Dysphoria Vs. Dysmorphia: What’s The Difference?

Medically reviewed by Melissa Guarnaccia, LCSW and April Justice, LICSW
Updated July 12, 2024by BetterHelp Editorial Team

When discussing mental health, it's important to understand that "body dysmorphic disorder" refers to a specific condition, distinct from gender dysphoria, which involves an extreme concern with one's physical appearance, whereas gender dysphoria is a condition in which a person experiences significant distress due to a mismatch between their gender identity and the sex they were assigned at birth. The words “dysphoria” and “dysmorphia” may sound similar, but when it comes to gender dysphoria and body dysmorphia, they are two very different things. The following explains some of the differences between body dysmorphia and gender dysphoria and how they're addressed, as well as how to find support if you need it through means such as online therapy.

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Body dysmorphia and gender dysphoria

A significant difference between body dysmorphic disorder and gender dysphoria is that body dysmorphic disorder (BDD) is a mental health condition, whereas gender dysphoria is not.

Gender dysphoria refers to a sense of unease that a person may have if their true gender identity and biological sex don’t align. Gender identity is the sense of gender that a person has about themselves, which may or may not be the same as their biological sex at birth.

What is body dysmorphia or body dysmorphic disorder?

Body dysmorphic disorder, or BDD, is a mental health condition that's diagnosed under the category of Obsessive-Compulsive and Related Disorders in the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders).

Body dysmorphic disorder is a condition characterized by the following criteria:

  • A preoccupation with one or more perceived flaws in one's physical appearance that are not observable or appear minimal to other people. This can be virtually any physical feature. The focus on appearance or body image can be very intense.
  • A perception that a flaw is significant or very negative. A person with BDD may look in a mirror, see something small or unnoticeable about their appearance, and perceive it as a major flaw that’s embarrassing and shameful. For a person living with BDD, even looking in an ordinary mirror can seem like seeing a reflection in a funhouse mirror.
  • Repetitive behaviors such as excessive grooming, checking one's appearance in the mirror frequently, skin picking, reassurance-seeking, or appearance-based comparison to others in response to the perceived flaw or concern.
  • Clinically significant distress or difficulty functioning in work, school, social situations, or other basic life activities due to the perceived flaw or appearance-related concern.

BDD is diagnosed when symptoms are not better attributed to another diagnosis or condition. Having a blood relative with BDD or OCD can be a common contributing factor to developing the disorder. BDD can impact your life and ability to engage in activities, including work, school, and social activities, in serious ways. Someone with BDD might cancel important activities, plans, and experiences in daily life due to their symptoms, including their behaviors or distorted view of their appearance. Body dysmorphic disorder can be hard to live with, and it's common for people with body dysmorphia to experience feelings of anxiety, depression, and low self-esteem. 

If you struggle with BDD or think that you might, you aren't alone, and the good news is that help is out there. Roughly 1 in 50 people are said to live with body dysmorphic disorder, and the age of onset tends to be at around 12-13 years of age. BDD is successfully treatable through forms of talk therapy such as cognitive-behavioral therapy (CBT). If BDD is impacting your life, or if you think that you might have BDD, it's important to reach out for help.

Body dysmorphia and eating disorders

Body dysmorphia and eating disorders aren’t the same things, but they do have some similarities. Each is a mental illness or psychological disorder that is related to feelings about or the perception of one’s body which can manifest as uncontrollable thoughts. Both tend to be associated with distressing and uncomfortable feelings about the body. Both frequently affect daily life. Another similarity is that people with body dysmorphia and eating disorders tend to have a preoccupation with body image and may experience a distorted body image. But while a person with an eating disorder typically is concerned with body size and shape, a person with body dysmorphia may be focused or anxious about a specific body part.

Eating disorders include anorexia nervosa, bulimia, binge eating disorder, and more. People with eating disorders can have co-existing body dysmorphia and vice versa. An eating disorder is a mental health disorder and can also be indirectly or directly linked to other mental disorders, such as anxiety or depression. If you or a loved one has an eating disorder, please reach out for help. Bulimia treatment, binge eating disorder treatment, and anorexia nervosa treatment can be very effective. If you require an anorexia nervosa treatment or treatment for any other eating disorder, please know that these treatments can help you live a healthy life, both physically and mentally.

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What is gender dysphoria?

Gender dysphoria is a common experience among transgender people, although not every transgender person experiences gender dysphoria, and symptoms can be unique to personal experience. Many individuals who experience gender dysphoria suffer from significant emotional distress, as they may feel trapped in a body that does not align with their true gender identity.

