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Gender identity

For some people the sex they were assigned at birth might feel wrong. Others may feel that their identity is fluid and that the binary description traditionally used to define gender does not tell the full story. Questioning gender may lead a person to transition, but it might also make more room for fluidity and self-acceptance. A therapist with a firm understanding of gender identity is well-placed to explore such issues.

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What is gender identity? 

Gender identity is a term used to describe the sense of who one is, one’s masculinity and femininity, and how we see and describe ourselves.

Some people feel their gender identity is different from the sex they were designated at first. 

Others do not define themselves as having a "binary" gender identity. 

It is important to clarify that gender dysphoria is not a mental illness, although some people do suffer mental ill-health because of gender dysphoria.

What gender identity is not

Gender identity is not the same as sexual identity, and just because a person questions or changes their gender identity doesn’t mean they must question or change their sexuality. So for example, being non-binary does not ‘make’ a person gay, straight or asexual. 

That said, having the freedom to explore or express your gender identity in therapy might raise new questions about other aspects of life – family, culture, society, work, love, and sexuality. The way we’re seen, and see ourselves, has a huge impact on self-esteem and wellbeing. 

What is gender dysphoria?  

Children are often interested in clothes or toys that society tells us are more often associated with the opposite gender. They also frequently struggle with the development of their physical sex characteristics. This is common and usually just part of getting older.

However, a small percentage feel significant distress about their sex or gender, which may worsen with time and may be a sign of gender dysphoria. 

How many people have gender dysphoria? 

There are no good statistics showing how many people have gender dysphoria. However, in 2018/19 some 8000 adults were referred to adult gender dysphoria clinics for consultation. 

What are the causes of gender dysphoria?

The cause of gender dysphoria is still poorly understood. 

What help is available for gender dysphoria?

The first step is to talk about it. At ProblemShared we have a number of experts who are available to discuss any issues around gender identity a person may have. Our professionals can also help signpost to other specialist services both NHS and private. 

What treatment options are there for gender dysphoria?

If a child has a gender dysphoria diagnosis and wants more help to cope with their gender presentation or their experience of dysphoria, they might eventually be referred to the Gender Identity Service, part of the Tavistock and Portman NHS Foundation Trust in London.

The child/teenager is then reviewed by a team consisting of:

  • A clinical psychologist.
  • A child psychotherapist.
  • A child and adolescent psychiatrist.
  • A family therapist.
  • A social worker. 

They will then conduct a full assessment over a number of sessions.

Depending on the results of the assessment, possible outcomes include:

  • Therapy.
  • Parental support or counselling.
  • Group therapy.
  • Referral to a specialist hormone (endocrine) clinic for hormone blockers for children who meet strict criteria (at puberty).

Talk therapy is the mainstay of treatment in children and adolescents. 

Adults who may have gender dysphoria are normally referred to a gender dysphoria clinic (GDC).

Much like children and adolescents, they will undergo a series of assessments by a team of health professionals. Suggestions about treatment may include:

  • Counselling.
  • Cross-sex hormone therapy.
  • Speech and language therapy (voice therapy) to help you sound more typical of your gender identity.
  • Surgery.

History of trans rights in the UK


The Gender Recognition Act comes into effect, which gives legal recognition to transgender people in the UK. 


The Equality Act makes gender reassignment a protected characteristic, which protects transsexual people’s right to fair treatment at work and when accessing public services. 

Books, podcasts and events about gender identity

NB: My Non-binary Life (2019)

Caitlin Benedict & Amrou Al-Kadhi present a BBC series about NB identity.

Listen online

The Trans Teen Survival Guide (2018)

Fox and Owl Fisher’s practical guide to trans and non-binary identity life includes info on dysphoria and depression.

Buy online

Other helpful resources for people questioning their gender identity

Gender dysphoria (NHS)

The NHS’s own guide to diagnosis and treatment of gender dysphoria.

Gender Identity Clinic (NHS Tavistock and Portman)

The website for the Gender Identity Development Service at the Tavistock and Portman NHS Foundation Trust.


For people in distress or despair, especially for people experiencing suicidal thoughts, Samaritans is open 24 hours a day by phone (116 123) and email (

Click here to see practitioners who specialise in gender identity (incl. dysphoria).