Can Cis People have Gender Dysphoria?

And if so, how?

Source image by Quinn Dombrowski

Gender dysphoria happens when some aspect of a person’s body or life is mis-aligned with what their deepest self really needs. Gender dysphoria comes in many different kinds that I encourage everyone to learn about, but the type that’s most familiar to most people are the physical dysphorias: ones having to do with our physical bodies.

At this point I think basically everyone understands that gender dysphoria is a thing trans people experience. What’s less well understood is whether cis people get it too.

Short answer: yes. Cis people can absolutely suffer from physical gender dysphorias.

Cis Physical Dysphorias

There are many ways this can happen, but I'll give just two, one for each gender.

Cis men sometimes get gynecomastia. That is, they spontaneously start growing breasts. Generally this is due to some dis-regulation or imbalance in their endocrine system. Bluntly: their hormones get screwed up somehow. There’s lots of ways for that to happen, but one such cause is certain kinds of tumors that produce hormones. So if a dude happens to get a tumor that produces estrogen, he can start developing breasts. For all that guys are typically really into tits, the vast majority of guys with gynecomastia are not happy about having their own pair. It’s a mis-alignment of their body relative to what their deepest self (i.e. the masculine gender identity part of their brain) needs and expects. Having gynecomastia typically triggers feelings of disgust or shame about their bodies. Clothes don’t feel like they fit right. There’s anxiety about other people noticing. All in all, it can be very distressing. Thankfully, doctors can intervene to diagnose the underlying cause (e.g. find the tumor), fix that with various medications and/or surgery, and if necessary provide breast reduction surgery to restore the guy's body to how he likes it. In other words, he can receive gender affirming medical care to de-feminize/re-masculinize his chest.

Cis women sometimes spontaneously start growing facial and body hair. Again, this is often related to hormone imbalances. PCOS, among its many unpleasant symptoms, can cause this. Most women are not excited about getting facial hair or body hair. Again, it is mis-alignment of their body relative to what their deepest self needs and expects. And it can trigger the exact same dysphoric feelings of disgust, shame, anxiety, etc. PCOS can be treated in various ways such as with hormone supplements or specific birth control pill regimens. Those treatments won’t make the unwanted hair go away, but can at least stop more of it from growing. Unwanted hair can then be removed with laser hair removal or electrolysis. So long as their PCOS is controlled, the hair shouldn't come back. This, too, is gender affirming medical care.

Source image by Mills Baker

There are traumatic causes of GD in cis people as well: a soldier whose humvee rolls over an IED and gets his penis blown off will often report psychological distresses that are a good match to gender dysphoria: feelings of incompleteness. Feeling unmanly or that he is now “less of a man.” Feeling disconnected or estranged from his body. In those cases, reconstructive surgery (or even penile transplants) can help restore these men’s sense of masculinity, wholeness, and rightness in their bodies, which then relieves the psychological distress of gender dysphoria.

For women, probably the most common analog is losing one or both breasts to cancer. Post-mastectomy, women often report very similar feelings of incompleteness. Of loss of attractiveness or of feeling unsexy. Of feeling less womanly. Of disconnection with their bodies and often difficulty with seeing themselves in the mirror or having to wash their chests in the shower. Not every woman feels this way, of course, and not every woman feels all of those symptoms after a mastectomy. But these feelings are common, and they are completely in-line with the markers of physical gender dysphoria. Some women find relief from these psychological distresses by simply wearing breast forms. But many women end up needing surgical reconstruction to restore a silhouette that feels right and feels like themselves.

So, yes. Cis people can definitely experience gender dysphoria. And in all of the above cases and many others I’m leaving out, gender-affirming medical care is appropriate and warranted: cis people deserve to feel comfortable and at-home in their bodies just as much as trans people do.

Cis Dysphoria vs. Trans Dysphoria

But just because cis people can experience physical dysphorias too does not mean it’s an equivalent experience to trans people’s dysphoria. In some ways they’re the same, but in some ways not.

In terms of causes and cures, cis and trans physical dysphorias are identical: in each case, the body deviates from what the self truly needs, and because of how gender identity works, that deviation triggers a host of psychological discomforts that we call “gender dysphoria.” In each case, gender-affirming medical interventions can shift the body towards what the self truly needs, which causes relief of the dysphoria: treat the root cause, and the symptom goes away all on its own.

Where cis dysphoria and trans dysphoria differ is etiology: cis dysphoria arises as a consequence of some kind of emergent medical condition, whereas for trans people it's the result of a congenital medical condition. For trans people, hormone signaling problems that occurred during fetal development before we were born caused our brains to develop with one particular gender identity while our bodies went the other way. Cis people get a matched-set of gender identity and body type; trans people get a mis-matched set.

(Consequently, trans people get a maximal version of gender dysphoria, because from the get-go our entire bodies are configured the wrong way for what our deepest self really needs. This is well worth digging into on its own, but is better saved for another article.)

Viewed another way, cis dysphoria happens when cis people’s bodies change in ways that are abnormal for their birth-assigned gender and trigger feelings of psychological distress. Trans dysphoria happens when our bodies change or simply exist in ways that are normal for our birth-assigned gender, but cause us psychological distress because that gender never matched our gender identity in the first place.

Either way, the distress is the same. And either way, the treatment—gender affirming medical care—is appropriate and warranted.

After all, trans people deserve to feel comfortable and at-home in their bodies just as much as cis people do.