Gender dysphoria

Gender dysphoria is a condition in which a person feels that there is a mismatch between their biological sex and their gender identity.

Information written and reviewed by Certified Doctors.

Contents

Introduction

Gender dysphoria is a condition in which a person feels that there is a mismatch between their biological sex and their gender identity.

Biological sex is assigned at birth, depending on the appearance of the infant. Gender identity is the gender that a person “identifies” with, or feels themselves to be.

For example, a person may have the anatomy of a man, but gender identify as a woman. Others do not describe themselves as either male or female, or may describe themselves as agender.

This mismatch can cause feelings of discomfort that are called gender dysphoria. Gender dysphoria is a recognised condition, for which treatment is sometimes appropriate. It is not a mental illness.

The condition is also sometimes known as:

  • gender identity disorder
  • gender incongruence
  • transgenderism

Some people with gender dysphoria have a strong and persistent desire to live according to their gender identity, rather than their biological sex. These people are sometimes called transsexual people, or trans people. Some trans people undergo treatment so that their physical appearance is more consitent with their gender identity.

Learn more in definition of gender dysphoria.

Early symptoms

The symptoms of gender dysphoria can appear at a very young age. For example, a child may refuse to wear typical boys' or girls' clothes, or dislike taking part in typical boys' or girls' games and activities.

In most cases, this type of behaviour is just a normal part of growing up, but in cases of gender dysphoria, it persists into later childhood and through to adulthood.

Adults with gender dysphoria can feel trapped inside a body that does not match their gender identity. This can cause feelings of discomfort and anxiety. They may also feel so unhappy about social expectations that they live according to their anatomical sex, rather than according to the gender that they feel themselves to be. They may experience a strong desire to change, or get rid of, physical signs of their biological sex, such as facial hair or breasts,

Learn more in symptoms of gender dysphoria.

How common is gender dysphoria?

It is estimated that 1 in 11,500 people experience gender dysphoria. However, there may be many people with the condition who do not seek help. On average, men are diagnosed with gender dysphoria five times more than women.

While gender dysphoria is rare, the number of people being diagnosed with it is increasing due to growing public awareness about the condition.

However, many people with gender dysphoria still face prejudice and misunderstanding about their condition.

Learn more in causes of gender dysphoria.

Diagnosis of gender dysphoria

If you think you have gender dysphoria, see your doctor.

Your doctor may refer you to a gender dysphoria clinic, which can offer you a personalised assessment.

Learn more in diagnosis of gender dysphoria.

Treatment for gender dysphoria

Treatment for gender dysphoria aims to help people remove the feeling of a mismatch between their biological sex and their gender identity.

This can mean different things for different people. For example, for some people it can mean dressing and living as their preferred gender.

For others, it can mean taking hormones or having surgery to change their physical appearance. Many trans people seek to have treatment to permanently change their bodies, so that they are more consistent with their gender identities.

Learn more in treatment for gender dysphoria.

Symptoms

There are no physical symptoms of gender dysphoria, but there are a range of feelings that people with the condition may experience, and behaviours that they may display.

In many cases, a person with gender dysphoria will begin to feel that there is a mismatch between their biological sex and their gender identity during early childhood.

For others, this may not happen until adulthood.

Children

If your child has gender dysphoria, their behaviour may include:

  • insisting that they are of the opposite sex
  • disliking or refusing to wear clothes that are typically worn by their sex and wanting to wear clothes that are typically worn by the opposite sex
  • disliking or refusing to take part in activities and games that are typically meant for their sex, and wanting to take part in activities and games that are typically meant for the opposite sex
  • disliking or refusing to pass urine as other members of their biological sex usually do, for example a boy may want to sit down to pass urine and a girl may want to stand up
  • insisting or hoping that their genitals will change, for example a boy may want to be rid of his penis, and a girl may want to grow a penis
  • feeling extreme distress at the physical changes of puberty

Children with gender dysphoria may display some, or all, of these types of behaviour. However, in many cases, behaviour such as this is just a part of childhood and does not necessarily mean that your child has gender dysphoria.

