Gender Incongruence


  • Gender incongruence is the term used in ICD-11 to refer to the experience of having agender that does not match the sex you were assigned at birth.

  • Transgender is an umbrella term to describe people whose gender is not the same as, ordoes not sit comfortably with, the sex they were assigned at birth.

  • Non-binary is an umbrella term for people whose gender identity doesn’t sit comfortably with‘man’ or ‘woman’. Non-binary identities are varied and can include people who identify withsome aspects of binary identities, while others reject them entirely.

  • Trans man is a term used to describe someone who is assigned female at birth but identifiesand lives as a man.

  • Trans woman is a term used to describe someone who is assigned male at birth but identifiesand lives as a woman.

  • Gender dysphoria is a term that describes a sense of unease that a person may have because of a mismatch between their biological sex and their gender identity.

What is gender identity?

Gender identity refers to our sense of who we are and how we see and describe ourselves. Most people identify as "male" or "female". These are sometimes called "binary" identities.

But some people feel their gender identity is different from their biological sex.

For example, some people may have male genitals and facial hair but do not identify as a male or feel masculine.

Some may have female genitals and breasts but do not identify as a female or feel feminine. Some people do not define themselves as having a "binary" identity. For them the concept of gender is not relevant to their identity.

They may use different terms, such as agender, gender diverse, gender non-conforming, to describe their identity. However, as a group, they are often called "non-binary".


Gender dysphoria and gender identity

Many people with gender dysphoria have a strong, lasting desire to live a life that "matches" or expresses their gender identity. They do this by changing the way they look and behave.

Some people with gender dysphoria, but not all, may want to use hormones and sometimes surgery to express their gender identity.

Gender dysphoria is not a mental illness, but some people may develop mental health problems because of gender dysphoria.

Signs of gender dysphoria

People with gender dysphoria may have changed their appearance, their behaviour or their interests.

They may also show signs of discomfort or distress, including:

  • low self-esteem
  • becoming withdrawn or socially isolated
  • depression or anxiety
  • taking unnecessary risks
  • neglecting themselves

Read more about the signs of gender dysphoria.

Children and gender identity

Children may show an interest in clothes or toys that society tells us are more often associated with the opposite gender. They may be unhappy with their physical sex characteristics.

However, this type of behaviour is reasonably common in childhood and is part of growing up. It does not mean that all children behaving this way have gender dysphoria or other gender identity issues.

A small number of children may feel lasting and severe distress, which gets worse as they get older. This often happens around puberty, when young people might feel that their physical appearance does not match their gender identity.

This feeling can continue into adulthood with some people having a strong desire to change parts of their physical appearance, such as facial hair or breasts.

Find out more information if you think your child might have gender dysphoria.

Guide for Parents of LGBT+ Children -

How to get help

See a GP if you think you or your child may have gender dysphoria.

If the GP agrees, they can refer you to a gender dysphoria clinic (GDC) where you’ll be assessed by a specialist team.

You do not need to be assessed by a mental health service first, and the GP does not need prior approval from their Clinical Commissioning Group (CCG) responsible for local health services.

You can self-refer to a GDC, but a referral by the GP is best. This is because they can give the GDC your detailed medical history.

If you are already seeing a doctor or psychologist for other conditions, ask them if they can refer you to a GDC.

Referrals for children and young people up to 18 years will be to the Gender Identity Development Service (GIDS) for children and adolescents.

Referrals for adults to one of the gender dysphoria clinics in England may be made from 17 years of age.

Gender dysphoria clinics in the north

Sheffield Health and Social Care NHS Foundation Trust Gender Dysphoria Service

Porterbrook Clinic
Michael Carlisle Centre
75 Osborne Road
S11 9BF

Phone: 0114 271 6671


The Sheffield clinic's website includes information about referrals, clinic opening hours and links to eligibility criteria.

New gender dysphoria services in 2020

In 2020 new NHS gender dysphoria services for adults will open in Greater Manchester, London and Merseyside.

These services will be delivered by healthcare professionals with specialist skills and based in local NHS areas, such as sexual health services. Full details will be available once each service is opened.

Initially, access to these services will be available to people who are already on a waiting list to be seen at one of the established gender dysphoria clinics.

NHS England will assess how useful these new pilot services are.


TranzWiki is a comprehensive directory of non-commercial groups and organisations supporting or assisting trans and gender diverse individuals, their families and friends across the UK.

You can find charities and support groups on the Tranzwiki page on the Gender Identity Research & Education website.

Information for trans and non-binary people seeking fertility treatment

Human Fertilisation & Embryology Authority Logo

Fertility may be the last thing on your mind when you’re experiencing the distress of having a body that doesn’t express your identity. Understandably, some trans and non-binary people are keen to start hormone therapy or have surgery as quickly as possible. However, you may find it a source of regret if you have treatment without preserving your fertility and then realise later on that it is not possible or more difficult to have a biological family. Thinking through all these issues now and understanding your options will help you make an informed decision.

Go to the Human Fertilisation & Embryology Authority webiste for ore information and help.