The journey is different for everyone, but when the sex assigned at birth differs from your gender identity, it can cause confusion, anxiety and depression that may need professional help.
The term for the discrepancy between sex assigned at birth and gender identity is called gender dysphoria which, according to the American Psychiatric Association, can begin to manifest in childhood, after puberty with the onset of secondary sex characteristics, or later.
“It is important to distinguish between these two terms as they are not the same,” said Dr. Derek Fenwick, a licensed clinical psychologist with Young Adult Services – The Right Track/LGBTQ Specialty at the Institute of Living, part of the Hartford HealthCare Behavioral Health Network. “One’s gender identity comes from an internal sense of one’s gender, while sex assigned at birth is the legal marker assigned by a physician based on external genitalia.”
Not everyone who identifies as something other than cisgender, or those whose gender identity matches their sex assigned at birth, will experience gender dysphoria, Dr. Fenwick said.
“We know that every person’s gender journey is unique to them. Individuals may identify as transgender, gender fluid, gender non-conforming, gender variant or something else without having the psychological distress,” he said. “I always like to inform people that gender non-conforming does not equal gender dysphoria.”
But signs of gender dysphoria can include:
- Depression.
- Anxiety.
- Anger.
- Body dysmorphia.
- General internal distress and confusion.
“This can lead to social isolation that further exacerbates one’s depression and anxiety,” Dr. Fenwick said.
Other factors that can impact personal levels of gender dysphoria for individuals include their culture, religion, family beliefs and societal factors.
“We talk about the analogy of a fish swimming upstream in a downstream world,” Dr. Fenwick said. “The individual who identifies as gender fluid or gender non-conforming constantly battles against societal expectations in a binary world. This may inhibit their ability to feel as though they can openly share their identity without facing discrimination, stigma and outright rejection.”
What will help, he said, is when society allows individuals to openly explore their gender identity in safe, affirming spaces. This begins as early as age three, when gender begins to establish itself in most people.
“We need to allow children to tell us what their gender identity is before placing them in a male or female binary box,” Dr. Fenwick said. “We need to remove our idea of a binary world in which everything is male or female because we know this is not the case. Allowing gender diverse individuals to openly explore their sense of self without fear of discrimination, rejection and stigma could help alleviate gender dysphoria for some.”
Other important ways to individuals can help reduce their own sense of gender dysphoria include: social transition, or wearing clothing or adopting a hairstyle that matches their gender identity; and seeing or joining other gender variant individuals in connecting and forming a supportive community.