Gender dysphoria is a difficult term to define in its entirety. This is due to several reasons, the primary being that dysphoria means different things to different people (read here for more discussion of definitions) and manifests in such different ways between various transgender and gender non-conforming people. The Diagnostical and Statistical Manual of Mental Disorders (5th ed.; DSM-5;  American Psychiatric Association [APA], 2013) does a nice job at providing a succinct definition; they define gender dysphoria as "the distress that may accompany the incongruence between one's experienced or expressed gender and one's assigned gender" (APA, 2013, p. 451). An important nuance in this definition which is often ignored or misunderstood is this:

Gender dysphoria is not required in order to identify as transgender.

The APA reaffirms this by further stating "not all individuals will experience a distress as a result of such incongruence" (APA, 2013, p. 451). However, for those who do experience this distress, it is important that this diagnosis exist so transgender people can receive additional specialized support from healthcare professionals.

As previously discussed, dysphoria can be fueled by external factors, such as facing transphobia for breaking gender norms of communication and movement. Dysphoria can also be sourced to internal feelings of discomfort centered around primary sex characteristics (gonads, genitalia) or secondary sex characteristics (features which manifest during puberty). This includes features such as one's voice, which tends to drop significantly during puberty in assigned-male-at-birth (AMAB) people and slightly in assigned-female-at-birth (AFAB) people. These negative feelings about one's voice and communication are informally referred to as 'voice dysphoria'.

"[Regarding presentation,] I feel ok until I open my mouth."

"My voice is triggering especially when I hear recordings of it. Hearing how I sound [makes me] feel like giving up." 

"I feel detached from [my voice and body] a lot of the time because neither feel right." 

These are just a few of the sentiments too often voiced in transgender circles. By and large, more frequent avenues of transition such as hormone replacement therapy (HRT) and various surgeries do little to affect these negative feelings about one's voice.  As always, this is not universal; there are those whose hormonal transition and/or surgeries result in a voice that works better for them, and our website will be updated with a page to discuss these options in the near future. There are also many transgender people who transgress gender norms and are proud of it. I've met many transgender women who love their rich, deep voices, or who make no conscious choice to communicate using more widely accepted models of femininity. These people are incredibly brave and should be respected and protected, as every person deserves the right to be comfortable with themselves and express their identity as they see fit.

The other side of that coin is that some trans people find their comfort in moving through social spaces by adapting social norms they want to explore or play with. Sometimes this is driven by wanting to be misgendered less by others; other times it is driven by simply wanting to feel comfortable in the movement itself. Regardless of the origin of the discomfort, if one doesn't like their voice quality or communication style, their quality of life (QoL) will decrease (Murry, Medrado, Hogikyan, & Aviv, 2004; Hancock, Owen, Siegfriedt, Brundage, 2009; Hancock, Krissinger, & Owen, 2011). For this subset of the trans population, it is essential that resources are made available to them so they can increase their quality of life, and build a more positive relationship with their voice.

Some transgender people are very successful in experimenting with their voice on their own. For others, changing deeply ingrained habits of voice production and communicating can seem insurmountable. Luckily, there are speech-language pathologists who specialize in working with transgender people to discover what their voice is capable of and developing a method of communication which is more comfortable for them to utilize. We call this work transgender vocal training.