Next Thursday, I will get a vagina. The procedure will last around six hours, and I will be in recovery for at least three months. Until the day I die, my body will regard the vagina as a wound; as a result, it will require regular, painful attention to maintain. This is what I want, but there is no guarantee it will make me happier. In fact, I don’t expect it to. That shouldn’t disqualify me from getting it.

I like to say that being trans is the second-worst thing that ever happened to me. (The worst was being born a boy .) Dysphoria is notoriously difficult to describe to those who haven’t experienced it, like a flavor. Its official definition — the distress some transgender people feel at the incongruence between the gender they express and the gender they’ve been socially assigned — does little justice to the feeling.

But in my experience, at least: Dysphoria feels like being unable to get warm, no matter how many layers you put on. It feels like hunger without appetite. It feels like getting on an airplane to fly home, only to realize mid-flight that this is it: You’re going to spend the rest of your life on an airplane. It feels like grieving. It feels like having nothing to grieve.

Many conservatives call this crazy. A popular right-wing narrative holds that gender dysphoria is a clinical delusion; hence, feeding that delusion with hormones and surgeries constitutes a violation of medical ethics. Just ask the Heritage Foundation fellow Ryan T. Anderson, whose book “When Harry Became Sally” draws heavily on the work of Dr. Paul McHugh, the psychiatrist who shut down the gender identity clinic at Johns Hopkins in 1979 on the grounds that trans-affirmative care meant “cooperating with a mental illness.” Mr. Anderson writes, “We must avoid adding to the pain experienced by people with gender dysphoria, while we present them with alternatives to transitioning.”