This was extremely helpful in increasing my understanding of being transgender. As I mentioned before, I didn't discover I was transgender until I was 78-79 years old. I had OCD and mentally tried to be perfect. I couldn't allow myself to even consider something was wrong. When I discovered there were transgenders I became curious and met with a therapist and quickly discovered I was transgender since I was in the early years of grade school. The OCD immediately went away. Finally my doctor referred me to an endocrinologist who requested a report from my therapist. She received it a couple of days later, and immediately made an appointment for me and I started a HRT. When I read my therapist’s report, I couldn’t believe that I had the symptoms of being transgender, since I was a little boy. I’m now almost 82 years old and I’ve been on HRT for 13 months. I have never felt better about myself. At least, at this time because of my age, I've decided to continue to express myself as a man in public and find ways to help people realize being transgender is real and should be respected and accepted. To this end I have written an eBook titled Who Killed Who? A Love Story. It is available in Apple Books and for Kindle/Android. The cost is $4.99. I would like to gift you a copy if you will tell me how. Of course, you can buy your own copy but it would be my honor to gift it to you as you have been so helpful to me! 😊

Thank you for putting out these videos. They help more than you know! All the love to you and the rest of the transgender community.

I have had a bit of an interesting journey, at 10 months old I was severely burned ( 3rd degree over 78% of my body) in a house fire and it was in the 1970s. Back then they didn't have an understanding of the effects of antibiotics on infants that they do now and as a result I have a number of long-time health problems. One of them is I had no testicular function but didn't know that until I was in my 30s. I had the second issue of an abusive childhood at home along with being assaulted by a teacher in the first grade. These things led to low self-esteem and along with constant badgering for my burns left me with serious self-hate. My emotions never worked correctly, and I had a pronounced hatred of my body. Part of the abuse I suffered at home was homophobia and as a result not only did I not have an understanding of why I felt like a girl but I tucked it away and blamed it on the burns. I went on to become a people pleaser and the person I was expected to be but by my 20s the dysphoria was really growing in me. I would blame my desires for female behavior on fetish and then I saw the truth one day in my 30s and started seeing a therapist. Its not been a smooth road but I wont bore you with that . My point to this story was to illustrate that I have always wondered if my dysphoria came from the fact I was essentially castrated as an infant .. and then buried it all for lack of understanding.. I only hope one day soon we will see solid research into the medical side of this.

Well I'm far from being young, but for me it always was mainly social dysphoria. I was the invisible man, and this was so painful that I ended up with social anxiety... I dreaded going outside and being misgendered everywhere, catcalled by strangers (I often got into fights with disrespectful pricks 😒), having to speak to people... I didn't even answer the phone. I didn't understand why people kept "she/her" me when they knew my appearance didn't match my true self (this was the 90's...). I used to tell them "I am INSIDE a woman, I'm NOT a woman"! The lack of descriptive vocabulary was painful and I'm happy to have it now. I took T to see myself in the mirror, hear my true voice, and be seen and heard by outsiders right away correctly. They now see me and say "sir" and "he/him" automatically. That's enough. I wanted to see myself and be seen. Now the genitals and breast are nothing distressing, just the markers of Nature's weird mistake. But they are hidden and functional so I don't mind. We older adults may have felt social dysphoria for a long time, it can be part of why we transition so late in life, with all the physical dysphoria narrative we can feel as though we can bypass transition because it is seen as less severe. And thus, we waste years, suffering...

Your third typology, "social dysphoria & physical neutrality," rings true to me and I thank you for discussing it, since I so rarely feel seen that way. In a perfect world, I would have been totally fine with my beard and other male characteristics, and I have less-than-zero AGP or kink/fantasy component to my dysphoria. But because I looked so much like a traditional cis man, over time those cumulative expectations added up to make me miserable. So my neutrality toward my body was progressively ruined, and I ended up with a sort of secondary physical dysphoria. Changing my body in response has definitely improved my life. As a visibly cis man, I hated being presumed to be hypersexual, and my "low" libido hurt a lot of relationships because I just wasn't a sexually aggressive or assertive person, which got read by my partners as indifference or rejection. Though being a sensitive, emotional, pacifist, soft boy, people still treated me like a capital-M man, fearing me as a potential source of violence or misogyny. So in my mid-30s I made the deliberate choice to demasculinize myself, settling into a nonbinary identity, and a neutral presentation, but with full-dose feminizing HRT and facial feminization surgery. Now instead of an atypical man who doesn't look the part and doesn't fit in, I'm a nonbinary transfemme where my outward presentation matches my personality and values, and more easily codes that way to strangers, friends, family, and partners.

I'm a 57 year old transgender woman that never had the courage to transition. I knew from a very early age that, I felt like I was a girl. My teen years and puberty were a nightmare, I was very depressed and had suicidal thoughts. I wasn't sure if I were gay, even though I was sexually attracted to girls, but I wanted more than anything to be female. I was afraid to come out so I suppressed it. Every now and then the dysphoria returns. It has really comeback with avengance now, but I have a wife of 28 years and a 23 year old son and the thought of coming out and losing them scares me to death. My wife freaked out because I cross dressed(I hate the term drag) at a Halloween party, and people told her I looked to comfortable as a woman. I really don't know how I will deal with it this time?

thank you Dr. Z You're doing a Great service to Generations of hurting people that have become victims of the Religious and Political Controllers of century's of social manipulation .

Thank you! I so needed this. I am 43 and just accepting that I am transgender. Not realizing it, but accepting it, due to an abusive upbringing and the society I grew up in.

Thank you dr z for taking you're time to make these videos, there more helpful than you know 😊

Wow this is so helpful. I wish more people who claim that we have gender dysphoria due to some trauma could hear you compartmentalizing this issue like that. Coz really looking back I never experienced any sort of abuse or trauma and I was still dysphoria since I remember myself which is about 2-3yo. I wish more people could hear you talking about it from a scientific point of view based on your professional experience. I hope in the future people will understand that dysphoria is as much a medical issue as any other health issue and won’t stigmatize us trying to deal medical help for it.

Thank you so much for your humanitarian work here on this platform. The fact that you offer such grounded discussion for those of us who are going through this is so important and so very appreciated.

