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Living with gender dysphoria is really challenging!

It can cause a lot of distress and anxiety. Gender dysphoria is an incongruence or conflict between the gender an individual was assigned at birth and the gender with which they identify. For those in our communities who experience gender dysphoria, there is likely a strong desire to rid oneself of dysphoria.


Some folks may be able to reduce their gender dysphoria entirely or almost completely, while most folks will deal with gender dysphoria in some capacity throughout their life. How we respond to gender dysphoria can alleviate some of the distress and make it more manageable.


Manifestations of Gender Dysphoria

Gender dysphoria manifests in different ways: body dysphoria (discomfort with one’s body), social dysphoria (discomfort with gender roles and expectations and the way one’s gender is perceived), spiritual dysphoria (a core sense of knowing one’s gender and how it’s different than one’s gender assignment), and emotional dysphoria (distressing feelings that arise in relation to one’s current gender experience).


Approaches to Harm Reduction

The framework of harm reduction comes from substance use treatment communities establishing tools aimed to create reasonable goals and steps to reduce distress and harm. Taking a harm reduction approach to gender dysphoria will look different for each person. Folks can individualize their harm reduction coping tools by experimenting and trying different strategies depending on the dysphoria manifestation.

Certain tools may work better on some days than others and it can be helpful to have a variety of alleviating and soothing strategies to try when gender dysphoria comes up.

Finding Your Community, Your Safe Place

For some, finding specific communities and spaces where we feel safe to wear clothes aligned with our gender identity may be harm-reducing when we do not feel it is safe to do so at work. For others, seeking out trans or queer specific events or groups aligned with the religion we practice may help maintain connection to a religious or spiritual practice which may have also caused us harm due to our gender identity. Maybe we seek out queer identified or affirming medical providers because it has been a while since we have been to the doctor’s office.


Grounding in Times of Anxiety

For many, gender dysphoria is  a constant “gender noise” or anxiety that is dysregulating and makes it difficult to function. It can be helpful to have grounding tools when we are heightened or dissociated.  Grounding tools help us regulate and anchor into the present moment when we are experiencing overwhelming feelings. There’s limitless possibilities for individualizing grounding tools. Examples include playing a favorite comforting song, taking a walk in nature and listening to the birds, taking a hot or cold shower, self-soothing talk to ease anxious thoughts, meditating, or a selfie photo shoot where you feel super cute.

Grounding tools help us regulate and anchor into the present moment when we are experiencing overwhelming feelings.

Be Patient, Be Kind to Yourself

It is so important that when gender dysphoria comes up, that we are kind to ourselves. The world around us shifts and changes constantly, and when we feel dysphoric due to our environment, there might be little we can do in the moment to prevent it, but we can remember that healing and growth are not linear and treat our inner thoughts with compassion. We can try to reduce dysphoria as much as possible where we can, and use grounding tools and self-compassion to work through the times we have less control.


About the Author

Micah Rea is an Licensed Marriage and Family Therapist (LMFT) at Well Clinic in San Francisco. In her words, “I work collaboratively with each client to create a space where they can express their full selves.”

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