The usual practice of doctors and other care providers in Ontario is to diagnose someone with gender dysphoria before prescribing them hormones.
Some people are not comfortable with the terms “gender dysphoria,” or with being diagnosed as experiencing gender dysphoria, because they do not feel that their identity should be listed as a kind of mental disorder. However, the diagnosis of gender dysphoria is what allows the medical insurance system to pay for transition-related health care, including surgeries. Both people in the trans community and people in the medical community are struggling to resolve this issue.
About gender dysphoria
Gender dysphoria can be understood as discomfort or stronger negative feelings that occur because of a difference between someone’s sense of who they are and the body they have, based on society’s expectations of how men and/or women are expected to behave. For example, imagine that when you were born, doctors told your parents, “It’s a boy!” However, you do not feel comfortable with the idea of being a boy, and may think of yourself as a girl or another gender identity that is not just “boy” or “girl.” The bad feelings that might come with the mix-up between your body (and other people’s ideas of how you should act because of that body) and your own sense of who you are can be described as “gender dysphoria.” The World Professional Association for Transgender Health(WPATH), which maintains the WPATH Standards of Care on which the Ontario health system for trans folks is based, wrote in their guidelines that:“Gender dysphoria refers to discomfort or distress that is caused by a difference or differences between a person’s gender identity and that person’s sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics)… Only some gender nonconforming people experience gender dysphoria at some point in their lives…
What gender dysphoria means for your care
The WPATH guidelines also say that:Some people experience gender dysphoria at such a level that the distress meets criteria for a formal diagnosis that might be classified as a mental disorder. Such a diagnosis is not a license for stigmatization or for the deprivation of civil and human rights. A disorder is a description of something with which a person might struggle, not a description of the person or the person’s identity. Thus, transsexual, transgender, and gender nonconforming individuals are not inherently disordered. Rather, the distress of gender dysphoria, when present, is the concern that might be diagnosable and for which various treatment options are available. The existence of a diagnosis for such dysphoria often facilitates access to health care and can guide further research into effective treatments.” (emphasis original) — World Professional Association for Transgender Health (WPATH) Standards of Care V7, p. 5-6.In other words, a diagnosis of gender dysphoria will likely help you get access to treatment like hormones or transition-related surgeries. If you are diagnosed with gender dysphoria that does not mean that you are in a mental state where someone could deprive you of your civil or human rights. A doctor cannot keep you from receiving care because you have a diagnosis of gender dysphoria, and struggling with dysphoria does not mean you are unable to provide informed consent, which is an important part of any treatment in any health care situation. You can read more about gender dysphoria in the WPATH Standards of Care, or on this Statement on Gender Identity and Diversity from the Children’s Hospital of Eastern Ontario (CHEO).