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Coping with dysphoria

Transitioning does a great deal to alleviate gender dysphoria, but it may not be available for anyone.

Some trans people may be unable or unwilling to transition due to many different reasons:

We are a group more vulnerable to harassment and discrimination than most. Witnessing instances of transphobia in the world – be it through social media or in person – can worsen existing dysphoria and depression.

Not everyone may realise they experience dysphoria as commonly understood as well. You might only realise that many emotions you previously felt about yourself and are still feeling now as dysphoria. Dysphoria may also be present even in people who are transitioning; while gender-affirming hormone replacement therapy and surgeries typically help in reducing the distress or discomfort you may experience in your own body, the dysphoria may not go away entirely.

There are four main ways to deal with dysphoria:

1) Self-care

Self-care means taking care of yourself so you can be well. Dysphoria, after all, is a stressor, on top of all the other stresses in the world you may experience.

There are a few different categories of self-care:

Emotional self-care

There are a few things you can do for emotional self-care when you’re experiencing gender dysphoria – journaling, relaxing, and expressing yourself.

Journaling

Journaling is ultimately a form of self-expression.

Journals and daily logs don’t need to be on pen and paper! You can keep a conversation with yourself on a note-taking app or some messaging apps, or record your thoughts in audio or video as you talk out your feelings.

If you’re stumped as to what to write about, you can make a list of things that you’re proud of, or things that you’re grateful for. Regularly recalling and focusing on the good things in your life can help you cope with the bad.

Getting out into nature

If you can afford the time, walking out in nature can help! Take some time to stroll in a park near you, or if you want to, walk in the Botanic Gardens, go cycling at East Coast, hike through the nature reserves, get lost exploring Pulau Ubin, watch the sunset from a beach and so on. Connecting with nature is proven to ease depression and anxiety, and promote a sense of wellbeing.

It helps to connect yourself to something bigger than you, to remind yourself that you’re a person in a body in a world that is full of beauty.

Making time for enjoyment

Find a healthy distraction and stimulate your senses – one way would be to play puzzle games, which have been proven to reduce stress and help people find momentary peace.

Some video games may also be a good way to distract yourself, along with other creative endeavours, like writing, music and art. Immersing yourself in elaborate fictional worlds – created by yourself, or made by others – can provide an outlet for you to get away from the stress you may experience.

Physical self-care

Making a habit to prioritise key bodily needs will help. Prioritise getting enough sleep, staying hydrated, and regularly eating healthy and nourishing foods. Your body may not feel like part of you and you might not feel at home with your body, but it is still important for you to take care of it; having a balanced, nutritious diet will help your body and mind feel at their best.

If you are pre-HRT but plan to go on HRT in future, taking good care of your health will reduce the risk of being denied HRT for medical reasons, and will also often also result in a better appearance when you do eventually transition. Your future self will thank you.

A healthy amount of exercise can also improve your mood and reduce depression.

Transgender men and other transmasculine people in particular often find that working out is a good way to deal with dysphoria, as it is a way to put on muscle and directly masculinise one’s body.

For transfeminine people, having some form of low-intensity aerobic exercise (like hiking, cycling or walking) will help in maintaining your body; working out with a loved one or an accepting community will also help in keeping you grounded! Some workouts (like those focused on the glutes, for instance) can also help feminise your body.

Spiritual self-care

Spiritual self-care refers to the act of nourishing your soul.

If you have a personal faith, you may find it a comfort to turn to, allowing yourself to feel less alone, appreciate the bigger picture of existence, transcend the concerns of the physical world, surrender your pain to a higher power, and comfort yourself in the thought that your small life is not all there is in a universe far older and grander and more mysterious than we can ever possibly imagine.

Try to stay away from any transphobia in your religion, even if you may personally agree with it, and even if it’s the main reason you have decided not to transition. Focus instead on the good your faith might bring into your life, and the greater peace and purpose you may experience in it. If you know other people in your religion who accept and affirm you as you are, take time to connect with them for community and support.

