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Ask Izzy: Advice on dealing with gender dysphoria from LGBTQ+ therapists

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Photo by Shvets Production / Pexels
Photo by Shvets Production / Pexels

Ask Izzy is a biweekly advice column about relationships, mental health, and sexuality. Written by Isabel Mata — a Seattle-based lifestyle writer, podcast host, and mental health advocate — Ask Izzy offers tangible expert advice so all readers can have stronger relationships, better sex, and healthier mindsets.

Dear Izzy,

How do I deal with dysphoria? I'm a Trans boy, and I've been having a rough time with physical and emotional dysphoria. What are some coping skills you might recommend?

— Searching for Support

Dear Searching,

I am so sorry that you are struggling with dysphoria. While it's a common experience within the Queer and Trans community, that doesn't make it any less painful. That being said, thank you for being vulnerable and asking for help. You came to the right place.

Given the importance of hearing from someone who completely understands your experience, I reached out to a few Trans-affirming therapists for their best advice, and here is what they had to say:

1. Prioritize emotional and physical self-care.
Self-care is the number one thing you can do for yourself while you work through the extreme emotions involved with gender dysphoria.

"Engage in practices that foster self-compassion and self-love, such as mindfulness, journaling, and connecting with supportive communities," said Prerna Menon, co-founder and psychotherapist at Boundless Therapy in New York. "Remember, seeking professional help is a sign of strength, and therapists who understand the complexities of your identity can provide invaluable support."

Self-care also means being "gentle with yourself and [giving] yourself permission to take the time it takes to figure it out," added Eden Katz, LMSW, a psychotherapist at Queer Therapy NYC. "Even if you don't have language for your identity now or ever, and even if it changes in the future because you grew and changed, that's okay too. The Queer community is here to embrace you wherever you are on your journey."

2. Assert your identity.
One of the most affirming things you can do for yourself is to assert your pronouns. Whether it's online or in a classroom, showing up as your authentic self can be radically empowering.

Depending on your level of comfort, you can take it up a notch and modify your appearance to also match how you feel within. Makeup, binding, tucking, and contouring are all things you can do to express yourself, along with wearing clothes that reflect who you are on the inside.

Clayre Sessoms, a private psychotherapist based in Vancouver, BC, added, "Such exploration can lead to a deeply personal and transformative experience, culminating in a more authentic and fulfilling life.

"As conversations surrounding gender continue to evolve, it's crucial that you feel comfortable and supported during your journey. When navigating these complexities of gender identity, gender therapy can serve as a key support mechanism. A trained and experienced gender therapist provides a safe and supportive environment for exploring your thoughts, feelings, and experiences related to gender. Gender therapy can equip you with the tools and guidance needed to better understand yourself and develop a strong sense of identity."

3. Challenge the gender binary.
As a Trans person, it is important that you allow yourself to color outside of the lines. Nicole Nina, LCSW, a private-practice therapist who runs Balancing Anxiety out of Colorado, said, "Many people who are Transgender do not see gender as a binary equation; they are willing to walk along both sides. Many times, this brings relief to not feel you have to fit neatly into a category — of gender or otherwise."

Another challenge that many Trans or gender-nonconforming people experience is internalized phobias and invalidation, which are a significant source of internal conflict. According to the blog The Body Is Not an Apology, "It's essential for [Trans people's] personal well-being to look inward and deconstruct oppression from within. Discrimination that is internalized puts us at odds with ourselves and obscures the societal causes of our internal struggles. Start by letting go of gender stereotypes and dismantling gendered language, then take it from there. Work to manifest radical self-love at a socially conscious level."

4. Lean on your community.
The most important thing to remember is that you are not alone. "There is a vibrant and diverse community of Trans individuals who have gone through similar experiences, and you're not alone," said Lana Lipe, LCSW, from Honu Therapy. "Seek out support from local LGBTQ+ organizations, online communities, and support groups to connect with others who can provide understanding and empathy."

Therapist Dolly Ferraiuolo, LCSW, at Share of Florida, added, "For those who have yet to find their chosen family, I encourage you to be patient and open-minded. Building connections takes time, but it's worth the effort. Seek out LGBTQ+-friendly spaces, join support groups, attend social events, or engage in community activities where you can meet like-minded individuals. Be authentic and true to yourself, as genuine connections often arise when we show up as our authentic selves.

"Remember that a chosen family can be created, and it's never too late to find a supportive network of individuals who will embrace and love you for who you are."