Facts to Know:
- Nonconformity in gender identity and expression is a matter of diversity, not disorder.
- Gender identity and sexual orientation are two separate components of a person’s identity.
- Transgender, gender nonbinary, and gender nonconforming individuals and their families face stigma and discrimination, which increases risk for anxiety, depression, non-suicidal self-injury, and suicide.
What is Gender Dysphoria?
Gender Dysphoria is a term used to describe the clinically significant distress caused by an incongruence between one’s gender identity and one’s gender expression and/or physical sex characteristics. It is important to know that not all people whose gender identity varies from their sex assigned at birth experience gender dysphoria. Estimates vary, but approximately 0.5% of adults and 2.7% of adolescents are thought to identify as transgender and gender nonconforming. Gender dysphoria can be present in childhood and worsen during puberty, but it can also emerge later in adolescence or adulthood. For people who do experience gender dysphoria, the discomfort can be overwhelming.
Gender-affirming psychotherapy, potential changes in gender role and expression, and access to gender-affirming medical interventions, such as hormones or surgery, can relieve gender gysphoria and improve overall mental health and well-being.
In order to meet criteria for a formal diagnosis of gender dysphoria, the distress associated with the incongruence between one’s gender identity, gender expression, and physical sex characteristics needs to be significant and/or associated with impairment in social, occupational, or other areas of functioning. Symptoms of Gender Dysphoria need to be present for at least 6 months for such a diagnosis. Symptoms may include:
- A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics
- A strong desire to be rid of one’s primary and/or secondary sex characteristics
- A strong desire to be of the other gender
- A strong preference for the toys, games or activities stereotypically used or engaged in by the other gender (in children)
- A strong rejection of toys, games and activities typical of one’s assigned gender (in children)
Gender Dysphoria is best diagnosed by a mental health professional combining a thorough interview and completion of objective measures which consider an individual’s history, concerns, and specific needs.
Gender-affirming psychotherapy provides a safe environment in which children, adolescents, and adults can safely explore their gender identity and find a comfortable gender expression. The goal of gender-affirming therapy is to facilitate identity development across the lifespan, assist individuals and their families in coping with any social stigma they may encounter, and promote resilience.
A family based approach is also highly recommended for children and adolescents with gender dysphoria. Family approaches emphasize the role of parents and other family members in treatment. This can include family sessions or parent groups that empower family members with tools to help in improving their relationhip and communication within the family and to support the gender journey of their child.
Gender affirming medical interventions are available that may help alleviate gender dysphoria. The decision to pursue medical interventions is highly personal, and is best evaluated in the context of overall identity development and wellbeing. Consultation with an interdisciplinary team of healthcare professionals specializing in transgender care may be helpful in making a fully informed decision that meets the individual’s needs.
- Puberty suppression can be used to delay puberty in children with gender dysphoria. This intervention allows youth more time to explore their gender identity and consider potential future interventions to physically masculinize or feminize.
- Hormone therapy is often used to assist in the development of physical sex characteristics that are congruent with a person’s gender identity.
- Gender-affirming surgeries such as chest surgery (breast reduction, removal, or augmentation), genital surgery, or other surgeries to masculinize or feminize one’s body and appearance (e.g., facial feminization surgery) may be important to alleviate gender dysphoria.
How Can I Receive Treatment for Gender Dysphoria at Columbia?
The Gender Identity Program is a specialized service that offers treatment geared for the needs of transgender, nonbinary, and gender nonconforming individuals and their families. We provide evaluation (including referral for medical interventions) and affirmative psychotherapy for gender dysphoria. We work as an interdisciplinary team to ensure access to medically necessary interventions and coordination of care across providers.
Search our providers for a therapist or psychiatrist with expertise in Gender Dysphoria.
To make an appointment, please call (212) 305-6001 or submit our online form.