Body dysmorphia is a mental health condition in which a person feels extreme concern about the way they look. Body dysphoria occurs when a person feels extreme distress about their gender identity.

Body dysmorphia and body dysphoria have some similarities since both conditions relate to a person’s feelings about their appearance or identity. However, the two conditions are not the same.

Healthcare professionals typically use the term “gender dysphoria” instead of “body dysphoria.” Therefore, this article will use “gender dysphoria.”

This article explores the similarities and differences between body dysmorphia and gender dysphoria. It discusses the symptoms, diagnosis, and treatment options for both.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Body dysmorphia, or body dysmorphic disorder (BDD), is a mental health condition in which a person feels extreme concern about one or more perceived flaws or imperfections in their physical appearance. These perceived flaws are unnoticeable or only slightly noticeable to other people.

These feelings can lead to anxiety and distress in various aspects of a person’s life, such as their work, education, and social life.

An older 2016 study suggests that adolescents may be more vulnerable to BDD due to the influence of social media and increased screen time.

The term “gender dysphoria” describes the psychological distress a person may experience if their sex assignment at birth does not align with their gender identity. Some transgender people may experience gender dysphoria, but people who are not transgender or gender nonconforming may also experience it.

Transgender people experience a disparity between their gender identity and the sex they were assigned at birth.

People with gender dysphoria may have difficulty identifying themselves within the rigid structures of gender in society. This can lead to low self-esteem, difficulties in relationships with family and peers, and a risk of self-injury or suicidal ideation.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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BDD and gender dysphoria have different symptoms, which the following sections discuss in further detail.

Body dysmorphia

According to the Body Dysmorphic Disorder Foundation, a person with BDD typically develops a set of worries and repetitive behaviors that can negatively affect their mood.

A person with BDD may experience symptoms such as:

  • believing they have a defect or flaw that is unattractive to others
  • focusing on the perceived flaw for an excessive amount of time
  • repeatedly picking at their skin
  • constantly looking in the mirror
  • engaging in excessive grooming
  • constantly comparing themselves to others
  • seeking approval and reassurance from others
  • trying to hide their perceived imperfection
  • undergoing cosmetic surgery multiple times and still not being happy with the outcome

Gender dysphoria

According to the United Kingdom’s National Health Service, a person with gender dysphoria may experience several symptoms, including:

  • feeling more comfortable in the gender role that they identify with
  • feeling uncomfortable in the gender role that traditionally matches the sex they were assigned at birth
  • wanting to disguise or change physical markers of sex, such as facial hair or breasts
  • strongly disliking parts of their body that are physical markers of sex, such as genitalia
  • having a negative self-image

People with gender dysphoria may also experience mental health concerns such as stress, anxiety, and depression.

There is very little research into how many people with gender dysphoria also have BDD. However, one 2020 study suggests that transgender people may be more vulnerable to and have higher rates of dissatisfaction with their bodies.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), a person must meet several criteria to receive a diagnosis of BDD or gender dysphoria.

Body dysmorphia

Some of the diagnostic criteria for BDD are:

  • thinking about a perceived flaw for at least 1 hour per day
  • performing repetitive, compulsive behaviors that relate specifically to the perceived flaw, such as checking in the mirror
  • experiencing intense feelings of stress or anxiety about appearance when in social, work, or family environments

Gender dysphoria

According to the DSM-5-TR, a person must experience at least two of the following criteria for 6 months or longer to receive a diagnosis of gender dysphoria:

  • having a strong desire to be rid of physical markers of the sex they were assigned at birth
  • having a strong desire to gain physical sex characteristics that they were not born with
  • identifying as a gender different from the one that traditionally aligns with their physical sex characteristics
  • experiencing feelings and responses that may be typical of a different gender
  • wanting others to treat them as a different gender

Below are some of the treatments for BDD and gender dysphoria.

Body dysmorphia

According to research from 2019, the first-line treatment for BDD is cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs).

CBT for BDD is a type of therapy that may help a person gain a better understanding of the thoughts and behaviors they are experiencing. A therapist may teach a person coping techniques and ways to take the attention off themselves and direct it elsewhere.

SSRIs are a group of antidepressants that may be able to help reduce obsessive and compulsive thoughts and behaviors.

Gender dysphoria

Treatment may be able to help reduce the significant anxiety and stress that a person with gender dysphoria may experience.

The first step is typically counseling. A counselor with the appropriate experience can help support a person with gender dysphoria.

The next step may be hormone therapy, which can either suppress or accelerate the hormones that are responsible for sex differentiation. For example, it may help restrict the growth of facial hair or encourage the growth of breast tissue.

A person with gender dysphoria may also decide to undergo surgery to gain the physical characteristics of their gender identity. They may need to receive hormone therapy and live as the gender they identify with for 2 years before undergoing surgery.

Body dysmorphia and gender dysphoria are similar in that people with either condition feel dissatisfied with aspects of their bodies.

Gender dysphoria involves significant distress when a person does not identify with the gender that traditionally matches the sex they were assigned at birth.

A person with BDD feels extreme dissatisfaction about a perceived flaw in their appearance.

Research suggests that a person with gender dysphoria may be more likely to experience dissatisfaction with their body. This could lead to the development of BDD. However, further research into the topic is necessary.

A person should speak with a healthcare professional if they think they may be experiencing body dysmorphia or gender dysphoria.