Dysmorphia vs. Dysphoria: What’s the Difference?

Have you fallen for the dysmorphia and dysphoria homonym trap? I have. These two words might sound similar—and overlap in definitions—but they’re two separate conditions.

Body dysmorphia, technically called body dysmorphic disorder, is when one sees flaws in their physical appearance that others cannot perceive whereas gender dysphoria is feeling uncomfortable in one’s assigned gender.

Understanding Dysmorphia

“Body dysmorphia involves perceiving certain physical flaws in your body that are not evident to other people,” explains gender-affirmed therapist Madison McCullough, LCSW. This condition lives under the “obsessive-compulsive and related disorders” in the DSM-5 and is driven by anxiety and misperception. 

Characteristics of dysmorphia include:

• Body checking, whether in the mirror alone or posted on social media
• Excessive comparison with other people’s bodies
• Consistently seeking validation from others about your appearance
• Compulsive grooming, makeup, exercise, or other lifestyle habits in an attempt to change a body part
• Worrying that your body isn’t okay and people will see you as less than accordingly

Some people may keep their dysmorphia to themselves, while others talk about it often. Either way, it can negatively impact one’s quality of life. McCullough says dysmorphia can isolate people and lead them to suffer in silence, which can negatively impact their relationships and social support.

Dysmorphia can mistakenly be seen as vanity or self-obsession. It is an obsession in the disordered sense, but it isn’t solely about vanity. Rather, it’s a mental health condition that can become debilitating.

Understanding Dysphoria

As big a deal as dysmorphia is, gender dysphoria is even more so, as it can be life-threatening. “Gender dysphoria involves persistent distress around one’s embodied experience of gender,” says McCullough. “It can coincide with anxiety and depression, and be detrimental to how people carry themselves in the world.”

While it may seem like a new concept, dysphoria has existed—and researched—for years. It’s only recently become more talked about.

Some symptoms of dysphoria include:

• The desire to present physically as a different gender than the one you were assigned at birth
• Feeling that the gender you were assigned is not right for you and is not who you are
• Dislike of sexual or sexualized body parts of yours
• Discomfort with physical or emotional traits you attribute to your assigned gender
• Feeling strongly that a different gender is an accurate representation of you

Just like dysmorphia, a person with dysphoria may discuss their feelings with others or not at all. It might take years for someone to speak about their condition or seek out gender-affirming help.

Furthermore, a person experiencing dysphoria can have dysmorphia, particularly around body parts they feel aren’t aligned with their gender identity. For example, an assigned female person who identifies as a man may see their hips as very wide, even if they aren’t. Conversely, a trans woman might see her shoulders as more broad than others do.

Key Differences between Dysmorphia and Dysphoria

These conditions can and often do overlap, but they are not the same. Dysphoria is about gender identity while dysmorphia is about body image. Specifically, dysmorphia is seeing one’s body as flawed in ways other people can’t perceive, whereas dysphoria is feeling like your body isn’t aligned with the gender you identify as.

Overlapping Features and Challenges

Both dysphoria and dysmorphia involve our bodies and our comfort in them. Those who experience either of these conditions feel uncomfortable in their skin and often struggle to verbalize their feelings with others. Moreover, both dysphoria and dysmorphia are often left undiagnosed and untreated, which can impact one’s quality of life.

Several boundaries hinder one from getting diagnosed. One of them is the societal stigmas around these conditions. Even after being assessed for these conditions, there’s a barrier to treatment. Not all insurances cover the necessary medication or therapies, which makes it difficult for those suffering to seek appropriate help.

Treatment and Support Options

Naturally, to move forward from gender dysphoria or body dysmorphia, getting professional help is the right step.

“People experiencing gender dysphoria should seek out a therapist who has extensive experience working with folks across the gender spectrum, and who is knowledgeable about different gender-affirming bodily interventions available to you,” recommends McCullough. This can involve mental health services like talk therapy or gender-affirming physical changes such as surgery.

When it comes to body dysmorphia, treatment usually involves therapy, medication, or both. “People experiencing body dysmorphia often find cognitive behavioral therapy or exposure therapy helpful, as both challenge their critical beliefs about their body and identify more affirming narratives,” says McCullough. Medications like SSRIs are often prescribed for body dysmorphia as they can help lessen anxiety and depression symptoms.

If therapy is unavailable, consider community care instead. LGBT centers often have virtual and in-person support groups that center around gender issues. There’s also GLAAD, which has various resources for trans and queer people. Meeting other people experiencing body dysmorphia or gender dysphoria and discussing coping mechanisms are useful tools for recovery.

Conclusion

Gender dysphoria and body dysmorphia are both serious conditions about our perceptions of our body. However, that’s where the similarities end. Dysmorphia is an untrue perception of one’s physical flaws, whereas dysphoria is a lack of congruity in one’s assigned gender and gender identity.

Both conditions can be difficult to discuss with others, impact a person’s self-esteem, and lead to a reduced quality of life. And each has available treatments. For gender dysphoria, you’ll need gender-affirming care, which includes gender-affirming physical procedures and therapy. For dysmorphia, you’ll need psychiatric help and potentially SSRI medication (if your psychiatrist deems it necessary). Even though these conditions can be severe challenges in a person’s life, once faced head-on, you can work through them.