The American Psychological Association (APA) defines gender dysphoria as "clinically significant distress or impairment related to a strong desire to be of another gender, which may include a desire to change primary and/or secondary sex characteristics" while noting again that not all transgender or gender diverse people experience dysphoria.

The gender a person identifies with may not be the same as their biological sex. Some people call one’s biological sex their “biological gender,” but gender is the identity, expression, or societal expectations, while sex is the label based on genitals and chromosomes at birth. For instance, a person whose biological sex was female at birth may identify as being of the male gender. A person who was “born male” may have been born with the male biological sex but their gender identity may not be male. What a person feels their true, individual gender is can be very unique and personal. Male and female aren’t the only genders people identify as, either. Some people may have non-binary gender identities, while others may have fluid gender identities. 

Gender dysphoria is often an incredibly distressing* experience for a transgender person, as it can create an intense internal conflict between one's innate sense of gender identity and societal expectations and norms. Gender dysphoria can start in childhood and continue into adolescence and adulthood. It is often described as stemming from feelings of being trapped in the “wrong body,” although “wrong body” is not always the preferred term. It can be a sense of the biological sex of a person’s body not matching their gender identity, which can be a difficult reality to navigate and can cause unease, discomfort, social isolation, and other symptoms. Gender dysphoria is often linked to mental health complications, such as extreme feelings of anxiety (anxiety disorder) and depression. While gender dysphoria and body dysmorphia are not the same, people can experience both gender dysphoria and body dysmorphia.

This could mean asking people to use the pronouns that align with a person’s gender, a style of dress or apparel that makes someone feel more comfortable, a haircut, hormone therapy, facial hair (through hormone treatments, for instance), breast size (e.g. augmentation for trans women,), surgery, voice training, or something else. For example, a person whose biological sex is male may identify with the female gender and want to be addressed with female pronouns. One transgender person might want surgery and HRT (hormone replacement therapy), whereas another transgender person may want neither or only one of those things.

When a transgender person has support and can live as themselves, whether it does or does not involve things like medical transition, mental health outcomes are highly improved. Support from mental health professionals, medical professionals, family, friends, and the community at large. Additionally, the transgender community can be extremely important in supporting the mental health of transgender individuals.

*If you need immediate support and need someone to talk to, contact TrevorLifeline at 1-866-488-7386 or go to their website. Or use the Crisis Text Line to connect with a trained Crisis Counselor by texting HOME to 741741.

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Feeling uncomfortable in your own body?

Find a therapist

If you're looking for someone to talk to, a counselor or therapist can help. There are several different ways to find a therapist online or near you. You can search the web, ask your doctor for a referral, contact your insurance company to see who they cover, or sign up for an online therapy platform like BetterHelp. BetterHelp is often more affordable than traditional in-person services without insurance, and all of the providers on the platform are licensed, mental health professionals. Adults can use BetterHelp to connect with a licensed therapist, and the platform TeenCounseling is available to serve teens from 13-19 years old with the consent of a parent or guardian.

A 2019 study found that internet-based cognitive behavioral therapy is effective for the treatment of BDD, while also increasing the availability of mental health services to these individuals. A recent 2021 study focusing on internet-based gender-affirming cognitive behavioral therapy for LGBTQIA+ youth and young adults found it to not only be effective for helping to treat the mental health challenges often experienced by those in the LGBTQIA+ community (such as depression and anxiety) but participants also “reported significantly reduced depression symptoms and improved stress appraisal and coping skills.” According to the researchers, “These findings suggest that digital technologies are a promising platform for the delivery of affirmative therapies for LGBTQA+ populations.”

Finding an LGBTQIA+ affirming provider who works with trans people as a demographic may be advantageous for those who need a safe space to talk about dysphoria and feelings related to gender and other similar concerns. Some therapists and counselors specialize in working with body image, body neutrality, body perception, body dysmorphia, body image distortions, eating disorder recovery, and obsessive-compulsive disorder, among other disorders. You deserve to find quality care that meets your needs and helps you live a happy life, so don't hesitate to start your search today.

Takeaway

Body dysmorphia, or body dysmorphic disorder, is characterized by the individual focusing excessively on a part or parts of their body that they perceive as flawed, often to the extent of interfering with their day-to-day life. Gender dysphoria, simply put, can be experienced when someone’s genitalia that they were born with does not match their gender identity. Both of these can be difficult to live with and work through, but it’s important to note that while body dysmorphia is a mental disorder, gender dysphoria is not. No matter who you are or what you are experiencing, you matter, your identity is yours to define and yours alone, and you deserve help and support when and where you need it. If you’re ready, you can take the first step to being treated by an experienced, empathetic, and knowledgeable online therapist.
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