“Gender dysphoria” is a term that describes a sense of unease a person may feel because of a mismatch between their biological sex, or sex assigned at birth, and their gender identity.

Gender Dysphoria in Children

A diagnosis of gender dysphoria in children is based on at least six of the following symptoms, lasting for at least six months:

• A strong desire to be of the other gender or an insistence that he or she is the other gender (or some alternative gender different from one’s assigned gender).
• In boys (assigned gender), a strong preference for crossdressing or simulating female attire; or in girls (assigned gender), a strong preference for wearing only typical masculine clothing and a strong resistance to wearing typical feminine clothing.
• A strong preference for cross-gender roles in make-believe play or fantasy play.
• A strong preference for the toys, games, or activities stereotypically used or engaged in by the other gender.
• A strong preference for playmates of the other gender.
• In boys (assigned gender), a strong rejection of typically masculine toys, games, and activities and a strong avoidance of rough-and-tumble play; or in girls (assigned gender), a strong rejection of typically feminine toys, games, and activities.
• A strong dislike of one’s sexual anatomy.
• A strong desire for the primary and/or secondary sex characteristics that match one’s experienced gender.

The condition is associated with significant distress or impairment in social, school, or other important areas of functioning.

Gender Dysphoria in Adolescents and Adults

A diagnosis of gender dysphoria in adolescents and adults is based on at least two of the following symptoms, lasting for at least six months:

• A marked mismatch between one’s experienced/expressed gender and one’s primary and/or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics).
• A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/express gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics).
• A strong desire for the primary and/or secondary sex characteristics of the other gender.
• A strong desire to be of the other gender (or some alternative gender different from one’s assigned gender).
• A strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender).
• A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender).

The condition is associated with significant distress or impairment in social, school, or other important areas of functioning. A diagnosis of “unspecified gender dysphoria” may be given when a person has symptoms characteristic of gender dysphoria but they do not meet the full criteria for gender dysphoria.