Dysphoria is best described as a dissonance between self and body. Sometimes, it may be simplified as “a woman trapped in a man’s body” or “a man trapped in a woman’s body.”

It may be unseen in a person’s life, and this is especially true in people who transition later in life.

While gender identities are more likely to be formed in early childhood – with a few expressing a wish to be the gender that they are as early as three years old – some trans people may be comfortable with stereotypically gendered clothes and activities as children and teenagers; others may repress their wishes as they meet with resistance from society.

Some examples of gender dysphoria may include:

Horror or revulsion when looking at or touching one’s own body parts

• This might manifest as a persistent awareness of body parts that feel like they should not be there (like the weight of breasts, or the presence of testicles or a uterus), or the feeling that a body part that isn’t there should be there (a phantom vagina or penis)

Depersonalisation and derealisation — a sense of detachment from your own thoughts, feelings, or body

Feeling out of place while with peers of one’s assigned gender

• For instance, trans people who are assigned male at birth (AMAB) may find it difficult to be vulnerable around men, something that might become evident when they go through National Service

Shame or guilt when one is unable to fit into common gender roles

Anger or sadness at being forced to cut one’s hair (for AMAB trans people) or being pressured to keep their hair long or wear makeup (for AFAB trans people)

The above is not an all-encompassing or definitive definition of what dysphoria is like.

Dysphoria can often present in varied ways — for some, flinching when someone uses their birth name; for others, feeling a want to be connected to others of their gender, and distress when they can’t do so.

Many describe a desire to repress their inner desires because of how society views being transgender as deviant.

Medical authorities and experts recommend transitioning as a treatment for gender dysphoria or incongruence, as it is the only course of action that has proven effective in alleviating gender dysphoria.

Medical experts largely state that transition is medically necessary and the only effective way to deal with dysphoria. Most trans people will medically benefit from some form of transitioning, regardless of whether their dysphoria is clinically significant.

The Singapore Psychological Society states that conversion therapy — attemping to ‘cure’ a person’s sexual orientation or gender identity and impose a ‘normal’ identity — is ineffective and possibly harmful to some, and exacerbates distress and poor mental health.

This follows the Ministry of Health’s recommendations on conversion therapy, which state that doctors and other healthcare professionals are expected to practice clinical ethics and consider and respect people’s preferences and circumstances (including sexual orientation) when providing care.

The American Psychiatric Association states that transition is medically necessary, while the American Medical Association agrees that delaying treatment for gender dysphoria can aggravate other health issues like depression and stress-related physical illnesses. The UK Royal College of Psychiatrists states that interventions that claim to convert trans people into cis people – or conversion therapy – is without scientific evidence and is unethical.

Multiple studies also find that transition dramatically reduces suicide risk, improving mental health and quality of life.

ICD-11, the list of mental and behavioural disorders compiled by the World Health Organisation, lists gender incongruence as a sexual health condition, a change from its previous edition, which bundled gender incongruence under the umbrella term gender identity disorder and listed it as a mental health condition.

The DSM-V, as compiled by the American Psychiatric Association, articulates explicitly that gender non-conformity in itself is not a mental disorder.

Still, both documents have definitions on gender incongruence and gender dysphoria, for several reasons: