Gender dysphoria —the distress that arises when gender identity does not match the sex assigned at birth— absorbs almost all clinical research. Its opposite face, gender euphoria, had barely been measured. An Australian cohort study published in eClinicalMedicine now puts numbers to that experience: who feels it most intensely, in which areas of life, and how it relates to access to gender-affirming care.
What gender euphoria is and how it is measured
Gender euphoria is defined as the set of positive emotions that arise when gender identity and expression are recognised and affirmed, both in oneself and in one’s surroundings. It is not simply the absence of dysphoria: it is an experience with content of its own, and it therefore requires its own measurement tools.
The authors used the Gender Euphoria Scale, which breaks the experience down into three subscales —social affirmation, self-affirmation and community connection— and adds questions about the frequency and intensity of those emotions.
Who took part
The work draws on TRANSform, a longitudinal project led by transgender people in Australia. Between 22 November 2022 and 12 April 2023, 732 people aged 16 to 79 responded, all of them with a gender identity different from the one presumed at birth: 36.9% identified as women, 36.9% as men, 25.8% as non-binary or gender diverse and 0.4% with a culturally specific gender identity.
Comparisons between groups were made with non-parametric tests (Mann-Whitney and Kruskal-Wallis), which are appropriate when variables do not follow a normal distribution.
Where the differences appear
The first contrast is internal to the community itself. Non-binary and gender-diverse people reported more euphoria of community connection, but less euphoria of self-affirmation than the women and men in the study. A non-binary identity appears to rest more on recognition by the group and less on individual confirmation.
The second has to do with age: Generation X participants (born between 1965 and 1980) reported more euphoria of social affirmation than millennials (born between 1981 and 1996).
The third is the most relevant from a clinical point of view. Those who had already accessed gender-affirming hormones showed greater self-affirmation euphoria than those who had not used them, and the same was true for those who had undergone gender-affirming surgery compared with those who had not. By contrast, euphoria did not vary significantly according to continent of birth, rural or urban setting, or socioeconomic level.
What these results mean
The fact that euphoria is not evenly distributed suggests that there is no single way of living one’s gender identity. The authors stress that knowing these differences makes it possible to design more individualised support in gender-affirming care, in mental health and in community spaces, and that the community works as a specific source of wellbeing, especially for non-binary people.
The association between having accessed hormones or surgery and greater self-affirmation fits with what is already known about the effects of gender-affirming care, but it should be read with caution: those who access such treatments may differ from those who do not in age, financial resources, family support or legal context, and the cross-sectional design of the study does not allow causality to be established.
Limitations and the next step
This is a cross-sectional study with a self-selected sample within a cohort project, using self-reported data; it is not representative of the transgender population as a whole and does not measure changes over time. The euphoria scale was recently created, which limits comparisons with other work. The authors call for longitudinal studies with larger samples, and for euphoria to be incorporated into routine assessment alongside dysphoria.
Measuring euphoria does not replace measuring dysphoria: it completes it. That dual approach helps to understand the health of transgender people as something more than a catalogue of risks.
Source: Sociodemographic and gender affirmation factors associated with gender euphoria: a cohort study. Blacklock CA, Tollit M, Pace C, Elphinstone B, Zwickl S, Cheung A, Pang KC, Buzwell S. eClinicalMedicine 2026;97:104039. DOI: 10.1016/j.eclinm.2026.104039.
Read the publication: eClinicalMedicine.
Article published at dosier.es. Image generated with artificial intelligence (marta ai → marta.syf.es).