I'm 64 years old I've gone through two million dollars of insurance money in my own money trying to figure out what's wrong with me I got sick in 1987 and it took tail 2008 for the doctors to figure out I had cyclic vomiting syndrome the University of Utah knows me like the back of their hand I've been to the man son a pain clinic and John Hopkins Hospital I've been to the male clinic I've done everything the doctors have asked me I've even let them cut my stomach open for exploratory surgery in 2016 on my psychiatrist after so many psychiatrist this one told me I was transgender I have so much anxiety and depression and I'm so stressed out I've almost lost my construction business I was doing really good in business up until I hit 50 it was tough I was sick a lot I hit 50 everything is going downhill fast 2 years ago my doctors put me on estrogen and testosterone blockers and I feel so much better I haven't felt this. Good in 40 years my doctor say if I could transition into a woman I would probably never have cyclic vomiting syndrome ever again and all my stress and depression and anxiety and dysphoria would all be gone I want so much to be a trans woman and wear beautiful clothes and express myself as I am a woman but I cannot pass and I'm worried about the children I worry so much about ruining a child's mind did I just don't dare go out in public my friend he tells me that I should not worry about that but I do I worry about the children's Minds then the effect I could have on them I asked God everyday why couldn't I just be normal why can't they hypnotize me or laser my brain so that I could just keep going on not always be thinking about this I just can't get it out of my mind and the older I get the worse it gets I can't think of anything else I'll lose my business what little is left if I transition I pray to God to give me some money to have my face surgery done if I could do that I know I'd be better than feel better even though I would lose my business and all my friends except a few understanding friends those are very few and far between even my own sisters have kick me to the curb and disowned me they say I'm a freak my nieces and nephews have nothing to do with me I go on and off on the testosterone blockers and estrogen if I start growing breasts I will no longer have work as a contractor then they'll be no chance whatsoever of having facial feminization surgery I'm willing to lose my business product got to have the money to do the facial feminization surgery to be the person that I really am inside I accept I'm a girl in a man's body but I just got to have some facial feminization surgery so I can go out into public and be who I am I was severely beat up six years ago because men should not be wearing women's clothes Ashley were beating me up they kept telling me that the whole time it took 4 weeks to recover from what they did to me all I want to do is pass just passed as a woman so I would not have effect on children and people would not want to hurt me but I just don't see that in my future struggling so hard to keep things together I wake up every morning wondering and wishing that this would be the day I could die I'm at my Wit's End and I just don't know what to do😢

❤im not crying, you're crying 😭♥️thank you so much for educating everyone. Ive always been trans masc since before i could explain it to friends as a young child ( 4 or 5yrs). When i began puberty at 9ish yrs old, my physical dyphoria began, and continued to intesify. The things i enjoyed were harder to do on all levels( physical, mental emotional...)and i was super alienated and harassed socially, to the point it was traumatic

this could easily be a book on it's own, i'm sure it will be a part of your much anticipated book. can't wait to hear more about it in future videos. looking back for me i'd say, wishing i could play with the girls vs boys started in 1st grade as far as i can remember. i don't see it as social i just had no interest in sports and i've never understood guy talk, how they view the female gender or their need to feel dominant over others. i have no recollection of kindergarten at all, it's like it never happened. pre-k i just had a small pool of kids to play with and boys played outside and girls played inside so segregated back then. genital dysphoria came around junior high for me but i think that is probably normal, back then boys didn't really start interacting with girls until about 6th grade. we moved out to a farm when i was in junior high and i became aware of castrating animals for meat raising so it's been on my mind as a possible solution for a long time now, kind of the biblical if your right hand offends thee cut it off mentality i guess. sexual took time to sink in partly because i never had the opportunity until age 20, always hearing how good it was supposed to be i didn't understand why it felt so awkward for me or why i felt the roles should be reversed sort of not wanting to take but rather be taken kind of thing so definitely submissive. i guess it was there from the start but i thought it would go away and that it was based on lack of experience or i just didn't find the right girl to be with but it's like a switch goes off in my head and i have to force myself to play the male role and i just want to get it over as soon as possible and feeling like a failure, out of place and empty. after my first time i began to find ways to avoid getting into that situation which wasn't hard since passive & submissive guys aren't very attractive to women. there is a lot of social and family pressure to live what they see as a normal life so a lot of distress from that. i still can't talk to my mom who's 90 without getting remarried coming up probably why i don't call very often. avoidance seems to be the primary way of coping it seems the physical i can tell myself this is just the way i was born so it's out of my hands, socially i can say i'm just not attractive to women, the sexual side though i had to own since i had the parts, i had the attraction and desire just couldn't put it all together the way a guy is supposed to so that's the hardest thing to deal with.

This is a really excellent video and I am interested to learn more about each topology as a means of self knowledge and further meditative thoughts on these topics. thank you for posting this- you have insights and answers I don't find anywhere else.

I encountered an older trans woman whose entire understanding of femininity was shaped and informed through "sissy" culture/kink and that really threw me. Her trans identity online was very sexual. My honest reaction was "this is the kind of person that makes AGP look valid oh god how cringe." As a more butch trans woman it freaked me out. Still not sure how I feel about that. I do note this person seemed to feel that feminine was weaker and lesser, I do not and most trans women I know do not feel that way, quite the opposite... Transitioning made me stronger than ever.

Thank you Dr Z for sharing this and for talking about AGP. I know it's a very difficult subject. My story is that I was comfortable being a boy, but hated the transition to manhood, hated body and facial hair, and didn't want to wear anything revealing from my wasit down, like shorts etc. But I was never embarrassed of my body in private and was quite comfortable with it. I hated traditionally stereotypical male pasttimes, sports and "entertainment" and saw myself more as a woman, jealous of women. I wanted to be with women, to talk with them, to go out with them, purely non-sexually. I still do. And I hate being the outsider. I hate when groups split down gender lines. And yet now, I'm quite OK being a man, don't have much if any dysphoria in that regard. I worry that the primary motive for me is sexual. I've always wondered how it feels to be a woman, emotionally, physically, sexually, I am jealous I cannot experience it. I cannot come to terms with the idea I could be trans. Nothing would give me greater pleasure I am sure. But I am so afraid of being a fraud, that I'm not genuinely trans, so I will stick with what I know.

23:20 she was so happy & excited while saying *ANYBODY*

Thank you for your excellent videos. As someone who is infinitely curious, it helps me greatly to learn where dysphoria may come from. I certainly feel my dysphoria is predominantly physical. I can feel physical pain from strongest dysphoric feelings, such as viewing myself in the mirror or a picture. Unless I'm dressed as a woman, then I feel 'good'. Having accepted being transgender, I notice I often feel dysphoria more intensely, but have found coping methods than are more effective. While intensity comes and goes,my dysphoria is always more prevalent when I am alone. Lately, I find myself picturing myself wearing what I see especially with lipstick, earrings, jewelry or fashion dresses. I love the necklace and how I think it would look on me. I literally sense the texture of the lipstick or jewelry. It is uncomfortable at first, but the longer I hold the image in my mind I feel better and better. I'm not sure this dysphoria or something else. I'm looking forward to the additional videos. If there is research on the various 'types', perhaps you could provide links.

At 45 years young....mine started as a kid, but overworked for 30 years to not allow brain to process it. 3 failed relationships later, the last left me feeling like my masculinity was just stripped away, or that for the first time i began to process my inner self. Physical dsyphoria first and followed by an overlap or a social response to that physical dysphoria. I have never felt comfortable in my body, in groups like (hanging with the guys), it always been more relatable and comfortable in feminine groups. Whether the things i found interest in or emotionally much more connected to the world around me, i have always been trans. With all that said, im stilm taking incredibly small steps in this process, but making it my goal to be as authentic and genuine to who i am first.....even if that means solitude in social settings, lack of friends, etc. These videos have really helped me try and wrap my understanding of what is going on, why it is, and again understanding my options going forward to live best life i can.

I love watching the evolution of your necklaces over various videos. Yas queen!

Do you have a video on this? I'm 35 but have known since I was 4-5 years old. There wasn't a "late realization", I've always known I was a girl. I went through several periods where I would attempt to transition but then get cold feet for fear of losing my parents, and religious concerns. When I was a teenager, I would fantasize about cutting off my genitals and running away. I've always found erections distressing, I've found sex discomforting and haven't been in a relationship in 12 years because it always felt wrong. I tried to adapt by focusing on loving myself for the body I have and trying to convince myself that although my identity was female, I wasn't the same as cis-women because I wasn't raised that way and life experience also defines who you are... so in a sense I was being what life made me. At my recent birthday, I realized just how deeply unhappy I was in every aspect of my life. I probably won't have kids, my parents are old, my nephews are grown up and I just couldn't do this anymore. I've been embracing myself and suddenly I don't hate my job as much and I love myself so much more. I haven't fully transitioned, I'm working on it, but I was numb to how exhausting the day-to-day friction of being someone I wasn't was taking on me. Life is so much easier. You seem to really focus on people in my age bracket as having a "sudden awareness" or "not realizing it".. But it has been something I've carried with me and thought about on a daily basis my entire life. I didn't transition earlier because I didn't feel like I could and I was afraid of going to hell. I always thought if I did, I'd have an inkling to return to God, and I'd end up detransitioning. Now I just pray daily that if I'm making the wrong choice that God let me know, but so far, I feel great. The mask has fallen off, and I can't bear to put it back on. Even my sexuality, which was very confusing has begun to clear up. I like men. My attraction to women was always an envious gaze. I've never had a desire or fantasized about having sex with a woman, it's always been men. I like women's outfits, or their make-up or how they style their hair, but I don't fantasize about them. That feels weird. Being with a man, as a man, also felt weird. I like the feminine role in a relationship. As a girl, it's perfect.

Hi dr Z, you might not see this but I don’t really remember what exactly caused my dysphoria but from then on it’s been getting worse. I have congenital hypothyroidism and wasn’t medicated until after a few days i was born, do you think this falls into the first typology for gender dysphoria?

Thank you for the video. I know it was topical, but it helped me understand the different types of dysphoria. I guess from the descriptions of types of dysphoria I have had 3 of the 4. When I was born I adored the female body. You could say I felt comfortable and safe. Growing up in a Hispanic family views have been toxic. Everything was gendered. Boys were supposed to be around their fathers and men's groups. The mothers and girls are in their female groups. But, I was one of the few who generally hovered over the female groups. Recently I was close to finishing my degree as an Anthropologist, but I changed my major to Linguistics (I don't regret it). Growing up in a "Traditional" set of values (Catholic/ Pentecostal Christian) they were often all gendered orientated and extreme. Through Anthropology I have seen that Religion has been controlling the social aspect of the world. I believe that it's fine if people believe in what they want as long as they don't force their perception and make the social and physical aspects of communication unbearable for others (causing mental and physical abuse). All religions will say their "religion" is better and will try to conquer the world physically or socially. These individuals then abuse their religion as a way to criticize others but get upset because the world sees the wrong that they do. They want to speak their mind without consequences, but honey the world is full of different people so there will be consequences when it does some form of harm to people. I realized that my grandmother from my moms' side does a lot of banter with her grandkids. When I tried to participate in it, one of the brothers-in-law intervened saying that men don't say that or say words like "beautiful". He further said men don't use those words on themselves. He grew up in a barrio, thinks the Marines "made" him a "better" man and is a typical conservative cop. You could see why I could hate his view point. Also he is a toxic Narcissict who does not have emotions and finds no point to apologize for any reason even if he makes a mistake. " Because in the Marine corps were not taught to apologize" (his words). I have also seen that roles have been gendered often, men are forced to carry heavy objects while the woman can carry boxes too, but act weak. A lot of gender roles are way too wrong that should not be forced socially when people do not want to participate in them. As a child, I had no voice. I had to follow and do what they say. I was a walking blank canvas pleasing others. I had to repress everything that was on my mind and force myself to make others think I'm a man. I was doing things for their validation. It wasn't until after I graduated from the university and using all I've learned from Anthropology, Feminist theory, and other courses that I myself might fall under the LGBTQIA+ group. I have already accepted myself as Bigender (men and woman). But my aim goal is to present medically and through surgery Bigender (Transwoman and Nonbinary). For now, I'm coping by using theories from my minor (Expressive Arts Counseling). I do want to transition, but I want to marry a woman and have kids first. I'm reaching my goals slowly but I will reach it. I have already applied to work in Japan. The thing is when people marry it's usually someone near their region due to familiarity and peer pressure. When they have sexual intercourse they imagine it's someone else instead of their partner. I see that as signs of in fidelity. That's why I won't listen to what people say around me. I won't jump for anyone that my hearts skips a beat too. I'm so close to work in Japan. It's more of a follow-through promise. I was close to suicide 5 years ago. I don't know if it was an angel or some being, but It used some force on me. I was close to hanging myself. I had to accept reality that I couldn't kill myself even though I wanted too. So I'll be off to Japan looking to marry a Japanese woman. I used to think that it was my subconscious, but the subconscious does not exert an external force on individuals. Whatever it was it gave me a purpose to live for and follow through. And so even though I can't kill myself I might as well live how I truly perceive myself instead of repressing it. I also have a Therapist who helps me when I need to talk about my problems, or just talking about my week. Having a Therapist is good because family and people will always be subjective and hurtful. Therapists will always have an objective perspective. If they are repressing you then look for a new therapist because as caregivers they are not supposed to give any sense of harm to the client. It is part of the code as service providers it's the first thing we are taught even though we (social workers, counselors, and therapists) are not working in a hospital. Now, that I've accepted myself I want to be known as ms., she, her and they, them, and their pronouns, but it's very difficult in Texas. Because Texas is a very very very very conservative state, but that means it's very very very very ignorant as well. When I was working as an Emergent Bilingual Teachers Aide I got mistaken for Miss by the students a few times. I wasn't upset, I let them know that they can call me Miss or Mr. and that it won't make me upset. I'm okay if people call me Sir; sure I'll get a little dysphoria, but it's manageable. I started to tear up because hearing Miss for the first time made me happy. I was grinning from cheek to cheek. I have to say it caught me off guard and that happiness put me in such a daze that it stopped my translations momentarily. I had to stop that work due to personal issues with family members who work in the same school district and other issues. For now, I'm substituting and working at KFC helping a friend who's a GM (since theirs, are not enough employees). Within the safety of a few friends and family members, they do call me the pronouns I prefer when we're alone or within our group. I'm glad that you make such helpful videos. Keep it up, Doctor. 😊 I hope you all have a wonderful and pleasant week if not, make it wonderful and see the positivity even though we accept that there will be bad events.

Ive had to walk away from every wedding event for like 15min bc of dysphoria. The whole “best way to be married” jargon is extremely hurtful.

For me there was definitely social dysphoria that carried over into my adulthood. I've always had crippling social anxiety without knowing why, I would miss months of school for medical reasons stemming from depression, I made very few friends, and I never pursued any long term relationships. All of this continued into adulthood, including when I went back to university at a later age. As I became more cognizant of the matter, I realized that my body language and voice were intimidating to some people, which is ironic considering that I'm 5'2". I caught myself playing into the typology of what an "alpha male" is supposed to act like, without even being conscious of it. I think it was to hide the feelings of vulnerability I felt in any given social situation. I had to be the dominant one, to seize control of the conversation, to impress everyone around me with my intellect and accomplishments. However, I'd be lying if I said there haven't also been body image issues. I just misattributed the cause, once again. I thought it was body dysmorphia, due in part to my weight problems at the time. I have a history of SH, of hating my image in the mirror, and of feeling like I want to tear off my skin. In the past it had never occurred to me that this had anything to do with gender, as I thought it was solely due to depression. I've often described my life as feeling like I never grew up, and was always faking being an adult. However, before I realized I was trans, I attributed that to being immature and irresponsible, like I just wasn't ready to take on the responsibilities of an adult. It hadn't occurred to me that many of those responsibilities are heavily gendered by society, and had nothing to do with my perpetual desire to go back in time and correct all my past mistakes that led to my growing up the wrong way.

I know that autogynophilia was a concept that only increased the already staggering amount of self-hatred I had accumulated. AGP was just the "icing on the cake" needed to keep me closeted for a while longer, which is just to say that I know now that sexual desire didn't lead me to become trans. So glad AGP became a thing just about the time I became an adult in the early '90s. 🙄

Thanks Dr. Z, you are the best.

Thanks, Dr. Z! ❤

I’m a young adult who began experiencing dysphoria as social. It became physical dysphoria later on as you explained. Since I started T, I’ve felt physical euphoria and love how I look and sound now. Medically transitioning created a shift in my brain’s view of myself for sure. Now, I have physical euphoria through T, fully view myself as a man, and would probably have physical dysphoria if I had to go off T. For me though it’s hard to distinguish physical v social dysphoria so take this with a grain of salt haha

Do you have any thoughts on dissociation as a defense mechanism for dysphoria easily being (mis)understood and passing as "neutral" feelings about the gendered aspects of one's body? I can only speak to my own personal experience but I found it impossible to understand the difference until I began to honestly question my gender. Then when I began my transition, I also began for the first time to truly and in earnest confront the extensive coping methods for dysphoria which I had developed over several decades. And that was very much one of them, to the point of not caring very much about my body one way or the other. I did not do things _intentionally_ to harm my body but was not concerned about that being an end result of what I was doing with it, either - because I felt disconnected from it and any long term consequences to it. I have since discovered through therapy and much, much introspection that this pattern of behavior started to manifest at the onset of puberty as a defense against the intense dysphoric distress it caused. Unfortunately, I had no language to describe it at the time and no resources or support to understand it, so I buried it and myself with it. But if you had asked me at any point during this, I'd say I had neutral or no feelings about any of the gendered characteristics of my body and fully believe that. Dissociation is a powerful mask for repressed distress, _especially_ to the one wearing it.

Thank you all your great videos

Thanks very informative 🎉

I just love how the necklaces just keep getting bigger and bigger

I have trauma and sexual based dysphoria. Since childhood I have been bullied by kids, growing without a father and then growing with a step father tyrant, caused strange things. I started crossdressing from a young age. I think my brain decided that if I was a girl people would love me because girls don't get punished or bullied. So sexually I imagined myself like a girl and now have dysphoria to see my masculine face in sex.

In regards to the sexual origins to gender dysphoria. One of the first things that came up for me was distinguishing between how many women express themselves, some more sexual than others. Should I say Victoria's secret. How do we distinguish, or separate, what we might call normal female sexual expression, with what a trans woman might do. If someone has social dysphoria as a child observes certain behaviors in women, more sexual\sensual ways of expression, and they are attracted to that form of expression, how would this be different than a cis woman? This makes me think of the book. Self-made man by Nora Vincent, and her observations of the differences between what men and women are allowed and not allowed to express outwardly. There seems to be a considerable contradiction when we talk about what is acceptable behavior depending on what we are assigned at birth. If I wanted to get all dressed up in a sexy gown and go on out on the town I would judged far more harshly, and pathologized for the same behavior that a cis woman would exhibit. This I would see as how my physical dysphoria began to develop. My discomfort socially as a male grew into a physical discomfort with myself. The realization that my emotions and desires had a physical component to them. That physical component included things such as sensuality, which can be expressed outwardly in the clothes that we wear and the manner in which we carry ourselves. This physical expression has such a strong social component as I mentioned above. Once I began to see just how different men and women were when it came to our physical worlds along with her emotional ones I was unable to go back to my old ways. Then I realised that these experiences, these physical and social parts of myself were completely tied into how the outside world perceived my gender. There was no escaping this disconnect between my inner and outer world., That's when I realized that for me to fully feel and express who I was, I had to be a woman.

you just described me. I'm older and all of what you just said is so true

I think this is a great overview of different causes of dysphoria, and it tracks with my personal understanding of it as well. Personally I don't know for sure if my dysphoria has a biological cause or was caused by trauma. It could be a mix of both. I was very young when I first felt dysphoria, around age 3 or 4, but it was linked to a traumatic childhood experience. I'd love to hear you get more in depth about trauma induced gender dysphoria, if you find the time to. I only really have myself to go by. For context I was born female. As a child my dysphoria was very vague and more of a strong wish to be male. I then didn't develop dysphoria about my secondary sex characteristics until after more trauma in my late teens, and first felt social dysphoria around that same time. I transitioned with testosterone and top surgery in my early 20's when my wish to be male became painfully strong, and am now in my mid 30's. I am very happy with my transition, but... I feel like I never really developed an inner sense of gender identity, and transitioning has largely felt like a way for me to reclaim my body and make it my own. And it genuinely helped me connect with my body. But I also love being female, in a sense. No desire to be an "intact" female like cis women, but just... basically I like being reproductively female and having a vagina, but live as a man and have male secondary sex characteristics. And I think that may be because my source of dysphoria may not be innate. I don't know though. Just a thought. My trauma changed me a lot, on many fundamental levels. It changed my sexuality to hypersexual, it split my consciousness into alters, and I believe it also made me seek and find comfort in being physically very masculine. And now after years of recovering, all these things remain part of me, just in healthier versions than initially. What changed with my recovery in regards to my dysphoria though is that it cleared up my genital dysphoria pretty much completely. That changed my self-perception a lot. Although there could be a biological component to my dysphoria as well, because it seems my brain somehow functions a lot better on testosterone than it ever did or could on estrogen, and I have a hard time explaining that with trauma. About my gender, I just don't see myself as anything in particular. Just a female who transitioned closer to male. Whenever I think of myself as a man, woman or nonbinary, neither feels right or wrong. So I prefer to not label my gender, but I go around that social inconvenience by labelling my body as ftm or transmasc, because I identify with my body as it is now in its final form. So I'd say it's pretty safe to say that transitioning is right for me, as I literally identify more with my transitioned body now than I do with any gender. 15 years of transitioning and still going strong, is also a pretty good sign, in my opinion.

Yes I relate to all to some degree and like you said it’s difficult to pin point exact cause because they blend together. For me, I started feeling distressed in elementary school. I was into sports and got very excited to play sports on break but the guys became hesitant towards me about 3 grade and became physical head injury. I think it was intentional because I was getting attention from the girls. Social byproduct of physical, not being able to express myself because I don’t have a penis. I remember wanting to have one and experiment but my dad embarrassed me. Yes social, physical and trauma based causes put me in severe gender dysphoria and ruined my school experience starting before puberty. It was rough and still is at times but at least I’m not embarrassed anymore and have become brave enough to just be myself. These videos really help. Putting subtitles at the bottom would help too because I like the quiet as I watch when very exhausted or late at night :) also be nice to confirm I’m hearing you right what kind of accent is this? Keep them coming. These are great. Thank you.

I think when I was a child, I had much more social dysphoria than physical, and then I developed and lived with both. I knew a trans woman who was just purely physical in her dysphoria, but in my experience, that's super rare. I've had treatment and now I don't have dysphoria. I was a little confused over the term "trans-identified", I wonder if you could explain what that means?

Thank you very much, DrZ. I wonder if the physical causes of GD are by far the most common... Should they be tested before doing anything else and if so, how to do it?

Can you give an example or two of what kind of trauma can lead to gender dysphoria? And thank you for your channel, it’s very helpful and needed!

Hi, love your content and those have been very helpful for my journey 😊 Could you specify what exactly is the root you are talking about here? Is the root the point when a person realized and became aware of being a trans or is the root the first time ever when person had gender dysphoria even though they didn't know back then it was gender dysphoria? Like, i realized my true self and started my transition on my late 30's (is this the root?) but when looked back, i can see clear situations where my gender dysphoria/true gender was peeking from the surface, and these experiences go back all the way on my early childhood (or is this the root?), but back then i didn't had the awareness, knowledge nor the words what those experiences truly were.

Another great podcast! It brought up many questions for me. I notice that addiction/compulsion was not one of the reasons you gave for dysphoria . I have had someone ask me that question.

I often think of the times in which I go to a formal event where men and women are dressed in their nicest clothes. Women in gowns men in suits. I would go to these events in maile drag feeling so out of place. I would look around at the women with such envy because they were able to express things that I could not. They can be beautiful, sexy, sensual all things that as a man were off limits. This is not the only reason for my dysphoria but it's a part of it and I think it's a valid part of it. I think it's valid for me to occasionally want to feel sexy, sensual or beautiful. I do realize that trans women are often criticized harshly for wanting these things as it is perceived to be demeaning to women, perceived to be sexualizing females yet women sexualize themselves.

Could you explain the physical dysphoria? Is it referring to a physical sensation of discomfort with ones body, like an emotional pain manifesting as a sensation in the gut, heart, head etc?

Not quite a cause, but I wonder if at some you might address the scenario when someone grows up in a single-gender environment like an all-boys school - one can spend a huge part of their formative years in such an environment and never feel like they fit in, but while an internal sense of gender might not be the cause, having one's social landscape at such an important time in life artificially cut in half can probably add quite a bit to the "what could have beens" an adult struggles with when assessing their past and present life, especially if gender issues are a factor. Such a niche upbringing is likely a niche within the already niche situation of being trans, but surely quite a few people have lived those lives, and some even transitioned, but it's not something that gets discussed due to how niche it is. Funny how nobody calls that artificially separation of genders/sexes in childhood "gender ideology"... (I guess technically that's "gender essentialism", but still...)

I had two causes of gender Dysphoria, one was been expected to distance myself from female contact, join a mail Trivia Pursuit game by dad, and two, hearing and seeing the news on tv about a woman being raped, abused and murdered by her male husband or partner, poor lady, the had my name, Peter, so I identified with the female sex or gender, I took on the name Petra in empathy.❤

I kind of relate a little to all four categories, actually. Predominantly number two. I think that there was probably a physical element at the start that I wasn't consciously aware of (that I couldn't have been consciously aware of), but my conscious recollection of this whole thing definitely originated in a sexual context when I was little, and that did subsequently bring on a conscious awareness of a physically oriented distress as well as a social distress. Feeling like you're in the wrong body is certainly made all the worse by having everyone around you perceive you and treat you like that very same wrong body, which just makes you feel worse about your body, which makes it worse when people treat you like the way you appear, and it just keeps getting worse and worse and worse over time until something has to give. The physical and the social both arose as a result of the sexual root for me. Or perhaps the physical and the sexual both manifested together as the root and then the social arose out of that. It's really hard to say; I was very, very young. And then trauma, while not a direct cause, certainly fueled it. When you explained the trauma patient's perspective, I think you probably skipped a step in the progression. As opposed to, "If I transition, then it's like all of these things never happened to me," it's rather more specifically, "If I transition, then it's like I become someone else, and then it's like all of these things never happened to me; they happened to that other person who I'm not anymore."

I literally don’t know how much longer I can hold on for. I keep getting in accidents cause I am so out of touch with my body. While I don’t want life to be like this anymore.

As a person with mostly (almost solely) social dysphoria who is turning forty this year, I wonder if there is also a skewing of the numbers around social dysphoria which comes from something like… people my age with mostly social dysphoria wouldn’t necessarily pursue treatment, partially by putting it down to discomfort with gender roles, gender expression and so on, and even if (as in my case) they’ve been sure that their actual gender is different than their assigned one, being ok with one’s body can both make it confusing as to what is going on and make it unclear what treatment could do for you. The mother of a friend of mine, when that friend started pursuing medical transition on a non-binary basis, said that she also felt her gender was wrong, but that she’d just learnt to live with it (implying that my friend should too). I used to think I was ok, though being constantly gendered was getting on my nerves. From the age of eleven or so, I felt like I got ”sorted wrong”, but my body didn’t bother me, just what my body meant to other people. First it was confusing that I wasn’t allowed to be left out of gender, then it was frustrating that however I tried, I was still sorted this way, then I got into despair and now into resignation and living mostly isolated and with friends who don’t sort me. I still haven’t pursued any treatment, because I’m not sure what I would gain compared with the cost. I think it also matters that to a large extent social dysphoria can be managed socially, while physical dysphoria can’t. Maybe the younger ones think that with physical transition, they can more easily manage social identity, and maybe they are right. If I felt I was a binary person, I probably would pursue medical transition, no matter that I don’t have physical dysphoria, but as it is I don’t know. I think it would be equally hard to convince people I have no gender whether I transition or not. In my experience, among my friends and acquaintances (who are all over the age of 30), people with mainly social dysphoria don’t seek help, unless they’ve decided to pursue medical transition as a means to manage social identity.

My mom was on birth control when I was conceived could that’ve been the cause of my dysphoria?

I deal with Anerexia as well

Lots of great insights here but I feel like there are aspects of this video that could mislead more than most of your content. First, while you didn't specify that typographies of transition causes have to be one or the other, it doesn't explicitly mention that some people experience a mixture of multiple causes. Lots of viewers will attempt to box themselves into one corner when in fact they are a blend of multiple causes. Secondlty, and more importantly, I think you missed a huge part of why sexual feelings or experiences tend to elicit gender dysphoria and/or transition. The wider culture accepts that there are odd, seemingly inexplicable aspects of human sexuality, and these are understood generallly to be kinks or fetishes. I think a lot of people knowingly or unknowingly use the idea of kink or fetish to contextualize playing around with ideas of embodying the opposite sex while in a safe, contained, and somewhat socially-sanctioned environment. I do not doubt that there are cis people with these kinks but many are eggs because it's the only way they can inhabit their true gender without all the social, financial, and psychological aspects of transition. Eventually they can come to realize that what was once erotic has shed its sexualization yet retained its gendered aspects. I think this accounts for much more than 2% of the population, and I think the mechanism is quite clear. I'm looking forward to your video addressing this. Cheers darling!

There is definitely some link between biology and dysphoria. To fix my bladder cancer, I followed the standard handling: chemotherapy followed by prostatecystectomy with urostomy. So far, so good, scanner is clean. But, there are side effects, one of them is growing bottom dysphoria. This is purely psychological. My explanation is that the perception of my bottom changed from something functional but not used to something dead (thanks Cisplatin and/or prostatectomy). The other border effect is the sensation of hard-core feminization that takes place. I try to find why ? I have not changed my low dosed hormonotherapy. My hormones are at the same woman's levels for years before and after cancer treatment. Next step, restart to visit my therapist to find how to mitigate the issues.

Good video and Thank you again ... One that you didn't cover is I think hererity. In the 20 years that I have been involve with the Transgender Community, I have found 13 cousins across the country, all from my mothers side of the family that are Transgender

Hello, could you please tell the difference between autogynephilia/autoandrophilia and gender dysphoria? Is the first one purely sexual thing? Are they related? Thank you!

Dr Z Really need your profesional opinion here. What if one desires to be transgender, basically since I've known transgeder people existed I wanted to be trans (mtf) Is wishin to be trans the same as been trans??

My face when she makes a list like this and I check all 4 boxes. 😅

In your experience has anybody been dysphorized by psychiatric therapy rather than psychological therapy. Is dysphoria emotional and impulsive as to satisfy a desire or is it rooted in a mental condition as a compulsion as gambling or kleptomania. I know there are wide variances as to how male and female behave but they are often blurred in the same person we just lean towards the one we like and feel is us. We are all conceived female but some of us become male, when the xy chromazone takes precedence or even why is a grey area. I can fully understand sexual dysphoria as for me its strength varies from day to day, what is the best thing to do or even if anything should be done. Is hormone therapy needed or do you go as far as full surgery.

Interesting. I guess I fit the physical type? The other 3 don't describe my experience. I came out at age 26, but I did have discomfort earlier. It wasn't easily identifiable as gender dysphoria though at younger ages. I just knew something was off. Wondering how common this is.

If the physical dysphoria is caused by autogynephilia sexuality what should I do? Can it disappear alone? I have no social dysphoria by the way. It has started as sexual but now I am not so sure that it is only sexual l, I think it has became more than only sexual. I am 38 yrs old. I think I am at the beginning of this discomfort with my male body and I am becoming a little obsessed with the ideia of taking hormones in order to get a more androgynous body. Please what should I do? I am afraid it get worse with time

Even growing up in the 90's and 00's I recognize the gaping lack of language about gender, which might have prevented a lot of us from figuring out their social dysphoria earlier on. I always felt hollow and disconnected when growing up and thought that gender for sure is just some theater we are all supposed to play. It took till my 30's to fully realize that that's not, in fact, how most people seem to feel and that letting myself live without any gender at all would be what I need to be happy.

I'm still not clear about 'Physical' causes of Gender Dysphoria. Surely if it is a Dysphoria that implies a kind of Disconnect between the body and the mind, whereby the body is blamed?

you've talked about euphoria as a form of dysphoria on this channel before, how would you classify that with regards to this typology? Say for example, a person experiences only social dysphoria but feels happier when they are able to feminise or masculinise themselves physically

I have social dysphoria. Body dysphoria came later, i only hate my breasts when the shape is visible with clothes on, I want to be perceived as male by any body any age. In high school I wanted to be part of the boy friend group but that wasn’t really possible, luckily adults are more open to a mixed friend group. I think it’s very obvious when cis men don’t want to share things with me because they see me as a woman and when they don’t want to tell jokes because they don’t think I’d find it funny (which is al rooted in misogyny). A friend of mine has more body dysphoria and it’s always interesting to talk to each other about it.

I used to believe that I didn’t have any recollection of any form of Dysphoria until I began to make myself remember by being honest. I remember the earliest being in the store when my father asked what pack of underwear I wanted. I remember I wanted the girls underwear that day, I liked them more. I knew nothing of gender at that age. He said no, those are girls these are the boys over here. I went with the boys but I remember that it bothered me. I didn’t understand besides as a biological boy I wasn’t supposed to associate with girl things.

I agree with alot of blanchards theory. Sex is a very strong drive and motivator so strong it can cause a straight man to want to become a woman because he is attracted to women and what to feel what he is attracted to by becoming what he is attracted to

Seems like every time I am ready to come out totally the climate around transgender people changes. Leaving my transition in limbo. My hairstyle is very long,facial hair removal is nearly complete but haven't started hrt although I am taking an herbal product estroginon and blocker novaride both over counter products.Does anyone know if these will work?Its been maybe six months since I started.I've known I am transgender for several decades.I am a young seventy something now.wish I would have made the changes long ago.

I’m perplexed and very curious about this condition. It seems like there could be a plethora of causes, dependent on the context of the individual’s life. So many things could potentially contribute, it’s a non-exhaustive list potentially. Genetic, environmental, like social and chemical toxins) etc.

This video needs more likes!! please 324 up to now!

Can a person who presents as androgynous enjoy flexibility of expression? Can a person be, in effect, bigender? I am thinking of a person comfortable with masculine and feminine expression. Does distress always accompany being misgendered? It would be lovely, I think to be so confident that other people's confusion doesn't affect a sense of authentic self.

I don't know where it falls into the list but I think for me it started with my sister dying when I was 4 and I thought it was my fault and everyday since then I wish I was a girl so I could replace her and my parents would be happy again. Anytime in media I was seing some kind of transformation of the body from one thing to another it fascinated me (even more so if the transformation was male to female). When I found out porn it became the only trope I was looking for: transformation.

I was 5 when I told my mom I was a woman

I can remember crossdressing as Alice and Dorothy of "Alice in Wonderland" and "Wizard of Oz" at age 5, improvising with towels as hair and skirts. I liked curtsying and bowing equally and loved using the Easy Bake Oven in kindergarten. I thought nothing of it. It's when I turned 9 that I began getting teased and verbally and physically abused by my uncle, older cousin , parents and teacher for being a "sissy", "wussy", etc. because I lacked coordination for sports, feared large flying insects and preferred to sit indoors and read comics. I was curious for decades about LGBT culture, especially transgenders. After seeing a couple of therapists at 45, I was diagnosed as transgender, joined a trans support group, began transitionig and came out a year later. As for autogynophilia, I see my femme wardrobe as just clothes, except for negligees, heels and black leather corsets, lol! My sex life improved 200% after my 2nd year of transition, with group sex, BDSM, sploshing, etc. with various genders of partners! Now, my gender dysphoria is mainly triggered by a malfunctioning electric shaver, lol!

