A boy smiling at his friend in the park.

Gender and mental health

What is gender identity?

Your gender identity is how you describe your gender. For example, you might say you are a woman, non-binary, transgender, a man, gender fluid, or something different. Your gender identity is your decision and is also about how you want others to treat you - for example, how you want people refer to you (‘she’, ‘him’, ‘they’ or something else).

Gender is different from ‘sex’. Your sex refers to your physical and biological body parts (like the penis, vagina, different hormones or breasts).

Over time, you might explore your gender and you might decide that you are a different gender than the sex you were born with. You might explore your gender at any point in your life, or continuously throughout your life, but it is common to do so during puberty when your hormones are changing and you’re exploring lots of different parts of who you are.

Here are some different words people use when talking about gender identity:

  • Cisgender/cis

    Someone who is the same gender they were assigned at birth.

  • Transgender

    Someone whose gender is different from their sex at birth.

  • Non-binary/genderqueer/gender fluid

    These are gender identities that sit within, outside of, across or between ‘male’ and ‘female'.

  • Pronouns

    The terms we use to refer to someone, e.g. ‘he’, ‘she’, ‘they’.

  • Intersex/Differences in sex development

    This is an umbrella term for a variety of different biological conditions that affect a person's sex development. Find out more about intersex below.

You may use something else to describe your gender. For more information about the different terms and gender identities, visit Stonewall.

Stonewall

Differences in sex development (DSD), sometimes known as intersex, is an umbrella term for over 40 biological conditions that affect a person’s sex development. This can include differences on the inside of your body and on the outside. It can be things like differences in the development of sex chromosomes, some hormones or the reproductive organs or genitals (the penis or vagina).

People with a DSD/intersex people develop in many different ways. Some might not have periods or be able to have their own children, while others may look different in their build or how they grow. But having a DSD is no different from having a variation of any other part of the body. No one body is the same and we are all unique.

Sometimes, when you are born intersex, differences in how your genitals look could be a sign of a serious medical condition. When this happens, a parent/carer might think about surgery as an option. In the UK, it’s likely that surgery will only be considered if there is a medical need for it, not simply because you look ‘different’. And even in these cases, adults/carers might be encouraged to wait until you are old enough to be involved in any decisions about surgery yourself. Just like any other part of the body, the care that you receive should always be based on the best available evidence and the impacts it could have on you.

Whether you have had surgery or not, having a DSD could mean you have a complicated relationship with your body. As with any other part of the body, a difference in your appearance or how your body works could have a big impact on how you see yourself. This can be very difficult but remember that support is out there to help you work through these experiences and live a happy and fulfilled life.

If you are intersex/have a DSD, knowing more about your condition may help you to feel more confident in your body. You can find out more about specific DSDs through the organisation dsdteens.

Visit dsdteens
Two young people sitting on the grass together in a park.
I have known since birth that I have what is called a Complete Androgen Insensitivity Syndrome (CAIS). Having this condition, for me, is as normal as the fact that I was born with brown hair and green eyes.
Esme, 23

If you’re a young person with a DSD, you might feel lonely, like people are judging you, or like you are being treated differently from everyone else. This can be especially difficult if your DSD is not openly talked about. But you are not alone.

If you are experiencing any of these feelings, it’s important to remember that you are not alone. Sex development happens to everybody but everyone has a different experience of it. There are others like you with a DSD and hearing their stories can help you to feel less alone.

If you need support with living with a DSD or if you want to find out more, take a look at these organisations and services that have information and advice to help you:

It's up to you

Having a DSD/being intersex does not define your gender identity. An intersex person may identify as male, as female, as non-binary or however they choose.

Some people prefer to use the term ‘variations of sex development’ (VSD) while others prefer to use ‘intersex’ or ‘DSD’. It is your choice how you refer to your own DSD and your choice if you want to talk about it or keep it private.

If you’re struggling with how you’re feeling about a DSD/being intersex, know that your feelings are totally valid. Having a DSD might make you feel different from other people and it can be hard if you feel like your DSD isn’t being recognised, but there are people that can help you find the support you need.

Meet Anick, a young activist who shares his story of being intersex. Trigger warning: talk of suicide, surgery and blood.

I didn’t know people could be so accepting of something which I was hiding for so long.
Anick Soni, The Intersex Diaries, BBC Radio 1

How might gender identity impact my mental health?