If you don’t have a personal faith, or if your faith is not as strong, you can volunteer and do charitable work. Focusing your energy on others rather than yourself and helping them shoulder their burdens in life may also help draw attention away from your own burdens, give you a community to belong to, and cultivate a sense of solidarity.

Mindfulness is also a good practice in nourishing oneself; as cliche as it sounds, it can help you ground yourself in moments of dysphoria and derealisation. You can use a guided breathing meditation tool or guided meditation videos if you find it easier hearing someone else walk you through an exercise.

2) Find communities where you can be yourself

Nearly all of us find that people who affirm our gender can help ease dysphoria.

This might mean some level of social transition: acknowledging your true self, introducing that true self to others, and interacting with other people as that true self. You can try doing so in an accepting community (online or in-person).

Wear something that makes you comfortable, such as clothes and accessories that affirm your gender identity. If you feel that you can’t do so, you can try wearing a small accessory that may be affirmative for you – a small pride pin, for instance, or a friendship bracelet.

You don’t have to be publicly out or even medically transition to find spaces to be yourself. You can express your true self through an online persona either anonymously or in social media spaces that are more accepting, or with friends and family that you trust. The most important thing is to feel supported and loved by the people around you. There’s no wrong way to be yourself!

If being that ‘true self’ openly feels too painful or frightening, you can also opt to live vicariously through fictional characters or gaming avatars and interact with their worlds (or with other gamers) through an identity and gender presentation you have full control over. Some people engage in acting and cosplay so they can take part in this.

The positive feelings you get when you can express yourself as your gender – be it through an online persona, or in person with trusted friends and family – is gender euphoria. That sense of comfort, certainty, joy and excitement in your identity isn’t something that is wrong. Being loved isn’t wrong, and neither is being yourself.

Some may feel that counselling or comforting other people suffering through bad periods of gender dysphoria helps ease their own. It takes the focus off your own pain, and the advice you give them might be helpful for yourself as well, along with the knowledge that you’re not alone. However, others find that doing this worsens their dysphoria as it reminds them of their own discomfort and brings that pain into focus.

3) Talk to someone you trust

Counsellors and therapists can act as a good sounding board to work through your gender dysphoria and can teach you tools to manage it daily.

You can also seek an affirming community of people you can talk to and find support. Take a look at our list of support resources here.

We encourage trans folk to connect with the people closest to them, but if you find that those around you tend to have very negative reactions when you talk about your feelings around gender, you can try limiting your time with them.

Establish boundaries for people in your life who have a difficult time accepting you. If you are in a position to do so, help them to understand you with external resources like I’ll Walk With You. Relationships are, after all, a two-way street.

4) Have healthy coping strategies

Small coping strategies can help with reducing triggers for dysphoria – steaming up or covering up bathroom mirrors, wearing a hoodie or loose clothing, using a sponge when you shower, etc.

You can also put together a care pack for yourself, like a sensory toy, an essential oil, lip balm, a picture of a pet or loved one, or even affirmation cards.

Self-soothing activities that stimulate the senses help here:

Small distractions can be really helpful – craft or handiwork, writing, playing music, and going out into nature can all help you think about something else for a while, even if it doesn’t take the dysphoria away.

You can also craft “escapes” – a favourite playlist, game or show.

These are just recommendations, and there’s no wrong way to deal with how we feel inside.

Remember to avoid unhealthy coping strategies. Workaholism, alcohol and substance abuse will ultimately lead to a state where instead of feeling more at home with your body, you end up feeling worse.

You may feel good or think you feel good in the brief moments where you are indulging in something unhealthy, but they will be detrimental in the long term. It may be important here to have someone close to you who can tell you if you’re not doing well, and to listen to yourself and your body.

Disclaimer: Information on this site is for general information only. It does not constitute legal or medical advice and is not a substitute for obtaining advice from a qualified professional. We do not represent or warrant that this information is suitable, reliable, complete, accurate or up-to-date.