Muscle Dysphoria Among the Transgender Population

Muscle dysphoria can impact anyone. However, certain populations are more likely to struggle with muscle dysphoria than others. What if transgender and gender non-binary people are one of those groups?

What’s Muscle Dysphoria?

Muscle dysphoria is when someone believes their body is too small, particularly their muscles [1]. People with muscle dysphoria are struggling with a subtype of body dysmorphic disorder (BDD).

BDD is when someone fixates on a perceived flaw and this causes them significant emotional distress. BDD may even get in the way of someone’s ability to participate in school, work, or social activities because of how distress it can be.

Here are some signs of muscle dysphoria:

  • Spending a lot of time thinking about how to become more muscular
  • Excessive body checking/monitoring practices (i.e weighing, measuring body, mirroring checking)
  • Diet and exercise routines that cause distress
  • Dissatisfaction with their appearance
  • Believe themselves to be small or average-sized even when presented with evidence to the contrary
  • Avoiding people or events due to insecurity about shape or size [1]

Muscle dysphoria is most often found in cisgendered boys and men [2]. Given the impact that muscle dysphoria can have on someone’s life, researchers are trying to figure out which populations are most at risk for this disorder.

One of the populations studied was gender minority people. Researchers found that transgendered men were more likely to struggle with muscle dysphoria compared to transgendered women and gender non-conforming individuals [2]. This means that transgendered men report a high drive to be muscular compared to other gender minority people. This is believed to be due to gender norms that men face [2]. For example, Western culture presents thin, muscular bodies as being the ideal male body. This can create pressure for men to become bigger. For some people, this can turn into muscle dysphoria.

Another reason that researchers believe that transgendered men may struggle with this is because they may be overexercising in order to get rid of any parts of their body that are viewed as feminine. For example, getting rid of fat stored around the hips or thighs [2]. Similarly, the transgendered women had the lowest drive to become muscular [2]. This is aligned with the societal expectations for men and women: men are muscular and women had a feminine shape [2].

Related Reading

Affirmative Treatment for Muscle Dysphoria

Given the pressures that transgender men face, there are a few things to consider when it comes to treatment. These are:

  • Affirmative Treatment- Affirmative treatment for muscle dysphoria means that the provider will hold in the mind the unique stressors that a transgender or gender non-conforming individual with be struggling with. This is important because these factors can influence someone’s symptoms and responses to treatment. For example, it would be important for a provider to remember that a transgendered man might be feeling pressure to be muscular as an attempt to conform with gender stereotypes. Affirmative treatment also means that treatment is a safe place for minorities.
  • Cognitive Behavioral Therapy (CBT)- CBT is the recommended treatment approach for people with muscle dysphoria. If you or a loved one are looking for treatment, it might be helpful to ask them what approach they use to treat your particular issue. While other approaches may also be helpful, CBT is believed to be one of the best approaches for this issue [1].
  • Co-Occurring Disorders- Someone who is dealing with a co-occurring disorder has at least two conditions. Sometimes co-occurring disorders can feed into each other and make symptoms worse. Muscle dysphoria is linked with mood and anxiety disorders, substance abuse, suicidal behavior, and disordered eating [2]. It’s important to treat the co-occurring disorder too. This not only can get someone some much needed relief, but can also be a powerful relapse prevention technique.

getting help from a counselor

If you or a loved one is struggling with muscle dysphoria, there is hope. Reach out for help today. You deserve it.


[1] Nagata, J.M., Compte, E.J., McGuire, F.H., Lavender, J.M., Brown, T.A., Murray, S.B., Flentje, A., Capriotti, M.R., Lubensky, M., Obedin-Maliver, J. & Lunn, M.R. (2021). Community norms of the muscle dysmorphic disorder inventory (MDDI) among gender minority populations. Journal of Eating Disorders, 9(87). 1-10.

[2] The Recovery Village. (2020, December 29). Muscle dysphoria.

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published September 2, 2021, on
Reviewed & Approved on September 2, 2021, by Jacquelyn Ekern MS, LPC