Do you need to have gender dysphoria to be transgender?

One question that frequently comes up on trans support boards like Reddit’s AskTransgender is whether a person needs to experience gender dysphoria in order to be transgender. Most commonly, a person feels strongly that they are indeed transgender for various reasons, but worries that their apparent lack of dysphoric feelings means that they aren’t “really” trans. This process of questioning can also be complicated by trolls across the internet who seem to believe they need to protect the very concept of transness by keeping out so-called “trans-trenders” who don’t meet some particular criterion (as if trans people have ever been considered to be more trendy, popular, or desirable than cis people).

This self-evaluation often weighs heavily in their decisions regarding their gender, such as whether or not to start transitioning, and these people deserve useful guidance. I have some experience in this area: before I transitioned, I didn’t think I had gender dysphoria at all – but I chose to start HRT anyway. This turned out to be the right choice for me even though I didn’t believe I was experiencing dysphoria at the time, and similarly situated trans people may also find that this is a positive choice in their lives. Here’s what this process looked like in my case.


Why I didn’t recognize that I was feeling dysphoria

Prior to transitioning, I didn’t believe I was dysphoric. In fact, I was – I just didn’t know what it felt like or how to recognize this. I’m very short with a slight build and almost no body and facial hair, and after growing my hair out, I was frequently read as a woman in public. For that reason, it was easy to feel at least somewhat comfortable in my body and in public.

However, I didn’t realize that I was experiencing the mental effects of dysphoria – in my case, flattened and irregular emotions, irritability and high levels of daily stress, a general feeling of hopelessness and pointlessness to life, and a kind of depersonalization/derealization that left me feeling displaced and disconnected from the world. Because I had been feeling this way my entire life, I didn’t know that this wasn’t normal for me or that it was possible for me to feel otherwise.

When I started HRT, I experienced a lifting of these symptoms within a week or two – and the difference was nothing short of miraculous. Life up to that point had felt like being separated from the world by a shattered and distorted glass. For the first time, it was like I came into proper alignment with reality – like I was feeling the world as it’s meant to be felt. I discovered the many textures of emotion that I’d never known before, a sense of purpose and fulfillment and belonging in my own life. I had never felt this kind of happiness before, a sense of simple joy and comfort and rightness that had eluded me for 23 years. It made me feel like myself for the first time, and being myself was finally a good thing.

If, before choosing to start HRT, I had known that I could expect these changes, I would have been highly certain that this was right for me. I would have known that I actually was experiencing gender dysphoria, and that I should probably pursue the typical treatment for this. However, without knowing that these changes were possible and would happen with HRT, I could have easily fed myself doubts forever and delayed transitioning indefinitely.

So: Under an assumption that gender dysphoria is necessary for a person to be transgender, crucial gender-related decisions such as transition may require information that cannot be gathered without first actually making the decision. But contrary to this assumption, accepting my transness and pursuing my desired gender was still the best choice for me. Choosing to start transitioning even though I didn’t believe I was experiencing gender dysphoria led to a clearly better outcome for me. It fixed things for me that simply could not have been fixed otherwise. Conversely, had I decided that my apparent lack of dysphoria meant that I wasn’t “really” trans and shouldn’t transition, this would have led to a much worse outcome.


Why I chose to start HRT

If I thought I wasn’t experiencing gender dysphoria, why did I elect to start medically transitioning? A number of lines of reasoning led me to believe that this was a worthwhile choice. Although I was comfortable with my body at the time, I realized that my body would not always stay that way. I imagined how I would feel in 5 years, 10 years, or 40 years, gradually feeling my body become more and more clearly masculine – growing and losing hair in all the wrong places, my body shape getting further away from what I wanted it to be, and knowing that I could have chosen otherwise but didn’t. When I envisioned this awful future, I knew that this path wasn’t right for me at all.

I had spent a couple years telling myself that I could wait to start HRT until later in my life – that I could hold off for now, and only think about starting hormones once it became really necessary due to reaching a point of physical masculinization where I just couldn’t stand it anymore. But I realized: If I’m going to do it eventually, then why wait? Why pack on years of going in the wrong direction, and end up spending even more years to reverse? Knowing what the right trajectory is for me, why not just get myself on that trajectory starting now?

