How to Deal With Gender Dysphoria: Mental Health, Gender Expression & Medical Treatments

Co-authored by Inge Hansen, PsyD and Glenn Carreau

Last Updated: January 25, 2023 References Approved

If you identify as transgender, genderfluid, or nonbinary and experience gender dysphoria, know that there are many ways to cope and overcome it. Gender dysphoria is defined by feelings of distress over your assigned gender or your body's sex characteristics, often driven by the desire to present as a different gender. Read on for comprehensive advice on what to do when you’re feeling dysphoric, from strategies for coping in the moment to idenitfying long-term solutions and treatments. Keep exploring coping methods until you find some that work for you.

Things You Should Know

Express your emotions creatively and recite daily positive gender affirmations to boost your confidence. Make time for things you enjoy and practice self-care.
Avoid people and situations that will trigger your dysphoria, and develop coping strategies to minimize known triggers in your everyday life.
Start changing your gender expression, wearing clothes that reflect who you are, and using gender-affirming items to make you feel comfortable in your body.
Build a support network and seek counseling for your dysphoria. Consider whether medical options like hormone therapy or surgery might help.

Method 1

Method 1 of 3:

Improving Your Behavioral & Mental Health

1
Express your emotions through writing, art, and other outlets. Find an outlet that allows you to vent your feelings and release the negative emotions. Pick something that aligns with your interests; for example, if you like to write, try journaling or blogging about your experiences. If you’re artistic, express yourself through art projects. If you play an instrument, make music that reflects your true feelings.^{[1]
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- Others prefer to channel their emotions through exercise. Do physical activities like yoga, running, and biking. Try hobbies like horseback riding or swimming as well. Exercise is proven to boost your mood and help you feel calmer.
- Venting your emotions is cathartic! You can relieve stress and express yourself by channeling your negative energy into something productive.
- If you’re unsure where to start, just drawing or writing whatever comes to your mind on paper (however dark) can help.
2
Reaffirm your gender with positive affirmations. Recite daily affirmations to remind you to stay true to yourself and love the person that you are. Affirmations can help you start your day with a positive mentality. They’ll also make you feel more confident, even if you’re not ready to show the rest of the world who you are yet.^{[2]
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Research source} Examples of positive daily affirmations include:
- “My gender identity is valid, and so am I.”
- “My body does not define my gender or who I really am.”
- “I am important and worthy of happiness.”
- You can also affirm your identity by making small but positive changes like styling your hair differently, wearing a new accessory, or telling someone your name and pronouns.
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3
Practice self-care and make time for things you enjoy. Whether you watch a favorite show, play a game, listen to music, bake, or do something else, set aside time every day for an activity that makes you happy. Pamper yourself with regular self-care, too; eat food you enjoy, take a relaxing bath, or wear your comfiest clothes and cuddle up with a book.^{[3]
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- Doing things you love provides a healthy escape that can reduce your feelings of dysphoria.
- Other healthy self-care habits include eating a balanced diet and getting enough sleep every night.
4
Stimulate your senses as a distraction if you start feeling dysphoric. Stimulating your senses is a great way to reduce anxiety! Look for things you enjoy that you can smell, taste, touch, see, and hear. If you’ve been feeling anxious lately, keep something on hand that you can use to stimulate your senses in a pinch. When you experience extreme dysphoria, keep exercising your senses until you feel calm again.^{[4]
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- For example, you might smell a favorite perfume, listen to calming white noises, touch a soft blanket you love, or look at a cute picture of your favorite animal.
- There are other ways to fend off an intense dysphoria attack. Try meditating or practicing deep breathing exercises to calm yourself down.
5
Develop self-help strategies to help reduce your dysphoria. First, identify everyday things that make your dysphoria more intense. Then, find clever ways to reduce those feelings or avoid them entirely. For example, if looking at yourself in the mirror feels painful one day, turn on the shower and steam up the room, or cover the mirror with a towel. Other strategies include:
- Learn to contour your face with makeup.^{[5]
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- Snuggle up to a pillow so it covers your chest while you sleep.
- Put on a large, shapeless sweater that covers your body’s curves.
- Use a large loofah or sponge to bathe with.
6
Steer clear of triggers that might make the dysphoria worse. People who don’t respect your identity aren’t worthy of your time. More importantly, being around them can quickly trigger your dysphoria. Start by setting boundaries: tell those people how you prefer to be addressed and why it’s important. If they don’t listen, reduce the amount of time you spend around them as much as possible.^{[6]
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- Say something like, “I identify as a woman, and my name is Jean. When you call me Mike, it makes me feel depressed and unwelcome. I’m asking you to call me Jean and not misgender me anymore.”
- You might encounter people who deadname or misgender you, unknowingly or on purpose. You can’t always predict it, but you’re certainly allowed to avoid situations where you know it’ll likely happen.
- For example, a clerk deadnaming you at the bank might be beyond your control, but you can choose to skip a family dinner if you know that your transphobic cousin will be there.
7
Be proud of yourself and embrace your hopes for the future. Dealing with gender dysphoria is never easy, but it can help to reflect on how far you’ve come. You’re here, and that’s an amazing accomplishment in itself! Have faith in yourself and your ability to keep pushing forward. Remind yourself that you’re not alone, you’re stronger for having come this far, and one day you’ll feel like the person you want to be.^{[7]
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- Try making a list of things you’re hoping for in the future. It will help you have hope in your daily life.
- Listen to someone who has been through a similar experience to yours or read stories from transgender and nonbinary people online who have suffered from dysphoria and triumphed. You’ll get a dose of inspiration.
8
Build a support network of friends or family members. It can help to know there’s someone you can trust to listen to you and understand what you’re feeling. It’s also a huge stress relief to express yourself and talk to someone freely. Establish connections with trusted friends and family who know the real you and accept you wholeheartedly, and confide in them when your dysphoria gets you down.^{[8]
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- Not everybody has the luxury of an accepting family, and while it’s not fair, it also doesn’t mean you can’t build a support network. Look for trans, nonbinary, or genderfluid online communities to make connections!
- You might be surprised by the number of people looking for others to talk to about their dysphoria. As lonely as you feel, many other trans people feel the same.
9
Go to therapy or find a support group. A therapist can provide a safe space to discuss your dysphoria and emotions while giving you additional tools and strategies to help you cope. If a therapist is outside your means (or if you’d like additional help), try attending peer support groups that specifically deal with dysphoria and other LGBTQ+ issues.^{[9]
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MedlinePlus
Collection of medical information sourced from the US National Library of Medicine
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- If you look for a new therapist, choose one who specializes in transgender experiences or is at least trained to help LGBTQ+ clients.
- Talking to outsiders or a professional can help you gain perspective while allowing you to talk freely about your problems without worrying about their feelings on the matter.
- Only talk to someone—be it a friend, family member, support group member, or counselor—when you feel safe and comfortable doing so.