For example, many girls behave in a way that can be described as 'tomboyish', which is often seen as part of normal female development. It is also not uncommon for boys to role play as girls and to dress up in their mother's or sister's clothes. This is usually nothing more than a phase.

Most children who behave in these ways do not have gender dysphoria and do not become transsexuals. Only in rare cases does the behaviour persist into the teenage years and adulthood.

Mind, the mental health charity, estimates that the number of people who request gender reassignment surgery (surgery to change a person’s physical sex) is around 1 in 30,000 men and 1 in 100,000 women.

Teenagers and adults

If the feelings of gender dysphoria are still present by the time your child is a teenager or adult, it is likely that they are not simply going through a phase or a stage of development.

If you are a teenager or an adult whose feelings of gender dysphoria started in childhood, you may now have a much clearer sense of your gender identity and the way you want to deal with it. Many people with strong feelings of gender dysphoria are fully transsexual by the time they are in their teens.

The ways that gender dysphoria affects teenagers and adults is different to the way that it affects children. If you are a teenager or adult with gender dysphoria, you may feel:

  • without doubt that your gender identity is at odds with your biological sex
  • comfortable only when in the gender role of your preferred gender identity
  • a strong desire to hide or be rid of the physical signs of your sex, such as breasts, body hair and muscle definition
  • a strong dislike for and a strong desire to change or be rid of the genitalia of your biological sex

These feelings can often be very difficult to deal with and, as a result, many transsexuals and people with gender dysphoria may experience depression or suicidal feelings.

See your doctor as soon as possible if you have been experiencing feelings of depression or suicide. They will be able to provide help and support.

A condition that describes the feeling of a mismatch between your biological sex and your gender identity.

Gender identity is your personal sense of which gender you belong to, or the way that you see yourself.

Transsexual is someone with deep and long-lasting feelings of gender dysphoria, who seeks to alter their biological sex to match their gender identity.

Causes

The causes of gender dysphoria are not fully understood.

Gender dysphoria was traditionally thought to be a psychiatric condition, which meant that its causes were believed to originate in the mind. This does not mean that gender dysphoria is a mental illness.

However, recent studies have suggested that gender dysphoria may have biological causes associated with the development of gender identity before birth.

More research is needed before the causes of gender dysphoria can be fully understood.

Typical gender development

Much of the development that determines your gender identity – that is, the gender that you feel yourself to be – happens in the womb (uterus).

Your biological sex is determined by chromosomes. Chromosomes are the parts of a cell that contain genes (units of genetic material that determine your characteristics). You have two sex chromosomes: one from your mother and one from your father.

During early pregnancy, all unborn babies are female because only the female sex chromosome (the X chromosome), that is inherited from the mother, is active. At the eighth week of gestation, the sex chromosome that is inherited from the father becomes active, this can be either an X chromosome (female) or a Y chromosome (male).

If the sex chromosome that is inherited from the father is X, the unborn baby (foetus) will continue to develop as female with a surge of female hormones. The female hormones work in harmony on the brain, gonads (sex organs), genitals and reproductive organs, so that the sex and gender are both female.

If the sex chromosome that is inherited from the father is Y, the foetus will go on to develop as biologically male. The Y chromosome causes a surge of testosterone and other male hormones, which initiates the development of male characteristics, such as testes. The testosterone and other hormones work in harmony on the brain, gonads (sex organs) and genitals, so that the sex and gender are both male.

Therefore, in most cases, a female baby has XX chromosomes and a male baby has XY chromosomes.

Changes to gender development

Gender development is complex and there are many possible variations that can cause feelings of a mismatch between a person’s biological sex and their gender identity.

Hormonal differences

In rare cases, the hormones that trigger the development of sex and gender may not work properly on the brain, gonads and genitals, causing variations between them. For example, the biological sex (as determined physically by the gonads and genitals) could be male, while the gender identity (as determined by the brain) could be female.

