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Distress and discomfort caused by a dissonance between a person’s gender identity and their sex characteristics, by restrictions and barriers to gender affirming medical care and/or by social pressures to present themselves as a gender at odds with their identity. Not all transgender people experience gender dysphoria, nor is all stress or discomfort experienced by transgender people considered gender dysphoria. Gender dysphoria is the medical diagnosis for being transgender as defined by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). This is controversial because it implies that being transgender is a mental illness rather than a valid identity. At the same time, a formal diagnosis is generally required in order to receive or provide treatment in many countries, so this enables access to medical care for some people who wouldn’t otherwise be eligible to receive it. Although some transgender people seek routes to medically affirm their gender, not everyone does.

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