Gender Dysphoria | Diagnosis & Treatment

How is gender dysphoria diagnosed?

You must meet certain criteria to be diagnosed with gender dysphoria, and these criteria differ based on your age.

To be diagnosed with gender dysphoria as a teenager or adult, you must have experienced significant distress for at least six months due to at least two of the following:

  • marked incongruence between your experienced and expressed gender and your primary or secondary sex characteristics
  • strong desire to be rid of your primary or secondary sex characteristics
  • strong desire for the primary or secondary sex characteristics of the other gender
  • strong desire to be of the other gender
  • strong desire to be treated as the other gender
  • strong conviction that you have the typical feelings and reactions of the other gender

Children are typically diagnosed with gender dysphoria if they have experienced significant distress for at least six months and at least six of the following:

  • strong desire to be of the other gender or an insistence that they are the other gender
  • strong preference for wearing clothes typical of the opposite gender
  • strong preference for cross-gender roles in make-believe play or fantasy play
  • strong preference for the toys, games or activities stereotypically used or engaged in by the other gender
  • strong preference for playmates of the other gender
  • strong rejection of toys, games and activities typical of their assigned gender
  • strong dislike of their sexual anatomy
  • strong desire for the physical sex characteristics that match their experienced gender

Gender dysphoria of childhood is not a surgical diagnosis. It is a medical diagnosis that does not require treatment, other than possibly individual or family therapy, until a child reaches puberty. Gender dysphoria is typically diagnosed by a therapist or other mental health professional.

How is gender dysphoria treated?

The goal of treatment is to address the distress and other negative emotions associated with having a gender that doesn't align with your assigned sex at birth. It's important to remember that the problem isn't your gender identity, it's the discomfort associated with it. That's why treating gender dysphoria is best accomplished through a team approach with clinicians from different specialties, including psychology, social work, endocrinology, urology and surgery. Treatment options include:

Counseling. Some people who experience gender dysphoria don't wish to pursue medical or surgical transition. For example, you may want to live and be recognized as your affirmed gender without using hormones or having gender affirmation surgery. An experienced therapist can help support you during all parts of your gender identity journey.

Hormone therapy. For people who wish to develop more physical characteristics of their affirmed gender, supplemental hormones can help. In children, puberty-blocking hormones can suppress the physical changes associated with puberty until they and their parents are ready to affirm their gender. In adults and adolescents who have passed puberty, hormones can help encourage the development of gender affirming physical traits.

Surgery. Procedures such as chest reconstruction or breast augmentation ("top" surgery) and metoidioplasty, phalloplasty or vaginoplasty ("bottom" surgery) can be part of the gender affirmation process. People who choose to undergo surgery usually do so after taking other steps in their gender affirmation journey first, such as taking supplemental hormones.