Gender dysphoria

Diagnosis

In teens and adults, a diagnosis of gender dysphoria includes distress due to gender identity differing from sex assigned at birth that lasts at least six months and involves two or more of the following:

• A difference between gender identity and genitals or secondary sex characteristics. Examples of those characteristics include breasts and facial hair. In young teens who haven't started puberty, the distress may be caused by a difference between gender identity and the secondary sex characteristics that they expect will develop in their bodies.
• A strong desire to be rid of genitals or secondary sex characteristics, or a desire to prevent the development of secondary sex characteristics.
• A strong desire to have the genitals and secondary sex characteristics of another gender.
• A strong desire to be or to be treated as another gender.
• A strong belief of having the typical feelings and behaviors of another gender.

Gender dysphoria also includes distress that makes it hard to handle work, school, social situations and other parts of daily life.

Treatment

The purpose of treatment is to ease gender dysphoria. Specific goals for gender dysphoria treatment depend on the person.

If you have gender dysphoria, it's important to find a healthcare professional who has expertise in the care of gender-diverse people. If you need help, you can look online for organizations such as the World Professional Association for Transgender Health (WPATH). WPATH offers a search on its website that can find healthcare professionals in your area who work with transgender and gender-diverse people.

Treatment for gender dysphoria can include changes in gender expression, hormone therapy, surgery and supportive behavioral health therapy.

Changes in gender expression

Gender expression involves how gender is shown to the world through the way a person looks or acts. Gender expression may include clothing, mannerisms, communication style and interests, among other things. Changes in gender expression to ease gender dysphoria can involve dressing, speaking and behaving in ways that are more consistent with a person's gender identity.

Medical treatment

Medical treatment of gender dysphoria might include:

• Gender-affirming hormone therapy to better align the body with gender identity.
• Gender-affirming surgery, such as procedures that make changes to the chest, genitals or facial features.

Specific medical treatment is based on a person's goals, along with an evaluation of the risks and benefits. Treatments also may be based on other conditions a person has. Social and economic issues may play a role in creating a treatment plan too.

Before someone has hormone therapy or surgery to treat gender dysphoria, a healthcare professional does a health assessment. This helps address any medical conditions that might affect gender dysphoria treatment. The evaluation may include:

• A review of personal and family medical history.
• A physical exam.
• Lab tests.
• A review of vaccinations.
• Screening tests for some conditions and diseases.
• Identification and management, if needed, of tobacco use, drug use, alcohol use disorder, and HIV or other sexually transmitted infections.
• Discussion about fertility and procedures that may be needed to preserve fertility.

A behavioral health evaluation also may be done by a healthcare professional with expertise in transgender health. The evaluation may assess:

• Gender health goals.
• Mental health concerns.
• Sexual health concerns.
• The impact of gender dysphoria at work, at school, at home and in social settings.
• Substance use or use of hormone therapy or supplements not recommended by a healthcare professional.
• Support from family, friends and other loved ones.
• Goals, risks and expectations of treatment.

Behavioral health therapy

The goal of behavioral health therapy is to improve mental well-being and quality of life. It isn't intended to change gender identity. Instead, this therapy can help people explore gender concerns and find ways to ease gender dysphoria.

Behavioral health therapy often can help people with gender dysphoria feel comfortable with the way they express gender identity. That may help improve daily life, including school, work and relationships. The treatment also can address other mental health concerns.

Behavioral health therapy might include individual, couples, family and group counseling to help people:

• Address the mental and emotional impact of the stress that results from prejudice and discrimination because of gender identity. This is called gender minority stress.
• Build a support network.
• Develop a plan to address issues related to sharing gender identity with family, friends, colleagues and others.
• Become comfortable expressing gender identity.
• Explore healthy sexuality.
• Make decisions about medical treatment options.

Other steps

Other ways to ease gender dysphoria might include use of:

• Affirming name and pronouns.
• Voice and communication therapy to develop vocal characteristics that better align with gender identity.
• Hair removal or hair transplants.
• Genital tucking.
• Chest binding.
• Breast padding.
• Genital packing.
• Legal services to help with name and gender changes on legal documents.
• Services to assist with appearance, such as makeup or clothing.
• Social and community services to help deal with issues such as workplace, family or parenting concerns.

Talk with your healthcare professional about whether these steps may be helpful for you.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Coping and support

Gender dysphoria often can be eased by being in a supportive environment. Social support from family, friends and other loved ones may help prevent depression, suicidal thoughts, suicide attempts, anxiety or high-risk behaviors.

Talking to other transgender or gender-diverse people also may help. Ask your healthcare professional about support groups in your area. Some community centers or LGBTQ+ centers have support groups. Online support groups are available too.

Joining an LGBTQ+ organization can help you build community and may offer useful support. Or consider getting involved in other community organizations where you feel comfortable and supported expressing your gender identity.

Preparing for your appointment

You may start by seeing your primary healthcare professional. Or you may be referred to a behavioral health professional.

Here's some information to help you get ready for your appointment.

What you can do

Before your appointment, make a list of:

• Your symptoms, including any that seem unrelated to the reason for your appointment.
• Key personal information, including major stresses, recent life changes and family medical history.
• All medicines, vitamins or other supplements you take, including the doses.
• Questions to ask your healthcare professional.