This could be caused by additional hormones in the mother’s system, or by the foetus’s insensitivity to the hormones, known as androgen insensitivity syndrome (AIS). In this way, gender dysphoria may be caused by hormones not working properly within the womb.

See androgen insensitivity syndrome for more information about this condition.

Other rare conditions

Other rare conditions, such as congenital adrenal hyperplasia (CAH), and intersex conditions (also known as hermaphroditism) may also result in gender dysphoria.

In CAH, the adrenal glands (two small, triangular-shaped glands located above the kidneys) in a female foetus cause a high level of male hormones to be produced. This enlarges the female genitals. In some cases, they may be so enlarged that the baby is thought to be biologically male when she is born.

Intersex conditions cause babies to be born with the genitalia of both sexes (or ambiguous genitalia). In such cases, it used to be recommended that the child’s parents should choose which gender to bring up their child as. However, it is now thought to be better to wait until the child can choose their own gender identity before any surgery is carried out to confirm it.

Two small, triangular-shaped glands that sit on top of the kidneys, high up inside the back of the abdominal wall. They produce adrenaline, steroid hormones and the male and female sex hormones, testosterone and oestrogen.

Chromosomes are the parts of a body cell that carry genes. A human cell usually has 23 pairs of chromosomes.

A foetus is an unborn baby, from the eighth week of pregnancy until birth.

In this article, gender refers to the feeling of being either male or female.

A condition that describes the feeling of mismatch between your biological sex and your gender identity.

Gender identity is your personal sense of knowing which gender you belong to, or the way that you see yourself.

A gene is a unit of genetic material that determines your body's characteristics.

Hormones are powerful chemicals that are produced by the body and have a wide range of effects.

In this article, sex refers to male or female, the biological sex that you were born with.

A transsexual is someone with an extreme and long-term case of gender dysphoria, who seeks to alter their biological sex to match their gender identity.

The uterus (also known as the womb) is a hollow, pear-shaped organ in a woman where a baby grows during pregnancy.

Diagnosis

See your doctor if you think that you or your child may have gender dysphoria. They can refer you or your child to a Gender Dysphoria (GD) clinic.

GD clinics offer expert support and help, as well assessment and diagnosis, for people with gender dysphoria.

There are strict criteria for diagnosing gender dysphoria, these are different for children and adults. However, the criteria are based on the assumption that gender dysphoria is a purely psychiatric condition (relating to the mind), which is now increasingly thought to be a misconception.

For this reason, and due to the fact that gender dysphoria is so complex, specialists tend to make a diagnosis based on each individual, rather than just on the criteria.

Each case of gender dysphoria is unique and should be treated as such. The traditional criteria for diagnosing gender dysphoria in children and adults are described below.

Criteria for children

To be diagnosed with gender dysphoria, a child should:

  • repeatedly insist that they want to be the opposite sex, or that they are the opposite sex, and behave as the opposite sex (this must not be just because they want any supposed advantages of being the opposite sex)
  • dislike or refuse to wear clothes typically worn by their sex and insist on wearing clothes typically worn by the opposite sex, or show dislike or unhappiness with their genitalia and insist that it will change into that of the opposite sex (for example, refusing to pass urine as members of their sex usually do)
  • not yet have reached puberty (when a child progresses into a sexually developed adult)
  • behave this way for at least six months

Criteria for teenagers and adults

To be diagnosed with gender dysphoria, a teenager or adult should:

  • feel persistently and strongly that they are the wrong sex and feel a strong identification with the opposite sex
  • feel discomfort in their sex and its gender role and strongly dislike and wish to be rid of the physical characteristics of their sex, such as breasts, facial and body hair and genitalia
  • not have a condition that causes them to display physical attributes of the opposite sex (although this is being increasingly questioned)
  • experience long-term anxiety, distress and impairment in social and occupational areas of life due to their condition

Assessment

As well as these criteria, a diagnosis of gender dysphoria will depend on a full and highly personalised assessment of your, or your child's, gender identity and preferred gender role.