Your experiences with your gender may affect your mental health in various ways. You might be questioning and exploring your gender, transitioning between genders, or thinking about transitioning. For some, this can be a confusing or difficult time. It may be distressing being viewed as a gender that doesn’t feel right, or being referred to with pronouns (‘he’ or ‘she’), that don’t feel right.

You may also struggle with your body image or how you feel in your own skin if your body does not match your gender. But it doesn’t always have to be this way and with the right help and support, things can start to feel better.

Gender dysphoria is the distress or unease you may feel if your gender does not match your biological sex - for example, if you are a man but have biologically female body parts, such as breasts.

Unfortunately, some people experience bullying, hostility or discrimination if their gender identity is not similar to the people around them. Experiencing this, or hearing about these experiences from others can mean there may be times or places where you don’t feel comfortable or safe sharing or expressing your gender.

You might experience:

  • feeling scared about sharing your gender with others
  • hiding your identity because of anxiety about how people might react and what they’ll say
  • worrying about what clothes you’re wearing to express your gender, or feeling pressure to express your gender in a particular way
  • feeling self-conscious about how you walk or talk
    feeling like you have to act a certain way and be someone you’re not
  • feeling misunderstood, even by those who are closest to you
    feeling under pressure to label your gender when you’re not sure, or to share your gender with others
  • people using the wrong pronouns, like calling you ‘he’ when you are ‘they’
  • being treated differently from others, or being bullied because of your gender
  • feeling pressure to conform with the sex you were assigned at birth
  • feeling unsupported or worried that your new gender won’t be accepted or understood by your family and friends
  • people using your old name (“deadnaming”) when you have a new name

Having these experiences, particularly if they are on a regular basis, can be extremely distressing and overwhelming. You might start avoiding places or making conscious decisions about everyday things that others don’t need to think about.

A young person standing with their back against a brick wall.
From a young age, I struggled with food. Puberty was a traumatic time because my body began changing in ways that felt completely at odds with how I saw myself. It led to me developing gender dysphoria and becoming severely anxious, withdrawn, and depressed.
Charlie, 20

Managing difficult experiences

Having these experiences, particularly if they are on a regular basis, can be extremely distressing and overwhelming. You might start avoiding places or making conscious decisions about everyday things that others don’t need to think about.

Constantly carrying these emotions and making these decisions can be exhausting, and you may find it makes everyday tasks like eating, concentrating at school/work, engaging in conversation, or getting good sleep very difficult. You may also find it leads to feelings of distress, anxiety, isolation, angerdepressionwanting to hurt yourself, or suicidal thoughts.

If you are experiencing any of the above, it’s important to know you are not alone. There are people who can help you and things can get better. There are helplines, therapists, counsellors and mental health professionals you can talk to who understand what you’re going through.

If you have experienced bullying, discrimination, or verbal or physical abuse because of your gender, you can report it as a hate crime.

If you need urgent help and are experiencing a mental health crisis, you should contact a helpline service on our urgent help page.

It may seem hard to believe, but things can change for society and for you. There are many people working hard every day to make society a more equal place for LGTBQIA+ people. You deserve to be who you are freely and without fear.

Report something
Close up of a boy sitting in a park. His expression seems worried as if deep in thought.
My gender identity also affected my mental health, because at first I just felt really, really confused, and it left me feeling like I was incomplete.
Asher

What you can do to look after your mental health

  • Talk about your feelings

    If you’re struggling, it can help to talk to someone about how you’re feeling. Speak to someone you feel comfortable with, like close friends, parents, a counsellor, a mentor or anyone else you trust. If you don’t feel safe talking to someone you know, you can call a helpline.

  • Write it down

    If you don’t want to speak to anyone about your gender identity just yet, or you’re worried about people’s reactions, try writing down how you’re feeling. Getting your thoughts out can help you feel better and help you figure out what’s going on for you.

  • Get creative

    Expressing yourself through things like drawing, music, dance, fashion, creative writing or craft can help you relax and also explore your identity. Do something you enjoy that feels good for you.

  • Supportive groups and communities.

    Finding supportive groups can be a great way to meet people with similar experiences to you and a shared understanding of what you’re going through. They can be safe spaces and create a sense of community for you, whether in person or online. A good place to start is seeing if there are any LGBTQIA+ youth groups in your local area or school.

