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Despite the central role of gender dysphoria in the lives of many transgender people, discussions of gender dysphoria remain scant in conversations about affirmative practice. As such, scholars have called for qualitative studies to explore gender dysphoria through the voices and perspectives of transgender people. The primary aim of this study is to use grounded theory methodology to gain a more in depth and comprehensive understanding of gender dysphoria from the perspectives of transgender adults. Data for this study is associated with the online, written responses of 362 transgender adults (nonbinary ϭ 118, trans woman ϭ 49, trans man ϭ 133, genderqueer/genderfluid ϭ 49, and 2-spirit ϭ 8). Data deepen understanding through the following 7 themes: (a) being impossible to explain, (b) never being seen as me, (c) living in an imposter's body, (d) shapeshifting nature of gender dysphoria, (e) being tortured by one's own body, (f) emotional suffering, and (g) disrupting impact. Findings shed light on the multifaceted impact of gender dysphoria as well as the depth and severity of suffering associated with these experiences. Participants' first-person descriptions of their own experiences with gender dysphoria offer concrete as well as metaphorical examples that elucidate the nature, severity, and impact of distress on multiple dimensions of functioning. Findings underscore the importance of transgender affirmative medical and mental health care rooted in comprehensive knowledge of the scope and impact of gender dysphoria and the interventions (e.g., transition related care) that help to alleviate gender dysphoria. Public Significance StatementThis study provides rich description of experiences of gender dysphoria among transgender individuals. Study findings dispel the myth of the singular transgender experience while advancing understanding about the range, severity, and impact of gender dysphoria. Findings offer important insights to inform the development of affirmative practices and policies to advance access and availability of comprehensive transition related care.

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