Your GD specialist will assess your gender development in childhood and puberty, or your child's gender development in earlier childhood. They will also carry out psychological assessments on you or your child, to assess the level of your or their cross-gender identification.

You or your child will also be offered counselling and details of support groups to help you cope with the condition.

In this article, gender refers to the feeling of being either male or female.

A condition that describes the feeling of a mismatch between your biological sex and your gender identity.

Gender identity is your personal sense of knowing which gender you belong to, or the way that you see yourself.

In this article, sex refers to male or female, the biological sex that you were born with.

A transsexual is someone with deep and long-lasting feelings of gender dysphoria, who seeks to alter their biological sex to match their gender identity.

Treatment

Treatment for gender dysphoria aims to help people with the condition live the way they want to, in their preferred gender identity.

What this means will vary from person to person, and some people will need more treatment than others.

Once you or your child has been diagnosed with gender dysphoria, different treatments can be considered. Counselling (a talking therapy) about the range of available treatment options and their implications should be offered to you or your child. See counselling for more information.

Treatment for children

If your child is under 18 years of age, they should be referred to a specialist child and adolescent gender identity clinic.

These clinics can offer ongoing assessment for children with gender dysphoria, and specialised treatment and support for children and their families. Your child will be fully assessed before any treatment begins.

Your child’s treatment should be arranged with a multi-disciplinary team (MDT), a team of different healthcare professionals working together. Your child’s MDT may include:

  • a mental health professional, who is trained in dealing with gender dysphoria in children and teenagers
  • a paediatric endocrinologist, a specialist in hormone conditions in children

Children before puberty

If your child is diagnosed with gender dysphoria before they reach puberty (when a child progresses into a sexually developed adult), they will not receive endocrine treatment. Endocrine treatment is treatment with hormones (powerful chemicals). It is the first step to developing the physical signs of your preferred gender.

Guidelines from The Endocrine Society do not recommend endocrine treatment for young children because a diagnosis of transsexualism cannot be made before a child has reached puberty. Transsexualism involves deep and long-lasting feelings of gender dysphoria that causes someone to seek to change their sex.

The Endocrine Society found that 75-80% of children who were diagnosed with gender dysphoria before they reached puberty did not have the condition after puberty. Therefore, endocrine treatment is not recommended until after puberty, when a diagnosis of gender dysphoria can be confirmed.

Children up to 16

If your child has been diagnosed with transexualism and they have reached puberty, they may be treated with gonadotrophin-releasing hormone (GnRH) analogues. These are synthetic (manmade) hormones that suppress the hormones naturally produced by your body.

The recommendation for endocrine treatment must come from a mental health professional, and they must continue to be part of your child’s ongoing care. An endocrinologist (a specialist in hormonal conditions) must also confirm your child’s diagnosis.

Puberty is divided into stages. These are called Tanner stages, named after James Mourilyan Tanner who first identified them. GnRH analogues may be suitable for children who have reached Tanner stage two, which means a number of physical changes have taken place, such as pubic hair starting to grow. In girls, this is around 11 years of age and in boys it is around 12 years of age.

See symptoms of puberty for more information about the different stages of puberty and the changes that take place.

Some of the changes that take place during puberty are driven by hormones. For example, the hormone testosterone, which is produced by the testes in boys, helps stimulate the development of the penis. As GnRH analogues suppress the hormones that are produced by your child’s body, they also suppress puberty.

GnRH analogues can be taken until your child reaches 16 years of age, after which cross-sex hormones can be taken (see below).

Children over 16

If your child has been taking GnRH analogues for several years and are still diagnosed as transsexual, they may be offered cross-sex hormones. These can alter your child’s body further to fit with their gender identity. The effects of these hormones are only partially reversible, so they are not offered to children who are under 16 years of age.

Once your child reaches adulthood at 18 years of age, they can begin the process of gender confirmation surgery, which will change their gender irreversibly (also known as transition). Not all children who experience gender dysphoria will go on to transition. In fact, the number of children who go on to become transsexuals is very small.