  • Find role models

    There are lots of people, whether they are people you know or influencers online, that can help you to feel positive and empowered. It can help to see other people like you who are going through a similar journey.

  • Clean up your social media

    If you are seeing things online that make you feel upset or pressured, remember you can mute, block or unfollow accounts that bring you down. Taking breaks from social media can really help too – so try deleting your apps for a weekend and seeing if it helps. For more tips on how to have a positive time online take a look at our social media and mental health page.

Our young Activists share their advice if you’re struggling with your mental health and gender identity.

Just know that there are people out there who understand you. You aren’t alone in this. There is a big, supportive community out there.
When I actually understood I was non-binary and I had learnt what it meant, it had a positive effect on my mental health! I felt so much better. There is no one way to look non-binary, it’s not a third gender, and never let anyone make you feel bad for asking them to use your correct pronouns.
You don’t have to figure yourself out quickly, if at all.
It’s very important to find someone you can talk to, who will make you feel comfortable and supported. The Internet has huge benefits if you find it difficult to connect with others in person.
A girl sitting in the park wearing headphones. She is looking down at her phone and listening to music.
Labels can be useful as a way to understand more about yourself and help others understand your experience of gender, however there is no rush to have a label so don’t feel like you need to find one immediately.
boy-in-a-jacket-looking-at-his-phone-ignoring-his-friends-who-are-talking-beside-him-while-sitting-on-a-bench-at-the-park
Because of this idea that it’s not socially acceptable for men to cry or show vulnerability, it can come across like men just don’t experience sadness. Although this obviously isn’t true, if you never see other men cry or show vulnerability, it can make you feel like an anomaly if you do feel sadness.

Telling others about your gender

Sharing your gender with people is different for everyone. For most people, it’s an ongoing process that involves having a series of conversations with different people. It can take time for you to have these conversations and each time could be very different.

Some people may not react in the way you would hope, but there are people who care about you and will want to support you on your journey, whether that’s family, friends, professionals, counsellors or online communities.

Often, people use the term ‘coming out’ to describe telling others about their gender. While this can be a really positive term for some people, it can also make people feel under pressure. You might feel some people have a right to know your gender when you don’t want to share or are not ready to do so. That is okay. There is nothing wrong with keeping your gender to yourself - it’s up to you how you define it and who you talk to about it.

It’s okay to not come out. You don’t need to take this at full speed if it’s going to affect your mental health.
Just because you aren’t ‘out’ doesn’t mean your identity isn’t real.
It’s okay if people don’t understand; it just means you can enlighten and teach them.
There is no one way to look non-binary. It’s not a third gender. Never let anyone make you feel bad for asking them to use your correct pronouns.

Tips for supporting a friend with their gender identity

  • Be an ally. This means being visible in your support for the LGBTIQA+ community.

  • Call out discrimination when you see or hear it.

  • Learn as much as you can about the experiences/challenges faced by the LGBTIQA+ community.

  • Join part of a movement for change. Many organisations campaign for LGBTIQA+ equality and you can help them campaign and spread the word.

Getting help

If you feel like your confusion or struggle with your gender identity is interfering with your daily life and affecting your mental health, talking to a GP can help. Your GP can suggest some options to give you more support, or may refer you to CAMHS.

There are also lots of organisations that have information and helpline services to support you.

  • Gendered Intelligence

    Works with the transgender community, with an emphasis on supporting young trans people aged 8-25.

    Has free resources for trans and gender-questioning young people and their families.

  • Mindline Trans+

    An emotional and mental health support helpline for anyone identifying as transgender, non-binary, genderfluid (or their family members, friends, colleagues and carers).

    Find information about call costs.

    Opening times:
    8pm - Midnight, Mondays & Fridays
  • Albert Kennedy Trust

    Supports LGBTQ+ young people aged 16-25 in the UK who are facing or experiencing homelessness, or living in a hostile environment.

    You can refer yourself online to arrange a face-to-face appointment with a member of staff in their Bristol, London, Manchester or Newcastle centres.

    They also offer a free webchat service.

  • dsdteens

    Made by and for young people, along with doctors and other experts, dsdteens provides information and advice for growing up with differences of sex development (DSD) (commonly called disorders of sex development or intersex variations).

More on looking after yourself

More tips, advice and information on looking after yourself.

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