Gender dysphoria is a concept that describes the experience of feeling that your physically assigned gender does not align with the gender you identify with. While gender identity issues have been researched and discussed for decades, they have only recently become socially acceptable and openly discussed. In the past, these issues were often diagnosed as disorders and suppressed with medication without proper examination.

Table of Contents

• Symptoms of Bottom Dysphoria
• Types of Bottom Dysphoria
• Gender Dysphoria and Transphobia
• Bottom Dysphoria and Emisil Mission
• How to Deal with Dysphoria FTM Daily
• Best Ways to Deal with FTM Bottom Dysphoria
• Hormone Replacement Therapy for Transgender Female to Male & Other Medicine
• Testosterone Therapy: What, Where, and How?
• Injections
• Pills or Capsules
• DHT Gel or DHT Cream
• Testosterone Patch
• Testosterone Pellet
• Body Changes: FTM Transition Timeline
• In Case Your Period Returns
• FTM and Intimacy: What You Need to Know

 

Symptoms of Bottom Dysphoria

Physical Symptoms:

Discomfort with Genitalia:

Bottom dysphoria often experience a profound sense of discomfort or alienation from your genitalia. This discomfort stems from the feeling that your physical anatomy does not match your true gender identity.

This can lead to a desire to hide or avoid seeing your genitalia, sometimes resulting in behaviors like avoiding mirrors, refraining from looking at or touching their own body, or wearing clothing that obscures the area.

Distress During Intimacy:

Many people with bottom dysphoria find intimate situations particularly distressing. The act of engaging in sexual activity may intensify feelings of dysphoria, especially if their partner interacts with their genitalia in ways that remind them of the mismatch between their body and identity.

This distress can lead to avoidance of intimacy altogether, creating challenges in romantic relationships and contributing to feelings of isolation.

Desire for Physical Changes:

A strong, persistent desire to alter the genitalia to align with your gender identity is also a common symptom. This may manifest as a longing for gender-affirming surgeries such as metoidioplasty or phalloplasty.

In the absence of surgery, you  may use prosthetics like packers to create the appearance of male genitalia, providing a temporary sense of relief from dysphoria.

Emotional Symptoms:

Anxiety and Depression:

The distress caused by bottom dysphoria often leads to significant mental health challenges. You may experience chronic anxiety and depression, driven by the daily reminders of your body’s incongruence with gender identity.

This emotional turmoil can be exacerbated by societal pressures, discrimination, or difficulty in accessing gender-affirming medical care.

Frustration and Anger:

Feelings of frustration and anger are common, particularly when the dysphoria interferes with daily life or relationships. These emotions can be directed inward, leading to self-blame or feelings of inadequacy, or outward, resulting in irritability or resentment towards societal norms that reinforce gender binaries.

Social Withdrawal:

Due to the intense discomfort associated with genitalia, people with bottom dysphoria may withdraw from social interactions, especially those that could involve physical contact or intimate relationships. This withdrawal is a coping mechanism to avoid situations that trigger dysphoria.

Types of Bottom Dysphoria

Primary Bottom Dysphoria:

This type of bottom dysphoria is centered around the deep-seated discomfort with the genitalia a person was born with. It is a core aspect of their gender dysphoria and is often present from an early age.

Symptoms and Impact:

You may experience an intense desire for genital reconstruction surgery. You might also use binders, packers, or other means to minimize the visibility or presence of their genitalia. Primary bottom dysphoria can be persistent and all-consuming, often dominating the thoughts and contributing to significant emotional distress.

Secondary Bottom Dysphoria:

This type emerges or intensifies later in life, often in response to social situations, intimate relationships, or increased awareness of the gender transition process.

Symptoms and Impact:

Symptoms may include a growing dissatisfaction with the genitalia as you progresses in your gender transition, particularly after beginning hormone therapy or when considering further surgical options. You may have previously been able to manage or ignore the dysphoria, but it becomes more pronounced as you move closer to living fully in the affirmed gender. Secondary bottom dysphoria can create additional challenges during the transition process, particularly if you are not ready or able to pursue surgery yet. It may also lead to feelings of frustration or regret if you feel the transition is incomplete.

Situational Bottom Dysphoria:

This type of dysphoria is triggered by specific situations or contexts, such as being in a locker room, engaging in sexual activity, or using public restrooms.

Symptoms and Impact:

People may feel relatively comfortable with their bodies in most situations but experience intense dysphoria when exposed to certain environments or activities that highlight the mismatch between their genitalia and gender identity. Situational dysphoria might not be constant but can be triggered by reminders of societal gender norms or during moments of vulnerability. Situational bottom dysphoria can create anxiety around specific events or activities, leading to avoidance behaviors. For example, people may avoid public restrooms or change rooms altogether, or feel extreme anxiety during intimate encounters.

Interpersonal Bottom Dysphoria:

This type of dysphoria arises in the context of interpersonal relationships, particularly in intimate or sexual relationships where the presence of another person intensifies the discomfort with your genitalia.