For more information about cross-sex hormone treatment and gender confirmation surgery, see the section below about treatment for adults.

The amount of treatment that your child has will depend on how strong and long-lasting their feelings of gender dysphoria are. However, all children and their families should be offered counselling and support through their gender identity clinic.

Treatment for adults

Adults who have been diagnosed with gender dysphoria and transsexuals should be referred to a specialist gender identity clinic. These clinics offer ongoing assessments for people with gender dysphoria. They can also provide support and advice about living in your preferred gender role, including:

  • mental health support
  • hormone treatment
  • ways to dress in your preferred gender role
  • ways to behave in your preferred gender role
  • language and speech therapy
  • hair removal treatments
  • peer support groups to meet other people with gender dysphoria
  • relatives' support groups for your family

For some people, support and advice from a clinic are all they need to feel comfortable in their gender identity. However, others will need more extensive treatment, such as a full transition from one sex to the other. The amount and extent of treatment you have is completely up to you.

Once you have been referred to a gender identity clinic, it is likely that you will have another full assessment, for a period of approximately three months. This will usually be with the input of a psychiatrist (a doctor who treats mental and emotional health conditions). This assessment is necessary to confirm your diagnosis and, if you want to have hormone therapy, means that you can take the necessary health tests first.

Cross-sex hormone therapy

Cross-sex hormone therapy means taking the hormones of your preferred gender:

  • a trans man (female becoming a male) will take testosterone
  • a trans woman (male becoming a female) will take oestrogen

The aim of hormone therapy is to make you more comfortable with yourself, both in your physical appearance and how you feel psychologically (mentally). These hormones start the process of changing your body into one that is more female or more male, depending on your gender identity.

Hormone therapy may be all the treatment you need to enable you to live with your gender dysphoria. The hormones may improve how you feel and mean that you do not need to start living in your preferred gender or have surgery.

Fertility

Before you start hormone therapy, your specialist should discuss with you what it can mean for your fertility.

Trans women who take oestrogen may become less fertile because oestrogen can lower sperm count and reduce the quality of the sperm. Some trans women choose to put sperm in a sperm bank before they start hormone therapy, so that they can use this sperm if they want to have children later.

Trans men taking testosterone may also become less fertile.

For trans men and women, there is no guarantee that fertility will return to normal if hormones are stopped.

Trans woman

If you are a trans woman, some of the changes that you may notice from hormone therapy include:

  • your penis and testicles may get smaller
  • you may have less muscle
  • you may have more fat on your hips
  • your breasts may become lumpy and may increase in size slightly
  • you may have less facial and body hair

Hormone therapy will not affect the voice of a trans woman. To make the voice higher, trans women will need vocal therapy and possibly vocal cord or trachea (windpipe) surgery. Hormone therapy may make it harder to get an erection and have an orgasm.

Trans man

If you are a trans man, some of the changes that you may notice from hormone therapy include:

  • you may have more body and facial hair
  • you may have more muscle
  • your clitoris (a small, sensitive part of the female genitals) may get bigger
  • your periods may stop
  • you may have an increased sex drive (libido)

Hormone therapy can also cause baldness and acne in trans men. Your voice may get slightly deeper, but it will not be as deep as other men’s voices.

Monitoring

While you are taking these hormones, you will need to go for regular check-ups at your gender identity clinic. You will be assessed to find out whether the hormone treatment is benefiting you, as some people may find the effects of hormone treatment unpleasant.

If you do not think that hormone treatment is right for you, discuss it with the healthcare professionals who are treating you. If necessary, you can stop taking the hormones, although some changes are irreversible such as:

  • a deeper voice in trans men
  • breast growth in trans women

Alternatively, you may be frustrated with how long hormone therapy takes to produce results, as it can take a few months for some changes to develop. Hormones cannot change the shape of your skeleton, for example how wide your shoulders or your hips are. It also cannot change your height.

Hormones for gender dysphoria are also available from other sources, such as the internet, and it may be tempting to get them from here instead of through your clinic. However, hormones from other sources may not be licensed and, therefore, may not be safe. If you decide to use these hormones, let your clinic know so that they can monitor you.

Real life experience (RLE)

If you want to have gender confirmation surgery, you will first need to live in your preferred gender identity full time for at least a year. This is known as real life experience (RLE) and will help confirm that permanent surgery is the right decision.

Once your hormone treatment is under way, you can start as soon as you are ready with the support of your clinic. The length of RLE varies from person to person, but is usually between one and two years.

You may have various other surgical treatments during your RLE to prepare for full transition surgery, including:

  • mastectomy (removal of the breasts) for trans men
  • mammoplasty (cosmetic breast surgery) for trans women
  • feminising facial surgery for trans women

Trans women should continue with hormone therapy for at least 18 months before having a mammoplasty to ensure that the treatment has had the maximum effect on the development of the breasts.

Gender confirmation surgery

Once you have completed your RLE and you and your multi-disciplinary team (MDT) feel that you are ready, you may decide to have surgery to permanently alter your sex.

The most common options are discussed below, but you can talk to members of your team, and the surgeon at your consultation, about the whole range of options.

Trans man surgery

For trans men, surgery may involve:

  • a hysterectomy (removal of the womb)
  • a salpingo-oophorectomy (removal of the fallopian tubes and ovaries)
  • construction of a penis using a phalloplasty or a metoidioplasty

A phalloplasty uses the existing vaginal tissue and skin taken from the inner forearm to create a penis. A metoidioplasty involves creating a penis from the clitoris, which has been enlarged through hormone therapy.

The aim of this type of surgery is to create a functioning penis, which allows you to pass urine standing up and to retain sexual sensation. You may need to have more than one operation to achieve this.

Trans woman surgery

For trans women, surgery may involve:

  • an orchidectomy (removal of the testes)
  • a penectomy (removal of the penis)
  • construction of a vagina from the leftover tissue of the penis (known as a vaginoplasty)

The vagina is created and lined with skin from the penis, and tissue from the scrotum (the sack that holds the testes) is used to create the labia. The urethra (urine tube) is shortened and repositioned. The aim of this type of surgery is to create a functioning vagina with an acceptable appearance and retained sexual sensation.

After surgery

After surgery, the vast majority of transsexuals are happy with their new sex and feel comfortable with their gender identity. One review of a number of studies that were carried out over the last 20 years found that 96% of people who had gender reassignment surgery were satisfied. However, some of these studies may not have been of high quality.

Following gender confirmation surgery, one possible complication is that people may face prejudice or discrimination because of their condition. Treatment can sometimes leave people feeling:

  • isolated if they are not with people who understand what they are going through
  • stressed about or afraid of not being accepted socially
  • discriminated against at work

There are legal safeguards to protect against discrimination (see guidelines for gender dysphoria), but other types of prejudice may be harder to deal with. If you are feeling anxious or depressed since having your treatment, speak to your doctor or a healthcare professional at your clinic.

Sexual orientation

Once transition has been completed, it is possible for a trans man or woman to experience a change of sexual orientation. For example, a trans woman who was attracted to women before surgery may be attracted to men after surgery. However, this varies greatly from person to person, and the sexual orientation of many transsexuals does not change after transition.

If you are a transsexual going through the process of transition, you may not know what your sexual preference will be until it is complete. However, try not to let this worry you. For many people, the issue of sexual orientation is secondary to the process of transition itself.

In this article, gender refers to the feeling of being either male or female.

Gender dysphoria is a condition that describes a feeling of mismatch between your biological sex and your gender identity.

Gender identity is your personal sense of knowing which gender you belong to, or the way that you see yourself.

Hormones are groups of powerful chemicals that are produced by the body and have a wide range of effects.

The ovaries are two small, round organs in the female reproductive system that release an egg every month.

In this article, sex refers to male or female, the biological sex that you were born with.

