Gender dysphoria, according to the Diagnostic and Statistical Manual of Mental Disorders, is defined as a “marked incongruence between a person's experienced or expressed gender and the one they were assigned at birth.” While not every transgender or gender diverse individual may experience gender dysphoria, those who do may have difficulties in public spaces, such as work or school, due to social norms and behavioral expectations associated with their assigned sex. Overarching effects of gender dysphoria can include anxiety, depression, eating disorders, and relationship problems.

Current research has found that gender dysphoria may make sexual intimacy difficult or stressful for intimate partnerships. A 2022 study of transmasculine and nonbinary individuals found that, this feeling of stress may come from receiving sexual acts more often than giving to a partner. They inferred that this is likely due to the distressing nature of experiencing an action that doesn’t align with their gender identity. On a different note, genital and chest dysphoria are also factors that may make sexual activity distressing. This may lead to those experiencing gender dysphoria choosing to avoid engaging in sexual activity, which can impact their ability to feel pleasure for themselves or connect with their partner(s). Everyone deserves to feel good about their body and to enjoy all aspects of sexual intimacy.

One study that conducted an evaluation of gender dysphoria prior to gender-affirming surgery found that those included in the study rated their sex life as very dissatisfying. Those in the process of undergoing gender-affirming care and biological changes may experience similar difficulties.

Sexual orientation and attraction have been known to change over the transition period for some transgender individuals. A 2024 brain study (amongst others) found that this sexuality change tends to follow the heteronormative pattern of their gender identity. In one of these studies, around 40% of transgender men previously attracted to men before their transition period reported being more attracted to women during their transition period. This could impact sexual intimacy in a variety of ways. Perhaps a current intimate partner would no longer be sexually attractive to the individual, making it more difficult to initiate sexual activity or become and continue to be aroused.

If gender dysphoria is causing distress in intimate partner relationships, it’s important to discuss which areas of sexual intimacy are most distressing and to open a line of communication that feels comfortable. A lack of communication can make it difficult to initiate intimacy, especially when still trying to understand oneself. Other research into partners of transgender individuals and those experiencing gender dysphoria has discussed that most intimate partners feel positively about this open line of communication and that they have used methods like couples therapy or sexual counseling to better enjoy sexual intimacy.

Gender dysphoria can happen in any stage of a person’s life, including during transition, and it is often confusing and/or frustrating. It may make participating in sexual activities with intimate partners difficult at times, causing discomfort and sexual distress. Intimate partners may struggle with these challenges but could find value in seeking couples or sexual therapy. It’s important to speak with a mental health professional if you are experiencing gender dysphoria.

References

• A;, S. L. D. A. (n.d.). “we faced every change together”. couple’s intimacy and sexuality experiences from the perspectives of transgender and non-binary individuals’ partners. Taylor and Francis Online. https://pubmed.ncbi.nlm.nih.gov/34357858/
• Bartolucci, C., Gómez-Gil, E., Salamero, M., Esteva, I., Guillamón, A., Zubiaurre, L., Molero, F., & Montejo, A. L. (2015). Sexual quality of life in gender-dysphoric adults before genital sex reassignment surgery. The Journal of Sexual Medicine, 12(1), 180–188. https://doi.org/10.1111/jsm.12758
• Carling, A. (2025, January 13). Navigating intimacy and sexuality: Lbtq+-partner´s perspectives on sexual relations and gender incongruence (with or without gender dysphoria). DIVA. http://mau.diva-portal.org/smash/record.jsf?pid=diva2%3A1924340&dswid=9529
• Klöbl, M., Reed, M. B., Handschuh, P., Kaufmann, U., Konadu, M. E., Ritter, V., Spurny-Dworak, B., Kranz, G. S., Lanzenberger, R., & Spies, M. (2024, January 12). Gender dysphoria and sexual euphoria: A Bayesian perspective on the influence of gender-affirming hormone therapy on sexual arousal - archives of sexual behavior. Springer Nature Link. https://link.springer.com/article/10.1007/s10508-023-02778-1  
• Lindley, L., Anzani, A., & Galupo, M. P. (2022, April 21). Gender dysphoria and sexual well-being among trans masculine and nonbinary individuals - archives of sexual behavior. Springer Nature Link. https://link.springer.com/article/10.1007/s10508-021-02242-y
• Mayo Foundation for Medical Education and Research. (2025, January 1). Gender dysphoria. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/symptoms-causes/syc-20475255#:~:text=Gender%20identity%20is%20having%20the,for%20people%20with%20gender%20dysphoria.