoturningyourwholeworldupsidedown.Everyoneexperiencesitdifferently.Herearesomeofthesignstolookforinyourselforalovedone,accordingtotheNationalHealthService(NHS)intheUnitedKingdom:low-selfesteemsocialisolationdepressionanxietyeatingdisordersneglectingpersonalcareResearchshowsthatgenderdysphoriacanalsoleadto:interpersonalconflictssubstanceuseanincreasedriskofself-harmorsuicideSymptomsofgenderdysphoriaEachindividual’sexperiencewithgenderdysphoriaisunique.Withthatsaid,theAPAhasidentifiedseveralsymptomsthatcommonlyoccurinadolescentsandadults.Toreceiveadiagnosisofgenderdysphoria,yoursymptomsmustbepresentfor6monthsorlonger.Thesymptomsmustalsobecausingsignificantdistressinoneormoreimportantareasofyourlife,suchashome,school,work,relationships,orsocialsituations.Thesymptomscanbesummarizedintothreemaincategories:1.AmarkeddifferencebetweenassignedsexandgenderidentityIfyou’relivingwithgenderdysphoria,youmayfeelthatyourname,appearance,anatomy,voice,reactions,feelings,orcharactertraitssimplydonotlineupwiththesexyouwereassignedatbirth.Downatyourcore,youmightfeelasthoughyouaresupposedtobesomeoneelse.Youmayfeel“trapped”insidethewrongbody.Youmaylookintothemirrorandfeelasifthereflectionstaringbackatyouisforeignsomehow—youknowit’syou,butit’snotreally“you.”It’simportanttomentionthatforsomepeoplelivingwithgenderdysphoria,genderidentityisnotascutanddryasthefixedbinariesof“male”and“female.”Rather,apersonmayfeelasiftheybelongsomewhereelseonthegendercontinuumaltogether,ornotatall.2.AdesiretoliveasanothergenderroleIfyouhavegenderdysphoria,youmaywishtoliveparttimeorfulltimeinanothergenderrole.Thiscanincludeusingadifferentnamewithpronounstoaffirmthatidentity.Forexample,apersonwithabirthnameofSamanthamaywishtouseamoregender-neutralnamelikeSamorevenSamuel.Alongwiththis,Samuelmaydesiretousehe/him/hisorthey/them/theirpronounswhileathome,school,work,oralloftheabove.Someonewithgenderdysphoriamayalsowanttoexpressadifferent(orfluid)genderidentitythroughtheirclothingandappearance,calledgenderexpression.Thisisusuallyaccomplishedthroughtheuseofclothing,shoes,jewelry,makeup,andhairstyle.Forsomepeople,it’simportantthattheirgenderidentitymatchestheirgenderexpression,butnotalways,accordingtotheAPA.Peoplewithgenderdysphoriamayalsohaveadesiretoseeklegalaffirmationoftheirgenderidentity,suchaschangingadriver’slicenseorothergovernment-issueddocumentation.3.AdesiretochangeyoursexcharacteristicsIfyouhavegenderdysphoria,youmayfeelthatyouwanttoenhance,remove,orotherwisechangethephysicalpartsofyoumostcommonlyassociatedwithyoursex.Somepeoplewanttodothistomorecloselyaligntheirgenderexpressionwiththeirgenderidentityorneutralizetheirphysicalappearance.Somecommonlyreportedchangesinclude:Breasts:bindingorpaddingGenitals:tuckingorpackingVoice:raisingordeepeningpitchHair:growthorremovalSomeindividuals—thoughnotall—mayfeelacalltoexploremorepermanentmedicaloptionstoaffirmtheiridentity.Someoftheseproceduresinclude:hormonetherapyfacialreconstructionsurgerieshairlinesurgeriesbreastaugmentationormastectomy(“topsurgery”)othergenderaffirmingsurgeriesSymptomsofgenderdysphoriainchildrenIntheirearlyyears,childrenmaybehaveordressinwaysconsideredgender-nonconforming,whichisanaturalpartoftheirdevelopment.However,ifchildrenshowaconsistentpatternofbehaviororpreferencesovertime—andthey’redistressedasaresultofthosefeelingsorbehaviors—theymaybeshowingearlysignsofgenderdysphoria.Thesymptomsofgenderdysphoriainchildrenaresimilartoadolescentsandadults,withafewnotabledifferences.ToreceiveadiagnosisthroughtheDSM-5,atleast6ofthefollowingsymptomsmustbepresentfor6monthsorlonger:astrongdesiretobeanothergenderadesiretowearclothingalignedwithadifferentgenderapreferencetoplayanothergenderinmake-believegamesadesirefortoys,games,andactivitiestypicallyassociatedwithanothergenderarejectionoftoys,games,andactivitiestypicallyassociatedwiththeirgenderapreferenceforplaymatesofadifferentgenderafeelingofdistressovertheirsexualanatomyapreferenceforanothergender’ssexcharacteristicsLikeadolescentsandadults,adiagnosisisconfirmedwhenthesymptomsofgenderdysphoriainchildrenareinterferingwithsocialsituations,school,orother“importantareasoffunctioning,”accordingtotheDSM-5.NextstepsIfyouareexperiencingsymptomsofgenderdysphoria,ordistressaboutthemisalignmentbetweenyourassignedgenderandyourgenderidentity,it’sunderstandable.Itmaybereassuringtolearnasmuchasyoucanaboutgenderdysphoriasoyoufeelsupportedonyourjourney.Hereareafewresourcestocontinuereading:HumanRightsCampaign:TransgenderResourcesTheTrevorProject:Trans+GenderIdentityTheTrevorProject:AGuideToBeingAnAllyToTransgenderandNonbinaryYouthGLAADTransgenderResourcesForparentsandallies,youcanfindalocalsupportgroupnearyouthroughPFLAG.Remember,witheducationandsupport,genderdysphoriaismanageable.Helpisavailablerightnow.Youcanfindacompassionate,understandingprofessionalthroughtheAssociationofLGBTQ+Psychiatristsorreachouttosomeoneyoutrust.Mostofall,remember:Youarenotalone.LastmedicallyreviewedonJune6,2021MedicallyreviewedbyFrancisKuehnle,MSN,RN-BC—WrittenbyHilaryI.Lebow—UpdatedonJune6,2021RELATEDHowtoSupportYourChildExploringTheirGenderIdentityHowtoSupportSomeoneExploringTheirSexualIdentityI’mHereforYou:AddressingSignsofSuicidalBehaviorinChildrenandTeensBellyacheorDepression?HowtoRecognizeMentalHealthConditionsinAdolescentsUnderstandingLGBTQ-AffirmativePsychotherapyReadthisnextHowtoSupportYourChildExploringTheirGenderIdentityMedicallyreviewedbyJoslynJelinek,LCSWYoursupportcouldmakeallthedifferencetoayoungtrans,nonbinary,orgender-questioningpersoninyourlife.Here'show.READMOREHowtoSupportSomeoneExploringTheirSexualIdentityMedicallyreviewedbyFrancisKuehnle,MSN,RN-BCForsomeoneexploringtheirsexualidentity,thesupportoffriendsandfamilycanmakeaworldofdifference.Herearetipsonhowtobeasupportive…READMOREI’mHereforYou:AddressingSignsofSuicidalBehaviorinChildrenandTeensMedicallyreviewedbyAkilahReynolds,PhDRecognizingtheearlysignsofsuicidalthoughtsandintentionsisanimportantsteptogetyourkidthehelptheyneed.READMOREBellyacheorDepression?HowtoRecognizeMentalHealthConditionsinAdolescentsMedicallyreviewedbyNathanGreene,PsyDRecognizingsymptomsofmentalillnessinkidscanbetricky.Learningmoreabouthowsymptomsmanifestisafirststeptogettingyourkidthehelp…READMOREUnderstandingLGBTQ-AffirmativePsychotherapyIdontunderstandtheconceptofhavingagayagenda.InmybeliefsystemcaringpeoplecloselyholdtoahumaREADMOREABIGHelpforBIGFeelingsMedicallyreviewedbyAkilahReynolds,PhDFinally,anarticlewrittenatalevelyourelementary-school-agedchildcanunderstand.We'regivingthemasimpleintroductiontotheirfirst…READMOREWhat’stheQinLGBTQ?“I’mnotafraidofbeinggay.WhatIfearisabandoningmyfamily.”Qisfor“Quirk”WhenIfirstacREADMOREHowDoesTraumaAffectLGBTQIA+Communities?MedicallyreviewedbyJanetBrito,PhD,LCSW,CSTWithhighratesoftraumareportedinLGBTQIA+communities,havingaccesstosafe,welcomingspacesisimportantforhelpingpeoplehealandliveas…READMOREBestOnlineTherapyProgramsof2021MedicallyreviewedbyAkilahReynolds,PhDWhatisonlinetherapyoronlinecounseling,andwhyshouldyougiveitatry?Onlinetherapyoffersasafe,securewaytointeractwithlicensed…READMOREDealingwithTeenEmotionsMedicallyreviewedbyNathanGreene,PsyDTheyhavenoideawhatyou'regoingthrough.Takealookatlegitstrategies,tips,andpsychologytohelpteenshandleemotionswhenitfeelslike…READMORE