Transgender individuals face significant health disadvantages called Transgender Issues and Gender Dysphoria. According to a large survey of transgender people in the US, many do not seek medical treatment because of previous negative medical experiences, fear of mistreatment by health providers, or inability to afford treatment. A majority of transgender people experience mental health problems; however, transgender identity itself is not a psychological disorder but a normal variation in gender identity. Gender dysphoria, on the other hand, is considered a mental health condition. This condition and its medical and nonmedical treatments are described in the rest of this article.


Transgender Issues and Gender Dysphoria


What are Gender dysphoria and important symptoms?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gender dysphoria is characterized by an incongruity between one’s assigned gender and the experienced or expressed gender. Gender dysphoria is associated with much distress and dysfunction, as indicated by the presence of two or more of the following six symptoms:

  1. The incongruity between one’s gender and sex characteristics.
  2. The desire to eliminate one’s sex characteristics.
  3. Believing one’s inner experiences are typical of another gender.
  4. The desire to be a different gender.
  5. The wish to possess sexual characteristics associated with another gender.
  6. Wanting to be treated by others as though belonging to a different gender.

Interventions for gender dysphoria include medical and nonmedical options, as described below.

Gender Dysphoria Nonmedical treatment

Psychological treatments for gender dysphoria often emphasize exploration and support.
Specifically, therapists assist patients in self-exploration of their gender identity, self-acceptance, building social support, understanding their sexuality, and coping more effectively with daily stressors.  In addition, therapists screen for various psychological disorders, such as anxiety and depression, and treat these conditions with therapy and/or medications.
The goal is to help patients gain confidence and clarity as they explore their feelings about their gender and continue along their journey of self-discovery.
Family therapy and couples’ therapy are often helpful too since a safe and affirming environment is crucial for reducing mental health problems in these individuals.
Beyond therapy, support groups, both for the patient or the patient’s family, maybe recommended too.

Medical treatment for Transgender Issues and Gender Dysphoria

Medical care consists of hormone therapy and/or surgery: Hormone therapy is used to feminize or masculinize a person’s body, to different degrees, depending on the individual’s wishes. Masculinizing hormone therapy suppresses female secondary sex characteristics (e.g., breasts) while inducing the development of male secondary sex characteristics (e.g., facial hair).  The hormone preparations contain testosterone—given as an injection, topical gel, patch, etc. In contrast, feminizing hormone therapy induces the development of female secondary sex characteristics while suppressing male secondary sex characteristics.  The hormones used include testosterone blockers and estrogen.  Some examples are estradiol, progesterone, medroxyprogesterone acetate, and finasteride. After receiving hormone therapy, some individuals decide to have surgery as well, to physically modify their internal and/or external genitalia. For instance, male to female surgery involves removal of the penis and testicles, and construction of a vagina.  Female to male surgery, on the other hand, involves the removal of the uterus and vagina, and often the construction of a penis and scrotum. Other surgeries commonly requested, aside from modifications of the genitalia, including the likes of breast augmentation, chest reconstruction, facial feminization, hair transplants, body contouring, and voice surgery.

How to find the right provider?

There is no one-size-fits-all treatment for gender dysphoria.  If you suffer from gender dysphoria, it is essential to seek a provider who is not only knowledgeable in the benefits and risks of various approaches to reducing gender dysphoria but also willing to work with you to create an individualized treatment that best meets your specific needs and goals.