Method 2

Method 2 of 3:

Exploring Your Gender Presentation

1
Wear clothing that makes you feel comfortable and confident. Your appearance can have a huge effect on how intense (or manageable) your dysphoria is on a daily basis. Stock up your wardrobe with clothing that affirms your gender identity and helps you feel more at home in your body, and wear them regularly.^{[10]
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- If you don’t feel safe wearing gender-affirming clothes in public yet, do so when you’re at home alone. Alternatively, wear a piece of gender-affirming clothing under your everyday clothes.
- Learn how to dress for your body type and accentuate or conceal certain body parts as desired. For example, long shirts hide your hips while short ones enhance them.
- Since stores carry clothing fitted for cis bodies, consider having your clothes tailored to fit your body better, or learn to use a sewing machine and tailor them yourself!
2
Look for gender-affirming items that help your self-expression. Use binders, packers, STPs (stand-to-pee devices), and prosthetics for sex to help you present more masculine. Breast forms, panty girdles, and padded underwear can help you appear more feminine—as can learning to tuck. Regardless of gender identity, things like wigs or haircuts can also help your presentation.^{[11]
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- While you can’t wear these items all the time, they can help you with dysphoria in public or other short-term situations.
- These items can be expensive, but they’re a good investment because they’ll dramatically affect your appearance (and self-esteem). You can also buy some of these second-hand for a reduced price.
3
Take your time and explore your gender in whatever way feels right. It's easy to pressure yourself to present yourself the way other people want you to when there are so many beauty standards and stereotypes. Let go of stereotypes and focus on what makes you happy! Remember: there’s no rush to figure out what you like. Experiment with different styles until you find something that feels like you.^{[12]
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- Remind yourself that nobody has control over things like body shape and bone structure. People come in all shapes and sizes! Accept your body and focus on the things you can change.

Method 3

Method 3 of 3:

