Gender Dysphoria Treatment

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Gender dysphoria is a term which describes the feelings of confusion or distress from a mismatch between your biological sex and your gender identity. Sometimes referred to as gender identity disorder (GID) or transgender, gender dysphoria relates to the gender identity that you feel yourself to be, as opposed to your biological sex based on anatomical appearance.

At Priory, we understand that coming to terms with gender dysphoria and feeling comfortable in your gender identity is vitally important to your emotional health and mental wellbeing. We have a dedicated Gender Dysphoria service at Priory Hospital Roehampton, where young people (aged 17 and over) and adults alike can receive psychotherapy services. These will help to understand more about the condition and how it makes you feel.

Biological sex and gender identity

While biological sex and gender identity are aligned for many people, you may feel as though you have been given the wrong body that you don’t identify with. This could be a person with male anatomy identifying as a female and vice versa, or not feeling as though you identify with either gender. This can cause significant stress and disruption to your daily life. Gender dysphoria isn’t always about identifying with the opposite sex; there has been an increased awareness in recent years of gender fluidity and identifying as non-binary. This can all be discussed during assessment and whatever you feel or identify with can be worked through in the specialist therapy.

The internal conflict between how society expects you to act and behave in accordance with your biological sex, in contrast to the gender in which you identify, can often make you feel uncomfortable, and affects people in different ways. There are many ways a person can express their identified gender, including chosen behaviours, dress and self-image, with dressing in the gender in which you identify particularly common. You may be unsure whether your identity would be best expressed materially, such as by wearing opposite-gender clothing (transvestism); or whether it is linked to a type of sexuality (autogynaephilia), or an underlying gender identity (gender dysphoria). A detailed gender dysphoria assessment will help clarify your issues and concerns.

If you have gender dysphoria characterised by persistent and strong feelings that you are in a body in which you don’t identify with, then you may live as a transgender or transsexual person. You may consult gender identity clinics about the option of surgical treatment or hormone therapy to align your physical appearance with your gender identity.

These wishes are usually accompanied by an inclination for social transitioning. This means you may adopt the gender pronouns associated with the gender you identify with, potentially changing the gender you are registered as on your official documents, such as your passport.

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Treatment for gender dysphoria at Priory

Treatment options will vary depending on your needs. The level of treatment required will be assessed individually, to help make you feel comfortable in your gender identity.

Much of the mental health treatment process will depend on how persistent and intense the feelings of dysphoria are, with Priory’s therapy services aimed at guiding you through any associated emotional difficulties you might have with gender dysphoria.

Tailored psychotherapy sessions can explore what it means to be any gender and the discomfort or unhappiness associated with gender dysphoria. The ultimate goal is to provide and promote ongoing support so that you can live out your life in your preferred gender identity. If your gender identity is less fixed, then specialist psychotherapy may be more helpful than physical treatments.

While talking through your feelings surrounding gender identity in an understanding environment may be enough to reduce any distress associated with your biological sex, some may wish to seek out further treatment options. If you are thinking of pursuing, or are currently undergoing, physical treatments at a gender identity clinic, then mental health support can complement this. One-to-one counselling and talking therapies will have an increased focus on any emotional difficulties or anxieties you may be experiencing.

Please note, in cases where those who have already transitioned are wanting to go back to their biological sex (referred to as transgender dysphoria), the specialist gender dysphoria psychotherapy may not be the best option for treatment support. Other services will be better designed to specifically deal with the complexities of these particular struggles.

Dedicated psychotherapy service at The Priory Hospital Roehampton

Priory Hospital Roehampton offers a dedicated psychotherapy service to support people with gender dysphoria. The service is available for anyone with gender dysphoria, to help understand what you are experiencing and why. This is regardless of any physical treatments that you may currently be undergoing or are thinking about.

The aim of the psychotherapy treatment is to:

Provide a supportive thinking and enquiring space to consider gender and how it affects us
Help to reduce the amount of distress caused by gender or gender preoccupation in everyday life
Enable you to tailor-make your gender identity, as relevant to you
Explore and widen a gender repertoire without restricting to binary gender models
Give you stability in your bespoke gender identity, irrespective of biological sex or gender framework

You will receive an initial assessment, followed by individual therapy sessions and possibly a weekly therapy group. The service is led by an experienced consultant psychiatrist who is gender aware and transgender-friendly, with over 15 years' experience of working therapeutically with people who have gender identity issues.

This page was clinically reviewed by Dr Az Hakeem (MBBS, FRCPsych, MSc, M.Inst.GA) in June 2020.

What is gender dysphoria?

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Gender dysphoria refers to an inner conflict between a person’s biological sex and the gender in which they identify. This can cause significant emotional distress and make you feel uncomfortable with your given gender to the point where carrying out the expected roles and traits of your biological sex.

Children, young people and adults can have gender dysphoria, although puberty is often the primary stage at which the associated feelings intensify or are removed completely. Some people with gender dysphoria find discussing their feelings and understanding of their gender identity can be enough to help them feel comfortable with their biological sex, without the need for any physical treatments

The state of mind associated with gender dysphoria can be expressed in many different ways, allowing you to show the gender you feel you belong to. This could be through a use of clothes to cross-dress, hairstyles and even openly wanting to be addressed by name and pronoun in accordance with the gender you identify with. Children will often display similar expressions of gender identity, including regularly stating they will grow up as a member of the opposite sex, or will request to have their appearance styled in the gender in which the most identify.

The particular challenges you may face if you are diagnosed with gender dysphoria include being stigmatised or discriminated against by other members of society, which can make you feel lacking in self-confidence and at greater risk of developing mental health disorders such as anxiety and depression. If your child has gender dysphoria, they may face bullying or harassment at school in an attempt to pressure them into adopting a persona or dress which is more akin to their biological sex.

You may also encounter difficulties at school or work due to the enormity of the emotional distress gender dysphoria can cause. This may mean everyday tasks become more difficult as you struggle to feel comfortable in your biological sex. The condition can also have a significant impact on relationships, whereby friends and partners may struggle to adapt to the changes in your lifestyle as you work towards changing gender for example.

Gender dysphoria differs from gender non-conformity, in the sense that the latter refers solely to behaviour. Gender non-conformity refers to behaviours you may display which don’t appear to match with your biological sex, and the term doesn’t relate to anything around your mental state, feelings or emotions.

Signs and symptoms of gender dysphoria

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While there are no physical symptoms of gender dysphoria, its effect on the mind in terms of the range of emotions experienced and display of behaviours can cause significant disruption to your daily life.

The common emotional symptoms of gender dysphoria can include:

Feeling that your gender identity does not align with your biological sex
Being more comfortable when in the role of your preferred gender identity
Having a strong desire to hide or get rid of the physical signs of your biological sex

Signs of gender dysphoria in children

The signs of gender dysphoria can appear in early childhood, where your child may request items of clothing or a haircut which isn’t perceived as representative of their biological sex. Taking a dislike to activities and play socially regarded as being preferable to their biological sex may be indicative of them growing up and working through their gender identity, and may not continue into adulthood.

Some of the most common signs of gender dysphoria in children include:

Wanting to wear clothes typically worn by the opposite sex
Refusing to take part of not having preference for games and activities typically associated for their gender
Going to the toilet in a manner unusual for their biological sex, such as a boy sitting down to use the toilet, or a girl standing up
Expressing hope that their genitals will change to the opposing gender
Becoming distressed at visible physical changes seen during puberty

Signs of gender dysphoria in adults

When signs of gender dysphoria are observed past puberty and into adulthood, it often confirms that the behaviours displayed in childhood weren’t just part of growing up. If you are an adult with gender dysphoria, there is less confusion regarding your gender identity and how you want to be perceived by others.

Having more certain feelings and active behaviours surrounding the conflict of identity are often employed to help you feel more comfortable about how you want to approach the situation. Some of the most common signs of gender dysphoria in adults include:

Fully aware that your biological sex conflicts with your gender identity
An intense desire to change or remove the genitalia or aspects of your anatomy associated with your biological sex
Feeling most comfortable when living life in the gender role you prefer
Wanting to hide or alter physical anatomy of your biological sex, such as breasts if you identify as male and muscle definition if identifying as female

You may find it hard to deal with your gender dysphoria, particularly when you wish to open up to others about your gender identity, and it can be common to suppress your feelings and attempt to live the life of your biological sex simply to avoid any potential negative feedback or pressure to conform to your biological sex.

Due to the social stigmatisation which can take place against those with gender dysphoria, the resulting feelings of isolation and low-self-esteem can be very distressing, and may lead to you experiencing depression, self-harm or even considering suicide.

What causes gender dysphoria?

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For details of how Priory can provide you with assistance regarding mental health and wellbeing, please call 0800 840 3219 or click here to submit an enquiry form. For professionals looking to make a referral, please click here