The testicles are part of the male reproductive system. They produce sperm and are located within the scrotum (a loose bag of skin) hanging down behind the penis.

A transsexual is someone with an extreme and long-term case of gender dysphoria, who seeks to alter their biological sex to match their gender identity.

The vagina is a tube of muscle that runs from the cervix (the opening of the womb) to the vulva (the external sexual organs).

The uterus (or womb) is a hollow, pear-shaped organ in a woman where a baby grows during pregnancy.

Ruth's story

Ruth, 22, was born in a male body but knew from the age of 16 that she wanted to be a woman. She describes her hormone treatment and surgery, and how she feels now.

Policy guidelines

The UK Gender Recognition Act 2004 gives certain legal rights to trans men and women.

You may be interested to read the following information:

Under the Gender Recognition Act of 2004, trans men and women can:

  • apply for and obtain a Gender Recognition Certificate to acknowledge their gender identity
  • get a new birth certificate, driving licence and passport
  • marry in their new gender

To apply for a Gender Recognition Certificate, you must be over 18 years of age.

The application process requires you to prove that:

  • you have or have had gender dysphoria
  • you have lived as your preferred gender for the last two years
  • you intend to live permanently in your preferred gender

Find out more about the Gender Recognition Act 2004 and how to apply for a Gender Recognition Certificate.

Sex Discrimination Act 1975

For people who have had, are having, or plan to have gender reassignment surgery, the Sex Discrimination Act 1975 provides legal protection in employment against:

  • victimisation
  • harassment
  • discrimination

If you are the subject of discrimination at work, report it immediately. For more information about your rights, see the Equality and Human Rights Commission website.

World Professional Association for Transgender Health

The World Professional Association for Transgender Health (WPATH) promotes evidence-based care in transgender health.

It produces the WPATH Standards of Care, which are clinical guidelines for health professionals who treat transsexual people.

In this article, gender refers to the feeling of being either male or female.

A condition that describes a feeling of mismatch between your biological sex and your gender identity.

Gender identity is your personal sense of knowing which gender you belong to, or the way that you see yourself.

In this article, sex refers to male or female, the biological sex that you were born with.

A transsexual is someone with an extreme and long-term case of gender dysphoria, who seeks to alter their biological sex to match their gender identity.

Jay's story

In this video, Jay describes his transition from female to male and how he feels now.

Definition

Gender dysphoria is a condition in which a person feels there is a mis-match between their biological sex and their gender identity.

Biological sex means the sex that you were born with. It is determined by the presence of sex organs. These are:

  • the testes in males
  • the ovaries in females

Gender identity is your personal sense of which gender you belong to. For example, if a person sees themselves as female, then their gender identity is female.

For most people, their biological sex and gender identity are the same. However, some people experience a mis-match between them, and this is called gender dysphoria.

Gender dysphoria is a recognised medical condition. It can be a complex condition, and it affects different people in different ways. It is not a mental illness.

Gender dysphoria has no bearing on a person’s sexuality. Just like anyone else, a person with gender dysphoria may be hetrosexual, homosexual, or bisexual.

Cross-dressers (Transvestites)

Some people choose to occasionally dress as members of the ‘opposite’ sex, while not choosing to live full-time as a member of that sex. These people can be called cross-dressers, or transvestites.

Some cross dressing is associated with sexual arousal, and this kind of cross dressing can be called tranvestism. For other people, cross dressing is not associated with sexual arousal, and this can be called dual-role transvestism.

Transssexual people

Transsexual people or trans people have strong and long-lasting feelings of gender dysphoria.

Trannssexual people can be biological males who gender identify as females, or biological females who gender identify as males. Some transsexual people do not gender identify as either male or female, but feel they are both, or somewhere in between.

Many transsexual people seek to change their biological sex using hormone treatment and surgery. This is often known as “transitioning”.

A person who seeks to undergo, is undergoing or has undergone transition may be known as:

  • a trans man (female to male)
  • a trans woman (male to female)
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