Finally, I simply couldn’t settle for just never knowing what HRT was like. To be clear on the degree of commitment here, if you decide you don’t like HRT, you can easily stop after a month or two with little or no permanent changes. To me, this was at least worth trying. How would I feel if I went the rest of my life without ever finding out what this does for me? That wasn’t acceptable to me – so I tried it, and soon realized this was one of the best decisions of my life.


Considerations other than dysphoria

Not every trans person feels a strong, clear aversive and negative feeling toward their body and its features. For those who don’t experience this, but still identify more closely with a gender other than the one they were assigned, there are plenty of other ways to clarify what you want out of gender in your life. For instance:

  • If you could have chosen to have a male or female body from birth, which would be preferable to you?
  • Do you feel that being one gender is better for you than being another? Which gender do you feel happiest in, and which gender do you feel less comfortable in?
  • Do you find yourself worrying that something could mark you as “not trans” or exclude you from transness? (Cis people typically don’t desire to be included within transness.)

Being transgender doesn’t always mean experiencing a vivid repulsion about aspects of your body and gender – it can also reveal itself as simply having more positive feelings toward the idea of living as another gender. Ultimately, this isn’t about who does or doesn’t fall within a given definition of “transgender”. This is about which choices are best for an individual as they navigate gender and its role in their life.

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About Zinnia Jones

My work focuses on insights to be found across transgender sociology, public health, psychiatry, history of medicine, cognitive science, the social processes of science, transgender feminism, and human rights, taking an analytic approach that intersects these many perspectives and is guided by the lived experiences of transgender people. I live in Orlando with my family, and work mainly in technical writing.
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8 Responses to Do you need to have gender dysphoria to be transgender?

  1. Allison says:

    FWIW, I know a trans woman who has been fully transitioned (incl. SRS) for several years.

    She says she never felt any kind of dysphoria, and she never felt like a woman (and still doesn’t.) But she’s happier than ever now that she’s transitioned, despite the down sides (mainly dating.) She feels more than ever that transitioning was the right thing.

    (BTW, I also don’t feel like a woman, but I’ve socially transitioned and am trying to get things moving for my SRS, and it’s the first time in my life I feel just plain happy to be me.)

    • Ana Alise says:

      I experienced the same sensation you described after starting HRT sadly I had to stop after a heart attack eight months into the process. As you have probably guessed yes I am an older person who is very thankful for the insight you are providing on these topics.

  2. Ana Alise says:

    I experienced the same sensation you described after starting HRT sadly I had to stop after a heart attack eight months into the process. As you have probably guessed yes I am an older person who is very thankful for the insight you are providing on these topics.

  3. Allison Wunderland, LLC says:

    Given a gender choice I would have picked cis-F. I note often, “I lost the gender crap-shoot.”

    Of late I’ve been reading about natal development, the two windows — 8 wks and 15 wks where the otherwise default female is flooded with testosterone. At week 8 this causes the genital tubercle to form a phallus and scrotum. At week 15 this flood does “gender mapping” in the brain, gender identity.

    Two possible complications with this testosterone flood: The mother may not provide sufficient testosterone. Or the fetus may be resistant to the effect of testosterone.

    One outcome of these deficiencies is the “inter-sex” child, ambiguous genitalia. Other possible outcomes are the development of male genitalia and a female gender-mapping. The field of human embryology notes a continuum of gender expression is possible and indeed manifests in the population.

    Back before we stepped out of the closet, this fixated obsession with “female” presentation was felt by myself to be a sort of perversion, “Gender Identity Disorder” or “paraphilia” . . . Mostly I couldn’t figure out that if I feel “female” but I’m not sexually oriented toward males, that this must be perversion. (We didn’t have a name nor a theory for what was going on.)

    And so now I realize (I feel) that I got mis-dosed with the testosterone and here we are.

    But mostly I’ve decided (I’m 69 yrs old) that I am an example of a broad continuum of sexual and gender expression. Some of us just don’t fit into the hetero-normative dyad.