Seeking Medical Treatments

1
Get a medical evaluation from a doctor experienced in transgender care. For some people, changing their outward appearance isn’t enough to get rid of dysphoria. The first step is getting a medical evaluation if you feel you need medical treatment for your dysphoria. Your doctor can formally diagnose the dysphoria and devise a treatment plan that works for you.^{[13]
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- Medical treatment for gender dysphoria usually means hormone therapy or gender reassignment surgery (or both).
- As part of the evaluation, your doctor will also ensure you don’t have any other medical conditions that might affect the treatment.
- Expect a physical exam and lab tests. Your doctor will also need to establish your medical history and any harmful treatments you may have tried in the past (like self-surgery or unprescribed hormone use).
2
Consider either feminizing or masculinizing hormone therapy. Hormone therapy induces changes to help your body match your gender identity. Feminizing hormone therapy involves blocking your body’s testosterone while taking estrogen to develop feminine secondary sex traits, while masculinizing hormone therapy does the exact opposite. Talk to your doctor about hormone therapy if you feel it would help.^{[14]
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- Your doctor can also help you weigh the risks and benefits of gender-affirming hormone therapy, so you can decide if it’s right for you.
- You can decide how much change you want from hormone therapy! Some might want to become as feminine or masculine as possible, while others might only want to minimize certain traits like breasts or facial hair.
3
Explore surgeries to change your face, chest, and genitalia. Gender reassignment surgery is actually a series of procedures that can help you transition to your self-identified gender. Facial reconstructive surgery can make your face look more feminine or masculine; chest (or “top”) surgery can remove or enhance your breast tissue; genital (or “bottom”) surgery can transform and reconstruct your genitalia.^{[15]
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- Discuss all the possibilities with your doctor to figure out the best course of action.
- Remember that you can do as much or as little as you want—just because you do a single surgery doesn’t mean you need all of them. You (and only you) get to decide what changes your body needs to feel complete.
- Surgery is only one of many ways to change your gender presentation. It’s tremendously helpful and even life-saving for many trans people, but you don’t need it to socially transition.
4
Use vocal and communication therapy to change your voice. If the sound of your voice triggers dysphoria, consider getting voice therapy. It will help you adjust both the pitch and pattern of your voice; you’ll learn speech patterns that suit your true gender, so your voice will sound closer to the way you want it to. ^{[16]
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Cleveland Clinic
Educational website from one of the world's leading hospitals
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- You can start the process on your own! Read aloud to yourself (or sing) and try to sound more masculine or feminine while speaking. Use a voice pitch analyzer app to check your pitch and speaking pattern.
- Testosterone will naturally lower your voice to a male range, but estrogen for trans women won't do the same—so this practice is helpful even if you haven’t started hormone therapy yet!
5
Make a plan to tackle coming out and transition goals if you have them. Research everything you’ll need to make your transition official. This can include changing your name legally, and deciding how to come out, whether you want to come out as transgender or socially transition as a nonbinary person. If you want to transition medically, look for a GP (general practitioner) doctor who can help you as well.^{[17]
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- You don’t necessarily have to transition as a part of coping with gender dysphoria. While many trans and nonbinary people transition in some way, it’s just one solution; there are many other methods of coping.

Expert Q&A

Question

What triggers your gender dysphoria?

Shahpar Mirza
Community Transgender Expert
Shahpar Mirza is a Community Transgender Expert who began his transition from female-to-male (FTM) starting in 2016. He has had hormone replacement therapy since 2017 and underwent a double mastectomy (top surgery) in April 2018. Through experiences such as working for the Queer Student Resources Center at Stanford University, he is passionate about spreading more awareness about the transgender community and clarifying common misconceptions people may have. He received his BS in Product Design from Stanford University in 2019.

Shahpar Mirza

Community Transgender Expert

Expert Answer

Try to identify the root of your gender dysphoria. For example, if your voice and chest triggers your dysphoria, you can take steps to change those things.
Question

How can I help my child with gender dysphoria?

Inge Hansen, PsyD
Clinical Psychologist
Dr. Inge Hansen, PsyD, is the Director of Well-Being at Stanford University and the Weiland Health Initiative. Dr. Hansen has professional interests in social justice and gender and sexual diversity. She earned her PsyD from the California School of Professional Psychology with specialized training in the area of gender and sexual identity. She is the co-author of The Ethical Sellout: Maintaining Your Integrity in the Age of Compromise.

Inge Hansen, PsyD

Clinical Psychologist

Expert Answer

The best thing you can do is to listen to and believe your child. They may or may not be ready for (or interested in) any type of medical transition, so it’s okay to go slow and take things step by step. Finding community with other families who have trans kids can also be a great help, and if needed, also find a gender-affirmative therapist.
Question

Is there a difference between gender identity and gender presentation?

Inge Hansen, PsyD
Clinical Psychologist
Dr. Inge Hansen, PsyD, is the Director of Well-Being at Stanford University and the Weiland Health Initiative. Dr. Hansen has professional interests in social justice and gender and sexual diversity. She earned her PsyD from the California School of Professional Psychology with specialized training in the area of gender and sexual identity. She is the co-author of The Ethical Sellout: Maintaining Your Integrity in the Age of Compromise.

Inge Hansen, PsyD

Clinical Psychologist

Expert Answer

Gender identity is our internal experience and naming of gender, while our gender expression is how we present our gender through clothing, behavior, personal appearance and other characteristics. Both of these are separate from sex, which has to do with anatomy and chromosomes.

Warnings

If you feel stuck, hopeless, or find yourself considering suicide, please reach out for support. The Trans Lifeline (877-565-8860) or the Trevor Project (866-488-7386) can help you.

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