Gender dysphoria


Gender dysphoria is a recognised medical condition for which gender reassignment treatment is available on the NHS in Scotland.
A person with gender dysphoria may:

  • experience distress, anxiety, uncertainty and persistently uncomfortable feelings about their biological sex not fully matching their gender identity (the gender they see themselves as)
  • have, and may act on, a gender identity which is different from their anatomical sex. For example, someone born with female sex characteristics deciding to live permanently as a man


Long lasting and extreme gender dysphoria can be known as transsexualism. This is the desire to live and be accepted as a member of the opposite sex.

It can also be accompanied by the wish to make his or her body as fitting as possible with the preferred sex through surgery and hormone treatment.

Non-binary gender identities

People with non-binary gender identities can experience gender dysphoria and may sometimes partially transition socially, take hormones or have some surgery done.

This includes androgyne, thirdgender and polygender people who do not feel comfortable thinking of themselves as simply either men or women. They might identify their gender as being a combination of the two, or as being neither.

Early symptoms

The symptoms of gender dysphoria may begin to appear at a very young age. For example, a child may refuse to wear typical boys' or girls' clothes, or dislike taking part in typical boys' or girls' games and activities.

In most cases, this type of behaviour is just part of growing up. However, in cases of gender dysphoria, it persists into later childhood and through to adulthood.


The exact cause of gender dysphoria is unknown. It is currently classed as a mental and behavioural disorder in the WHO International Classification of Diseases. However, many recent studies have suggested that it is more to do with biological development (relating to the body).

Research into what causes gender dysphoria is ongoing.

How common is gender dysphoria?

Gender dysphoria is rare, but the number of people being diagnosed with it is increasing due to growing public awareness about the condition. Although awareness has increased, many people with gender dysphoria still face prejudice and misunderstanding about their condition.
There is no reliable information on the number of transgender and transsexual people in Scotland and there is currently no routine collection of data on gender reassignment.

The Gender Identity Research and Education Society provides guidance on estimating the number of people experiencing gender dysphoria.


Treatment for gender dysphoria aims to help people become content with their gender identity. This can mean different things for different people.

  • For some, it can mean dressing and living as their preferred gender.
  • For others it can mean taking hormones that change their physical appearance.
  • Transsexual people may seek to have surgery to permanently alter their biological sex.

See our policy guidelines section for information on legislation and the NHSScotland Gender Reassignment Protocol.  

Last updated: 20 March 2013

Continue to next section: