Healthdirect Free Australian health advice you can count on.

Medical problem? Call 1800 022 222. If you need urgent medical help, call triple zero immediately

healthdirect Australia is a free service where you can talk to a nurse or doctor who can help you know what to do.

beginning of content

Gender incongruence

7-minute read

What is gender incongruence?

Gender incongruence is the term used to describe when your gender is different to when you were born. People with gender incongruence may describe themselves as transgender (trans) or gender diverse.

What is gender?

Gender and sex are different things.

Your gender identity is how you feel about yourself. It reflects your experiences and your sense of self. Your gender might be the same or different to the sex you were given at birth. There are many ways to experience gender and it may change over time.

Your sex is assigned to you at birth based on your external genitals. That is, whether you have a penis or vagina. Most people will be male or female. Those with ambiguous genitals may be labelled intersex or another term.

What is trans?

Trans, transgender, and gender diverse are terms used to describe people with gender incongruence. These are umbrella terms. This means they cover a broad range of other identities, including binary and nonbinary genders.

Nonbinary is an umbrella term for identities outside the binary ‘man’ or woman’. Nonbinary people don’t feel completely male or female. They may feel:

  • like a combination of both male and female
  • neither male nor female
  • may not experience a sense of gender

Cisgender is the term used to describe people whose gender matches their sex at birth.

Brotherboy is the term Aboriginal and/or Torres Strait Islander people use to describe a man with transmasculine experience. Transmasculine people are assigned female at birth but identify with a masculine identity.

Sistergirl is the term Aboriginal and/or Torres Strait Islander people use to describe a woman with transfeminine experience. Transfeminine people are assigned male at birth but identify with a female identity.

There are many other ways people may describe their gender. There are no right or wrong ways to experience gender.

What is gender dysphoria?

Gender dysphoria is the distress or unease someone with gender incongruence may feel. For some trans or gender diverse people, this may relate to:

  • your assumed gender
  • your body
  • the way you are gendered and seen by others

Not all trans or gender diverse people experience gender dysphoria.

What are the signs and symptoms of gender dysphoria?

Gender dysphoria can look different for everyone. Most people will feel a level of distress, unease, or discomfort in themselves. This may look like anxiety, depression, irritability, or other changes in behaviour. If gender dysphoria is not managed it can seriously affect your mental health and wellbeing.

Puberty can be a very difficult time for children with gender dysphoria. This is when their bodies start to change. Teenagers with gender dysphoria are more likely than others to self-harm or have suicidal thoughts. So it is important to get help.

How is gender dysphoria treated?

People with gender dysphoria need to get gender affirming care. Delays in this can make symptoms worse and lead to further declines in your mental health and wellbeing.

Different people need different types of gender affirming care.

When should I see my doctor?

Having gender incongruence or being transgender is not in itself an illness. You may choose to see a doctor for many reasons. This might be for support with gender dysphoria or to get gender affirming care.

Your doctor can help by:

  • providing general support
  • referring you to a psychologist
  • supplying hormone treatment
  • referring you to other health workers experienced in gender affirming care

See your doctor if you want to talk about options for gender affirming care.

Gender affirmation

There is no right or wrong way to affirm your gender. Your gender is not defined by your:

  • name
  • pronouns
  • clothes
  • body parts

Some trans people may not share their gender with others. They may not want to change themselves or their life in any way.

Social affirmation

You may choose to express your gender identity by:

  • changing your name
  • changing your pronouns
  • changing your hair
  • changing your clothes

This is ‘social affirmation’ or ‘social transition’.

Legal affirmation

Legal affirmation might include changing your legal name or gender markers to reflect your gender.

TransHub have information on the legal processes. Some require letters from your doctor or psychologist. Others require you to have received gender affirming surgery.

Medical affirmation

Medical affirmation can include gender affirming hormone therapy and gender affirming surgery.

Some trans people want hormones or surgery to make their body appear more masculine or feminine.

Puberty blockers

Puberty blockers are medications given at the start of puberty. They supress your hormones. This stops the physical changes of puberty, such as breast growth or voice deepening.

The effects of this medication are reversible.

Puberty blockers work best when they are started at the beginning of puberty. This is usually between the age of 9 and 11 years.

Gender affirming hormone therapy

Hormone therapy will cause both permanent and reversible changes to the body. The effect of hormone therapy is different for everyone, but some common effects are discussed below.

People under the age of 18 will need consent from all parents or legal guardians to access medical affirmation.

For people who have already been through puberty, hormones can be started at any time.

Gender affirming hormone therapy, for someone who has taken puberty blockers, is usually started at 16 years.

Feminising hormone therapy

Oestrogen is used in gender affirming hormone therapy for people who were assumed male at birth. This can cause many physical changes including:

  • breast growth
  • a more feminine body shape

You will also require a medication to suppress your existing testosterone.

Masculinising hormone therapy

Testosterone is used in gender affirming hormone therapy for people who were assumed female at birth. This can cause many physical changes, including:

  • a deeper voice
  • more body hair
  • a more masculine body shape

Doctors from different specialties can prescribe hormone therapy. Some doctors, endocrinologists, and sexual health doctors will give gender affirming care.

Gender affirming surgery

Some trans people want surgeries or procedures to change the physical features of their body. This is gender affirming surgery.

If you decide to take hormones, you will usually take these for at least one year before surgery.

Gender affirming care

Gender affirming care includes social, psychological, and medical treatments to help support your experienced gender. It can be hard to find gender affirming doctors. Unfortunately, many trans people have bad experiences. It is wrong for any health professional to try and change your gender or identity in any way.

Resources and support

It is important to get help if you are experiencing gender dysphoria. There are many sources of information and support available.

You can find a list of gender affirming clinicians at TransHub and AusPATH. They both also provide lots of information about gender incongruence and gender affirming care.

Young people can find information at:

Parents can find support at Parents of Gender Diverse Children. Most youth services will have information on local LGBTIQ+ support groups.

For additional support, you may like to contact:

QLife:

  • qlife.org.au for webchat
  • call on 1800 184 527 (3pm – midnight)

Lifeline :

  • www.lifeline.org.au for webchat (7pm – midnight)
  • text 0477 13 11 14 (12pm – midnight)
  • call 13 11 14 (24 hours a day)

Kids helpline, for young people aged 5-25 years:

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: June 2022


Back To Top

Need more information?

These trusted information partners have more on this topic.

Top results

How Emma learnt to accept herself and her gender identity | ReachOut Australia

Emma, a young transgender woman, shares how reaching out for support helped her to accept her gender identity.

Read more on ReachOut.com website

Gender Identity Examples, Meaning & Definition | Kids Helpline

Gender identity is more than being male or female. Kids Helpline can help you understand what it is and how you can understand your own identity.

Read more on Kids Helpline website

What Is Gender Identity | headspace

Gender identify and mental health is an issue that affects many young people. Learn more about the affects of gender identify and how you can get help from headspace.

Read more on headspace website

Gender dysphoria & identity: kids & teens | Raising Children Network

Gender identity is feeling male, female, both or neither. Gender dysphoria is when your child is distressed by feeling different from their birth gender.

Read more on raisingchildren.net.au website

Gender dysphoria & identity: kids & teens | Raising Children Network

Gender identity is feeling male, female, both or neither. Gender dysphoria is when your child is distressed by feeling different from their birth gender.

Read more on raisingchildren.net.au website

Gender dysphoria & diversity: support | Raising Children Network

If your child is gender diverse or experiencing gender dysphoria, support means embracing their gender identity. Your support boosts your child’s wellbeing.

Read more on raisingchildren.net.au website

Your child’s gender diversity: your family | Raising Children Network

If your child is gender diverse, it’s OK if you and your child’s siblings have mixed feelings about your child’s gender identity. It’s good to seek support.

Read more on raisingchildren.net.au website

Gender expression | Head to Health

Gender identity and expression can be considered on a spectrum. The expression of your gender is an important part of your self-identity, and is central to your mental health and wellbeing.

Read more on Head to Health website

Overview of Sexual Orientations - for Young People | headspace

Sexuality can be a tricky topic for many young people. There can be a lot of pressure placed on young people by friends, family and society to identify as ‘straight’ or ‘gay’. Visit headspace for an overview of the different sexual orientations people identify themselves with.

Read more on headspace website

Teens and sexuality | Autism Awareness Australia

While preteens and teens with autism develop physically on the same timeline as their peers, they often need additional support to manage the challenges that come along with their developing sexuality

Read more on Autism Awareness Australia website

Healthdirect 24hr 7 days a week hotline

24 hour health advice you can count on

1800 022 222

Government Accredited with over 140 information partners

We are a government-funded service, providing quality, approved health information and advice

Australian Government, health department logo ACT Government logo New South Wales government, health department logo Northen Territory Government logo Government of South Australia, health department logo Tasmanian government logo Victorian government logo Government of Western Australia, health department logo

Healthdirect Australia acknowledges the Traditional Owners of Country throughout Australia and their continuing connection to land, sea and community. We pay our respects to the Traditional Owners and to Elders both past and present.