Symptoms and Impact:

People may feel an overwhelming sense of shame or inadequacy when the genitalia are seen or touched by a partner. This can lead to avoidance of intimacy, difficulty in forming romantic relationships, or challenges in expressing sexual desire. Interpersonal bottom dysphoria can strain relationships, as it may cause the individual to withdraw emotionally or physically from their partner. It can also lead to communication difficulties, where the people may struggle to articulate their needs or feelings to their partner.

Gender Dysphoria and Transphobia

Transgenders experience gender dysphoria more frequently than anticipated. This feeling of being "trapped in the wrong body" is often ignored and suppressed, leading to anxiety, depression, and even suicidal tendencies. This is particularly common among female-to-male (FTM) transgender individuals.

• Statistics: Around 70% of FTM individuals experience gender dysphoria and have faced anxiety, depression, and suicidal thoughts.
• Transphobia: Despite growing societal acceptance, transphobia remains a daily challenge. Many transgender individuals face physical injury or even death due to their gender identity.
• Public Education: The need to destigmatize and educate the public about transgender issues is critical. As more countries show increased interest in understanding gender dysphoria, the hope is that societal attitudes will continue to improve.

Bottom Dysphoria and Emisil Mission

At Emisil, we’ve been working with the FTM transgender community for over eight years, and we understand the rapid changes affecting this community. Bottom dysphoria, specifically related to the genital area and intimacy issues, is a significant concern for many of our clients.

• Body Dysphoria: Focuses on dissatisfaction with one's body as it does not match their gender identity. This can be managed with binders, multifunctional FTM prosthetics, or sex reassignment surgery.
• Social Dysphoria: Occurs when an individual is misgendered, leading to feelings of anxiety, depression, and other disorders.
• Mental Health: About 70% of individuals experiencing gender dysphoria are also diagnosed with psychiatric disorders, and the risk of additional psychological issues and suicide increases in unsupportive environments.

At Emisil, we aim to create ultra-realistic packers and other products that help lessen bottom dysphoria and improve mental well-being.

How to Deal with FTM Dysphoria Daily

Navigating the daily challenges of FTM bottom dysphoria can be difficult, but there are some practical strategies that can help you deal with these feelings and cultivate a sense of control and well-being. By creating a supportive environment, seeking professional guidance, and engaging in positive activities, you can develop effective coping mechanisms. Below are several steps that can assist in managing dysphoria and improving your quality of life:

• Safe Space at Home: Create or find a safe space where you can be open and vulnerable. If your home environment is not safe, consider finding an FTM support group.
• Professional Help: Mental health evaluation is crucial. Seek out progressive and experienced gender dysphoria therapists.
• Hobby or Volunteering: Engaging in group activities, volunteering, or finding a new hobby can improve mental health and reduce social dysphoria.
• Avoiding Triggers: Avoid situations or people that trigger gender dysphoria. Remember, you have the right to remove yourself from unsafe situations.
• Self-Help Groups & Forums: Engage with self-help groups and online forums where you can express your identity and find support.

Best Ways to Alleviate FTM Bottom Dysphoria

Bottom dysphoria is a daily struggle for many FTM individuals, often impacting various aspects of life, from self-esteem to social interactions. While the journey to alleviating these feelings can be complex, there are practical steps that can make a significant difference. By focusing on emotional well-being, physical appearance, and body training, you can find ways to feel more comfortable in your body and reduce the intensity of dysphoria. Here are some strategies to help alleviate bottom dysphoria:

• Emotions Are Important: Accept and share your emotions with someone you trust. Expressing yourself can help you understand and plan coping strategies.
• Appearance Hacks: Changing your wardrobe and hairstyle can help reduce dysphoria and better express your gender identity.
• Binders & Packers: Using binders and packers can help alleviate bottom dysphoria, especially during intimate situations.
• Body & Voice Training: Regular training can help achieve a more masculine look and deeper voice, contributing to reducing dysphoria.

 

Hormone Replacement Therapy for Transgender Female to Male & Other Medicine

Before starting hormone replacement therapy, it’s important to be fully informed about the process and its implications:

• Testing: Multiple tests, including bloodwork and a physical exam, are required before starting therapy.
• Mental Health Evaluation: Your mental health must be assessed, and you need to express your goals and expectations.
• Hormone Therapy: Typically begins with small doses of testosterone, which may be administered via injections, gel, patches, pills, or testosterone pellets.

Testosterone Therapy: What, Where, and How?