Thanks for spelling out the importance that gender dysphoria IS a pathology. If a person is not suffering (dysphoria being the scientific term for suffering) mentally, emotionally, physically - WHY would someone transition and expect to get health insurance for doing so. If it isn't based on dysphoria - it is basically cosmetic body modification for other reasons.

I have this disorder. Can I consider myself after the operation as a sterile woman? I will not be deluding myself, right? I can consider myself born female, but with a congenital defect in the brain, because my mental health can never bear the idea that I was born male, and that there are people who see me as a transvestite male and imitating women. Because I never see myself like this and I do not bear this idea because I am sure that this struggle with myself is real and not an illusion. is this normal ? Can I live a normal life? Because I've been thinking a lot about ending my life. Especially when I see people's comments .. and I feel that they never understand me. I saw comments saying that it is just an illusion and that I will never be able to become a female, but I actually feel that I am a female and I cannot be a male and I have a complete rejection of it. I have tried a lot Accept the idea, but to no avail. I feel that my mental health is affected by these comments, and they make me feel very distressed and think of suicide. Can someone help me and give me answers? I really just want to rest with myself and end this torment. I don't care if I'm male or female. I do not accept the term transgender either because I want to be a normal person.

Klienfelters? Did you say that?

Their trans phobic in Springfield the ones who actually struggle with gender Dysphoria the ones who don’t with beards and messed up hair r excepted. I have little money but I try to align myself as the female I am the others get accepted as men

I feel so lost

The cause = psycho-sexual logic that does not match the body. The origin of this cause is unknown. What you list are not the causes but the triggers (what obviously gendered things make you feel bad = biology, social, sex).

The possibility that my gender dysphoria was rooted in trauma was something I thought was very likely. It wasn't until my mother told me that she, my dad, and my grandparents refused to buy me, or let me play with, girls toys when I was very young that I dismissed this causation.

The treatment for AGP is to take away testosterone levels as testosterone cause AGP. Hence lowering test levels provides relief. This is why trans women feel such insane relief from medical transition. They believe this means they have been a woman all along and use this to guide their assurance. This is not true though. The relief they are getting is relief from the paraphilic behavior and urge. It is like an addiction, you feel relief from the strain is no longer there. To treat AGP without transition you would still need to lower test levels to an appropriate dose that gives relief and then after awhile you would increase again to normal level. This will cure AGP even if it comes back and repeat.

Put me down as understanding AGP to be BS! For those interested read Julia Serano's analysis on the topic. It almost sounds like you are suggesting something outside Blanchard's 'theory'.

the principal one : Autogynephilia

I agree gender dysphoria is a pathology and very rare not as common as its insinuated here and mass media.

I’ve never had sexual desires except having srs I don’t use my parts I stopped functioning down their after 4 years but I’m attracted to men I’ve Alwsys dated older men I hate my generation some people never grow up

It’s also annoying when people mean well but only want to buy you clothing associated with your sex not gender.

if i transion will get rid of gender dysphoria chloe anne

I wondered if you would have a trauma based one.

God loves and cares about all of you. It might not seem like it because of all the bad things happening but he really does. He let his Son, Jesus Christ, die so that if we belive and leave our sinful ways all of our sins will be forgiven and we will live forever in Heaven where there is no suffering. He has shown me love while I was still a Sinner and did not deserve it and I know he will love you too. God bless you all

I have an idea for psychological therapy for people who have trouble accepting their bodies, with the purpose of avoiding the use of drugs and mutilation. I would ask anyone who says the other gender: (1) What do you dislike about your body that makes you reject it? (2) Which needs will be satisfied if you become the other gender (3) Do you think you will be losing anything when you transition? (4) The reality check, they must be warned that hormones will be required for the rest of their lives and maybe other health problems due to the drugs or mutilation, and also that they will never be exactly like the other gender. Have you tried this? Give it a try

I think the concept of autogynophilia is very toxic. I am a fan of your work here in youtube, but just hearing you mention AGP made me physically unwell and I could not continue the video. In the past I struggled with very negative feelings because of the autogynophilia concept and this delayed my transition many, many years. I dont think AGP applies to me, but just the thought it might be caused so much self-doubt and shame.

I appreciate this video, but please forgive me for correcting your English. You continually used a word "erotimized" but the correct word is "eroticized". Normally I wouldn't mention it but your videos are very important and there are many haters out there who will use any little discrepancy to invalidate someone they disagree with. ☮💜

Bro 😭😭😭I can not dude

Blanchard disingenously tried to attribute AGP wherever he could and his simplistic two type taxonomy of male to female transsexuals was all about sex. Since in his view women could not be driven by perversion he conveniently disregarded female to male trans people. Are some people driven exclusively by sexual motives? Yes but far from all and particularly not if your feelings originate before puberty. Accusing testaments of early childhood dysphoria as lying was his pattern which is why he is now discredited except among right wing or TERFs.

1. Mean people

I don't think that a physical cause of gender dysphoria has been found, so I don't know how you can say that 80-90% of your clients have a physical cause. How do you diagnose this ?

Sex is a binary that nature created for sexual reproduction. Half of us may be able to produce eggs, half may be able to produce sperm, including those who are intersex. People always have and always will, I think, instinctively identify bodies as male or female because we are hard-wired to as a survival strategy. Who is a threat? Who might we successfully reproduce with? We read the most subtle of cues in a split second - how someone walks - which is influenced by the shape of the male or female pelvis. I don’t think that fighting this instinct, or conforming to it through medical body modification, is the most realistic or healthy way to go. It’s the assumptions of gender conformity that are changing and can continue to change. Acceptance of femininity in males, masculinity in women. If one can develop a sense of peace with one’s gender nonconformity, then, I think one can be tolerant of those who make assumptions. Live in their natural body, as feminine or masculine as they chose - rather than giving away their power or peace of mind to another person’s assumptions about them. There is a sex binary, but we are all non-binary when it comes to assumptions based on gender conformity. ❤

Autogynephilia was shown to be prevalent in cis women, and that's all you need to know.