    • Mal says:

      To my knowledge, the great T-flood hypothesis doesn’t fit with mediated transport/gating, i.e. there’s not much of an effect on brain organisation and nothing proven at this point, all just-so stories on that end, while the actual data points in another direction.

      There is also a good deal of evidence to suggest that many observed changes related to T in the brain (and there really aren’t many, more similarities than differences anyway) are actually habituations to a serum-level of T, in order to mitigate potential unfit effects. Of course there are differences in brain sizes relating to body mass which in which T is indirectly a factor. This mean that it takes an appreciably longer amount of time for an electro-chemical signal to traverse a larger brain accomodating a larger body a fact that seems to explain away much in terms of processing differences that have been observed.

      In Daphna Joel’s (who recently changed Dick Swaab’s opinions) work on brain “mosaicism”, massive samples of adults can’t even be said to have brains (high res MRI/fiber-tracking) or behaviours (census data) which would predict gendered-behaviours let-alone their biological sex. From my understanding from Fausto-Sterling’s exhaustve work gender-expression and -rolling doesn’t really start to form until around ~2 years of age following available (often overly limited models, imo), though there is much evidence for an earlier influence from parents now that some people gender via sonagram.

      It’s also important to note that testosterone is not as cognitively mind-altering after an initial period of acclimation as some would like to believe, but of course physical changes in a body come with cognitive affordances and constraints. In any cause, I recommend reading Sari van Anders work on hormones which forces one to take a good hard look at causality regarding T-expression and behaviour (it’s a real chicke-egg problem in many contexts).

      Brains don’t have sex/gender only whole people in context do.

      P.s. if you like we can get into the dumb rat-behaviour research that has been done on these kinds of things, really idiotic stuff looking at “thrusting” vs “lordosis” as a rat version of masculinity and feminitiy…

  4. oreb says:

    Just a couple of thoughts. Sorry for the poor English, messiness, etc.

    Mmmh… I think somebody trying HRT short term as a way of figuring out themselves should be very careful not to rush to interpret experienced psychological well-being by itself as evidence of being trans. This well-being might have a certain quality to it hinting into that direction; you mention some of that when talking about your own personal experience, but anyhow.

    I don’t know, but I mean… Don’t some sufferers of mental illnesses like depression report similar experiences (the feeling that a veil between them and the world has been lifted etc.) after they start to receive medication? And in that case saying that their brain was ‘meant’ to be on that particular chemical environment, that the medication is bringing the patient into alignment with their true medicated certainly sounds a bit off. And, of course, it is not always true either that the drug in question has to be taken indefinitely for a permanent result.

    Imagine, let’s say, an overly neurotic male that finds relief after starting HRT simply because the greater ease in accessing his emotions that comes with it has somehow allowed him to sort out his inner shit, but who at that point might as well just get off the hormones go on with his old life. In that situation somebody with a certain priming (the kind of priming resulting from compulsively reading, ethcem, /r/asktransgender etc.) might jump into conclusions and mistakenly go down the road of transition.
    One is essentially fiddling at the fringes of an unknown realm there and I definitely wouldn’t trust my capacity to take the right decision in that situation. You need protocols, safeguards.
    Ah, what about the placebo effect, by the way? Has anybody done a study comparing the effects of short term HRT vs a placebo in cases of gender dysphoria?
    Some people seem to assume everybody has some strong core gender identity that will ring an alarm at the minimal ‘wrong’ change, but what if the assumption is simply not true. You seem to be saying the later is in fact the case.

    The mind is a cage of lies. We are misinterpret the origin of our emotions all the time (I doubt estrogen can change that :-p).

    Hope this made some sense.

  5. Marcus says:

    Thank you for this. It is exactly what I needed to read. I don’t experience dysphoria as I know many trans-identified individuals do, or at least I don’t think I do. I am considering trying T to see how I feel. My issue is that I don’t feel particularly one way or anther about my body – I don’t hate it and definitely don’t love it, but I do want to change parts of it. I’ve had a little pushback from someone who identifies as a transman with regard to dysphoria being a pre-requisite to the trans identity, but you articulated that issue really well. The additional questions help. And yes, I would feel better if I could align my body more so with my masculine, yet sensitive brain!

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