Testosterone therapy can be administered in several different ways, each with its own benefits and considerations. Choosing the right method depends on your personal preferences, lifestyle, and medical advice. Here’s an overview of the various methods available:

• Injections: This is the most common method of testosterone administration, offering a quick and efficient introduction of the hormone into the bloodstream. Injections are typically given on a regular schedule, which may require regular visits to a healthcare provider or learning to self-administer at home.
• Pills or Capsules: Oral testosterone is an easier option for those who prefer not to deal with needles. However, this method requires strict adherence to timing and consistency to maintain stable hormone levels, and it may take longer to see results compared to other methods.
• DHT Gel or Cream: Applied directly to the skin, usually on the abdomen, shoulder, or upper arm, this method allows testosterone to be absorbed through the skin. It requires careful application and time for the gel or cream to dry before covering the area with clothing, ensuring the hormone is effectively absorbed.
• Testosterone Patch: A convenient option for those who prefer a more hands-off approach, testosterone patches are applied to the skin every 24 hours. Patches need to be rotated to different areas of the body to avoid skin irritation and should be applied consistently to maintain hormone levels.
• Testosterone Pellet: This relatively new method involves implanting a small pellet under the skin, which provides a slow and steady release of testosterone over 3-6 months. While it offers long-term convenience, it requires a minor surgical procedure to implant and replace the pellet.

Body Changes: FTM Transition Timeline

Once you begin testosterone therapy, your body will start to undergo noticeable changes as it adjusts to the hormone. These changes can vary in timing and intensity depending on the individual, but here are some of the key transformations you can expect:

• No More Periods, Muscle Mass Change, & Hair Growth: One of the first changes many individuals notice is the cessation of menstruation, which typically occurs within 2-6 months of starting testosterone. The exact timing varies from person to person. Alongside this, you will likely experience an increase in facial and body hair growth. Changes in body fat distribution and muscle mass usually begin within the first 6 months of therapy. Incorporating an exercise routine into your daily schedule can accelerate these changes, while relying solely on testosterone will result in the full effects becoming visible after about two years.
• Voice Change: A significant milestone in testosterone therapy is the deepening of the voice. Medical research indicates that your voice will start to become deeper and more masculine within the first year of treatment. However, the full voice change may take up to two years to manifest, with the timeline varying for each individual.
• Bottom Changes: Changes in the genitalia typically begin within the first 3 months of testosterone therapy. Over the course of 1-2 years, you should notice clitoral enlargement and a reduction in vaginal size and sensitivity. Many FTM individuals choose to use additional medications, such as DHT gel or cream, to promote genital growth. These products work by delivering a dose of testosterone directly to the bloodstream when applied to specific areas, stimulating growth

Although this process can be effective, it is not without discomfort. Users of topical DHT cream or gel often report experiencing pain and discomfort, particularly during the initial weeks of use. This sensation, commonly referred to as "growing pains," usually subsides after a few weeks of continued treatment.

In Case Your Period Returns...

Sometimes, even while on testosterone therapy, you may experience the return of your period, which can be both frustrating and triggering for gender dysphoria. If this happens, it's important to understand that you are not alone, and this situation, while difficult, can be managed. Stress, lack of rest, and other factors may contribute to the reappearance of your period, so it's essential to be prepared and equipped with strategies to handle it. Below are some practical tips to help you cope:

• Find the Best FTM Period Products for You: Being prepared with the right products can make a significant difference. There are various options available, including reusable pads, menstrual cups, and tampons. If the visual reminder of your period is triggering, a tampon or menstrual cup might be more suitable. Conversely, if you’re uncomfortable with internal products, pads may be the better choice. The key is to find what works best for your comfort and peace of mind.
• Consider Birth Control as an Option: Period experiences vary widely—some people have minimal symptoms, while others may struggle with heavy flow and painful cramps. If you find yourself in the latter group, a doctor may recommend hormonal birth control to help stop or reduce period symptoms. There are several options available, so research and consultation with your healthcare provider will help you choose the best one. While this is currently one of the most effective ways to manage period symptoms, advancements in medicine may provide even better solutions in the future.
• Acceptance is Key: When your period returns, it’s natural to feel betrayed by your body and overwhelmed by negative emotions. It’s crucial to acknowledge these feelings and find ways to regain control of your mind and body. During this time, your hormones may amplify your emotions, so staying grounded is essential. Practicing self-affirmation, dressing in a way that aligns with your gender identity, and being kind to yourself are all important steps in this process. Don’t overthink the fact that your period has returned; try to accept it as a temporary occurrence and focus on moving forward. Engaging in physical activity, spending time outdoors, and keeping busy with various activities can help maintain balance and prevent a flare-up of bottom dysphoria. Additionally, keeping track of your menstrual cycle can help you prepare mentally and physically, reducing the likelihood of feeling caught off guard.
• Find Support: If your emotions become overwhelming or your dysphoria intensifies, don’t hesitate to seek support. Joining an FTM support group, whether online or in-person, can provide the community and understanding you need. These groups offer a safe space to express your feelings and fears without judgment. If you need additional support, consider reaching out to a professional for help. There are many support groups tailored to different ages, situations, and needs, ensuring you can find one that fits your circumstances. Below are a few trustworthy and professional transgender support groups online:
• Trans Lifeline: https://translifeline.org/ – A valuable resource for all aspects of transgender support.
• Therapy Tribe LGBTQ+ Support Group: https://support.therapytribe.com/lgbt-support-group/ – Focused on young people and their unique challenges.
• The Trevor Project: https://www.thetrevorproject.org/ – Specifically designed for young people in crisis.