Leiden Psychology Blog

Living with gender dysphoria

Living with gender dysphoria By torbakhopper: transgender flag waving

You may have heard the phrase ‘born in a wrong body’. However, for anyone who isn’t transsexual, it is very difficult to imagine what that feels like and how it affects our daily lives. Where does the feeling, gender dysphoria come from in the first place?

Gender dysphoria...

...means that an individual’s gender identity (the conviction of being male or female) doesn’t match their physical sex. It can result in discomfort or even depression, but it is different from low self-esteem or self-hate.  People who experience gender dysphoria are called transsexual.

How does it arise?

It is still unclear how the gender identity is created, but it has been hypothesized that a part in our brain is programmed with a gender identity when we’re still in the womb.  In the fetus, the sexual differentiation of the body happens before that of the brain. However, the brain may develop differently from the body, which possibly results in transsexualism. Ramachandran proposed a ‘brain-based body image’: there might be a gender-specific, programmed body image, which is misaligned in transsexuals. Others have studied alternative factors such as white matter differences in trans men and women, androgen receptors, neurons and genetics.

What does gender dysphoria feel like?

Every transsexual person experiences gender dysphoria differently. For some, gender dysphoria is always present, while others have ups and downs. Below are a few short personal descriptions:

  •  “I feel it in two different ways: as shame and as lacking something. I feel ashamed because of the visible things like my chest and my wide hips that everyone can see. And I feel like I’m incomplete because the genitals that should be there are missing. It physically hurts.”
  • “It feels like I want to jump out of my own skin or tear it off.”
  • “It’s like looking in the mirror, but seeing a stranger. When you move, the reflection moves. You know it’s you, but it shouldn’t be you. You shouldn’t look like that, or sound like that. And yet, everyone else sees you like that.”
  • “Gender dysphoria made me feel detached from myself. I was merely going through the motions of life, as if I was controlling a body that wasn’t mine.”
  • “I didn’t hate myself. I didn’t hate my body. But I hated some parts because they weren’t supposed to be there. Sometimes they’d make me feel confused, like ‘what are these things doing here?’. But on other days, those parts would make me feel repulsed; physically sick and full of rage.”

Two bloggers have written elaborate, personal accounts: This is what dysphoria feels like and The Difference Between Dysphoria and Negative Body Image.

Is being transsexual a choice?

If a transsexual person could just choose their gender identity so that it matches the body, they would stop experiencing gender dysphoria. Unfortunately, gender identity seems unchangeable. Instead, transsexuals have to alter the body to make it match the gender identity. Many view the case of Bruce Reimer as proof that gender identity can’t be changed. He was born a boy, but after a ruined circumcision he was surgically turned into a girl and raised as one. However, he never felt like a girl. After years of difficulties, Bruce Reimer, although now living life as a man named David, took his own life.

Situations in daily life 

Transsexualism can sometimes lead to awkward or even dangerous situations. 

Going to a public toilet – when I began my transition, I looked very feminine for a boy. I looked masculine enough to get stared at or yelled at in the women’s toilets, but not masculine enough for the men’s toilets. Others don’t dare to go to the toilet all day. Several legislators in the United States have even tried to make it illegal for transsexuals to go to the toilets that are appropriate for their new gender!

Sports – having gender dysphoria makes it difficult for me to play sports. I want to be treated as a man, but I can’t swim without a top or change in the men’s room like a regular guy. This has put me off sports for years, even though I’d love to take part in it.

Sexual orientation - many people think that all transsexuals are gay. Transsexuals can be heterosexual, homosexual, bisexual or asexual. Some have asked me why I ‘became’ a man if I’m attracted to men. Who or what you like is not the same as who you are. Gender identity and gender dysphoria are unrelated to sexual orientation.


Of course, if you look past the gender dysphoria, transsexuals are just regular people who eat, sleep, study and work. There may be more hardship along the way compared to those who aren’t transsexual, but it’s very much possible to live an ordinary, happy life.

A small FAQ on transsexuals as well as recommended documentaries.

#Freedom440

'Freedom' is the motto of our 440th anniversary celebrations. Scientists from the Leiden University highlight this issue from different disciplines. Read the blog posts from other scientists about this on our Leiden University Blog (some posts are in Dutch). Please share your thoughts or images on what freedom means to you on Twitter: #freedom440

1 Comment

Jojanneke van der Toorn
Posted by Jojanneke van der Toorn on June 11, 2015 at 13:57

Thank you for writing this blog post, very interesting and informative!

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