[TW: dysphoria, self-harm, body image issues, slurs]

• consistently telling adults they are not the gender they were assigned.
• rejecting clothes and toys typically associated with the gender they have been assigned.
• refusing to use the bathroom in the way associated with the gender they have been assigned.
• significant distress at the bodily changes that occur during puberty.

It is important to note here that, whilst we bleat on that toys and clothes should just be for kids, and not assigned gender, that society still teaches kids that some things are for boys and some things are for girls, and so a child insisting they belong in the other category could be a sign of gender dysphoria. However, said child might just prefer diggers to dolls, so bear that in mind.

In teens and adults:

• Certainty that their true gender is not aligned with their body.
• Disgust with their genitals. They may avoid showering, changing clothes, or having sex in order to avoid seeing or touching their genitals.
• Strong desire to be rid of their genitals and other sex traits.
• A combination of anxiety, depression, dissociative disorders, self-harming tendencies and lots of awful mental health problems.

Whilst some steps have been made towards better apparatus for diagnosis for gender dysphoria, the health care system is often slow on the uptake. For example, the NHS choices site still talks about “gender vs biological sex”, going on the old notion that genitalia equate to gender, and not that gender is a societal structure and assigned to people at birth. But we can hope that one day they will get better.

As with gender identity, dysphoria is a personal experience for those who are affected by it. They may have all of the symptoms listed above or none of them, and they may require medical treatment or they may not.

A few ways to help a friend suffering with dysphoria:

• Believe them. Don’t try and wave their feelings away.
• Support them. Ask them what they want you to do to help. It might be as simple as spending time with them, or buying them snacks.
• Don’t assume you know better. If your friend has been prescribed medication to help, or directed to some self-care/mindfulness resources, don’t dismiss them as meaningless. The last thing your friend needs right now is being told they are overreacting and don’t need the treatment.
• Join in their treatment. If they have been prescribed some self-care/mindfulness activities to help relieve their symptoms, do them with them. Help your friend cook a nice meal, take them out to the cinema, sit and colour in with them. Make sure they don’t feel alone, because dysphoria can make people feel really vulnerable and alone.
• Help your friend find resources. There are more and more resources available online these days about dysphoria and people coping with it. It can be scary looking all this stuff up when you’re feeling so low. Sit with your friend, let them know you have their back, but don’t crowd.
• Back off if asked. Your friend will know you mean well, and want to help them, but sometimes that means backing off and leaving them to it. By all means let them know they can phone/text/email you whenever, but then leave it at that.

Dysphoria is not fun, it’s not pretty, and it isn’t easy. Be mindful, be helpful, but back off if needbe. That’s all we ask.