A quick note: This blog post uses some terms that might be unfamiliar. We’ve used links to define them in parentheses.

What is dysphoria?

Many, but not all, transgender people  experience dysphoria. Here is a formal definition of dysphoria from the UK’s National Health Service: “Gender dysphoria is a condition where a person experiences discomfort or distress because there is a mismatch between their biological sex and gender identity. Gender dysphoria is a recognized medical condition, for which treatment is sometimes appropriate. It is not a mental illness.” In that definition, treatment commonly refers to transition that can change the body, such as hormones and surgery, which are supervised by a medical professional. Because everyone experiences dysphoria differently, medical transition may not be right for some trans people, and it’s important that all trans people take transition at their own pace. This comic discusses how one trans person found the right pace for their transition. Gender dysphoria is not something that is necessarily “fixed” or “cured” by medical interventions. Additionally, medical interventions for dysphoria are not considered necessary by many health insurance providers. So, due to their high costs, these options are financially out-of-reach for many trans people who need them.

Some trans people don’t experience dysphoria at all, and for some trans people, dysphoria is more about the discrepancy between their identities and other’s perceptions.  Here is one trans person’s account of what dysphoria is like: “Body dysphoria feels like the worst-fitting outfit you’ve ever put together, but you can never take it off. Or sometimes it’s more like a pebble in your shoe, or a belt that digs into your side, or a tiny thing that is just noticeable enough to throw your day off. Some days I wake up and it’s just there. Some days it’s because I tried to fit my not-so-masculine body into my masculine clothes, and the parts that didn’t fit made me want to scream and disappear and puke up all my guts at the same time. It can grow into a scary place where I don’t know if my body belongs to me, and I feel e this.like I’ve been detached from something essential and am about to wash out to sea. Maybe a picture makes me hate and fear the body I don’t have because it’s not the body I wish I had. Maybe I think that the someone I desire won’t desire me because I don’t look like all the handsome cisgendered men they probably grew up loving. (Click here for the definition of cisgender.) Maybe it doesn’t make sense why I feel these things, but I still feel them and they still hurt.”   Dysphoria can create disparate health and wellness outcomes, and therefore personal and academic outcomes for those who experience it. 

How do trans people cope with dysphoria?

Although dysphoria can be challenging and painful, there are many ways trans people have learned to cope. Some trans people with dysphoria seek medical treatment to make their bodies match their identities, some seek mental health services to help cope with dysphoria, and some use coping skills they’ve learned. One recent study found that transmen’s mental health was improved by chest-binding, which helps transmen’s chests appear flatter and more masculine. Here are 25 ways that the author of the quote above copes. For a lot of trans folks, one of the most valuable tools to cope with challenges like dysphoria is friendship. In one survey of MTF trans youth, ninety-eight percent of respondents stated that friends were “somewhat” or a “great deal” helpful for emotional support. (Here is the definition of MTF.)

…Support from people like you!

You’ve probably heard a lot about trans people’s struggles with mental health. What we don’t talk about enough is that support from family, friends, and partners can greatly reduce the risk of trans people’s poor health outcomes. For example, among trans people, “social support has been linked with lower levels of both depression and anxiety and fewer suicidal behaviors.” It’s also been positively associated with self-esteem and quality of life. That’s because social rejection is the cause of a lot of trans people’s poor health outcomes in the first place.  Creating a campus atmosphere of understanding, inclusion and acceptance can go a long way in supporting our trans peers.

So how do you support a trans person dealing with dysphoria?

Because dysphoria is about the discrepancy between someone’s sense of self and their body or other people’s perception of their gender, the best way to support your transgender friend or partner through dysphoria is by (1) seeing their gender the same way they do, and (2) communicating that (as well as your communicating overall care for them, of course!)

Sometimes, cisgender people have to challenge their own assumptions, thoughts, and unconscious beliefs about bodies and identities. For example, we are all socially conditioned to associate certain physical characteristics with maleness and/or femaleness, and these associations are deeply ingrained. However, being supportive to a trans person (particularly one you are intimate with) means actively working to undo those associations. Instead affirm that your friend or partner truly IS the gender they identify as regardless of their voice, mannerisms, or body shape.

That core belief, and your willingness to challenge the thoughts you have that are in conflict with it, is the foundation of supporting any trans person in your life through dysphoria.

Tips to communicate respect for trans folks and help alleviate dysphoria:

• Use the name and pronoun the trans person prefers.
• Don’t disclose someone’s trans identity to others without their consent.
• Respect trans people’s decisions about if, when, and how to transition.
• When you’re with others who know the trans person’s identity, correct them if they get names and pronouns wrong.
• If you’re dating someone, ask what words they want to use to talk about their bodies (for example, chest vs. breasts).
• Use compliments and descriptors that reflect your friend’s or partner’s gender identity. For example, if your partner identifies as a masculine person, they might prefer to be called  “handsome” rather than “pretty.” Luckily, “fabulous” and “smart” are gender-neutral.  
• When you are struggling to see your friend or partner the way they want to be seen, it can be best to process this with a cisgender ally rather than the trans person. But be sure to do this in a way that respects the trans person’s privacy. For example, check in with them first about who to process with.
• If dating a trans person (or anyone really,) practice consent consistently and carefully. Consent is important in all relationships, but it’s especially important in trans relationships because, as we’ve discussed here, trans people’s relationships with their bodies can be complicated.

More resources

Here’s more information on how to support trans folks.

For more content on healthy relationships in the LGBTQ community, check out this online course offered here at UNC.

If you are transgender and are struggling with dysphoria, social support, or anything else, contact the LGBT Center here on-campus or Trans Lifeline.

Anole Halper is a graduate intern with Student Wellness. They are getting a dual Masters in social work and public health. Their research interests include sexual violence prevention and LGBTQ health equity issues.