What is gender dysphoria?

Q: What are the symptoms of gender dysphoria?

Characteristics include a strong dislike of one's own sex characteristics, a strong desire for the physical characteristics of the other sex and a wish to live as and be treated as the other sex. There must also be clear distress or a problem with everyday functioning, for example at school, at work or in relationships.

Q: Is there a test for gender dysphoria?

No. There is no blood test, scan or questionnaire that can demonstrate gender dysphoria. A psychologist or psychiatrist makes the diagnosis after a series of conversations. A questionnaire such as the Transcheck can help organise your thoughts and prepare for a conversation with your GP, but it is not a diagnosis.

Q: What is the difference between gender dysphoria and gender incongruence?

Gender incongruence is the term used in the WHO's ICD-11. It describes the difference between experienced and registered sex, without distress being a requirement. Gender dysphoria is the term used in the DSM-5 and does require clear distress or an impairment in functioning. The group with gender incongruence is therefore broader.

Q: Can gender dysphoria in a child go away on its own?

This does happen. In follow-up research, the dysphoria subsided in a considerable proportion of children during or after puberty. This is called desistance. It is not possible to predict in advance which children's feelings will persist. Discuss your concerns with your GP, who can advise you and refer you if necessary.

Q: How long is the waiting list for a gender clinic?

Waiting times are long: waiting more than a year for a first appointment is common, and the waiting time varies by centre. Your GP can refer you to a gender team, including those at Amsterdam UMC, Radboudumc and UMCG. In the meantime, a psychologist can provide support. See waiting times and care pathway.

Silhouette of a person looking outside through an open window — Photo: Mouli Sharma via Pexels

Gender dysphoria is the persistent discomfort or distress someone experiences when their body or registered sex does not fit with how they experience themselves. It is a medical term and also the name of a diagnosis in the psychiatric manual DSM-5. People with gender dysphoria feel persistently uncomfortable with their sex and suffer as a result.

What is gender dysphoria?

The word dysphoria means discomfort or distress, the opposite of euphoria. Gender dysphoria therefore refers to the distress, not to the identity itself. The term was introduced in the DSM-5 in 2013, replacing the older term gender identity disorder. The thinking behind this change was that a person's experience is not the disorder; rather, it is the distress associated with that experience.

The severity varies greatly from person to person. Some experience mild dissatisfaction, while others suffer severe psychological distress that disrupts daily life. Not everyone who identifies as transgender has gender dysphoria, and uncertainty about one's identity is not in itself a diagnosis. For more about the underlying concept, see what is gender.

Gender dysphoria symptoms: what are the signs?

For adolescents and adults, the DSM-5 describes a clear incongruence between experienced and registered sex that lasts for at least six months. The characteristics listed include:

a strong dislike of one's own sex characteristics, or, in adolescents, of the characteristics that develop during puberty;
a strong desire for the physical characteristics of the other sex;
a strong desire to belong to and be treated as the other sex;
the conviction of having the feelings and reactions associated with the other sex.

There must also be clear distress or problems functioning, for example at school, at work or in relationships. The full criteria are listed on the page about DSM-5 and gender dysphoria.

Gender dysphoria often occurs alongside low mood, anxiety or loneliness. Are you thinking about suicide or worried about someone? Call 113 Suicide Prevention on 0800-0113 or chat via 113.nl.

Gender dysphoria or gender incongruence: what is the difference?

Gender incongruence is the term used in the ICD-11, the World Health Organization's classification that has been in effect since January 1, 2022. The term describes the difference between experienced and registered sex, without distress being a requirement. The ICD-11 also no longer places gender incongruence among mental disorders, but in a chapter on sexual health. Gender dysphoria, the term used in the DSM-5, does require distress. The spelling gender dysphoria is also sometimes written as gender dysphoria; it refers to the same thing. See ICD-11 and gender variance. The definitions from the DSM-5 and ICD-11 are compared on transwijzer.nl.

How is gender dysphoria diagnosed?

The diagnosis is made by a psychologist or psychiatrist, usually within a specialised gender team. This involves a series of conversations about the person's history, symptoms and expectations. There is no blood test, scan or other physical measurement that can demonstrate gender dysphoria. The diagnosis is based on what someone reports and on the clinician's assessment. This makes the diagnosis less definitive than that of a physical condition. Read more about how the process works at gender dysphoria diagnosis.

Is there a gender dysphoria test?

No. There is no test that can determine whether you have gender dysphoria. Online questionnaires may help organise your thoughts, but they do not provide a diagnosis. On this site, you can find the Transcheck, a list of 50 questions for people who are uncertain. The result is a tool for your own reflection and for a conversation with a doctor or psychologist, nothing more.

Gender dysphoria in a child

The DSM-5 has separate criteria for children. Behaviour that differs from what is expected of boys or girls, such as a preference for certain toys or clothing, is not in itself gender dysphoria. In follow-up research, including a study by Steensma and colleagues (2013), the dysphoria subsided in a considerable proportion of children during or after puberty. This is called desistance.

If you are worried about your child, read gender in children and the guide for concerned parents. For more about medication for young people, see puberty blockers.

What can you do and where can you turn?

Your GP is the first point of contact. Your GP can discuss your concerns with you, consider other possible causes of your symptoms and refer you if necessary. This may be to a local psychologist or to a gender clinic. Gender teams can be found at Amsterdam UMC, Radboudumc in Nijmegen and UMCG in Groningen, among others.

The waiting list for a gender clinic is long: waiting more than a year for a first appointment is common. Current information is available at waiting times and care pathway. During the waiting period, psychological support may help, including with symptoms such as low mood or anxiety.

Treatment for gender dysphoria

Treatment ranges from counselling and social transition to hormone therapy and surgery. Hormones and surgery are significant interventions and partly irreversible. Which step is appropriate varies from person to person and should be decided in consultation with the clinician.

Critical considerations

There is no scientific consensus about the causes of gender dysphoria or the best treatment. The British Cass Review (2024) concluded that the evidence for medical treatment of young people is weak. Sweden and Finland have tightened their care for minors. In the Netherlands, the Health Council advised on June 30, 2026, that care for young people is carefully organised. See the Cass Review.

The group seeking care has changed. In the past, it mainly consisted of young children, often boys, with early-onset and persistent dysphoria. Since around 2012, many more young people have sought care, including a strikingly high number of girls, often with additional issues such as autism, anxiety or depression. The original Dutch Protocol was not designed for this group.

The role of social factors in this increase is the subject of debate. The concept of rapid-onset gender dysphoria, introduced by Littman (2018), is controversial. What is clear is that additional issues deserve attention: a diagnosis of gender dysphoria should not overshadow other problems.