Video game characters are far more than pixelated heroes for transgender and gender diverse (TGD) players; they are often vital tools for survival, offering a unique space to explore identity and affirm gender in ways the physical world may not allow.
A major new systematic review led by the University of Nottingham has found that customising an in-game avatar serves as a powerful psychological mechanism, directly reducing gender dysphoria and boosting mental wellbeing for TGD individuals.
The study, which analysed a decade’s worth of empirical research (2013-2025), reveals that digital worlds provide a critical “safer” alternative to offline environments, where TGD people frequently face stigma, discrimination, or physical danger.
“In times of increasing infringements on transgender and gender diverse people’s rights and access to care, it’s becoming incredibly important to explore new ways of supporting these individuals,” said lead author Dr Cecilie Lolansen.
Internal gender identity
The researchers found consistent evidence that aligning a digital avatar with one’s internal gender identity triggers significant positive psychological outcomes.
Participants across multiple studies reported experiencing “gender euphoria” — a profound sense of comfort and joy — when their avatar matched their desired expression. This phenomenon is partly explained by the “Proteus Effect”, where a user’s behaviour and self-perception shift to align with the traits of their digital representation.
Conversely, the study noted that when customisation options were limited or forced players into binary gender roles, it could induce feelings of disconnection or even gender dysphoria.
Not all video games are created equal when it comes to these benefits. The review identified role-playing games (RPGs) and narrative-driven titles as the most effective tools for identity work.
High levels of customisation were crucial. The game Baldur’s Gate 3 was specifically highlighted by participants for its inclusive design, which allows players to decouple physical appearance from voice and pronouns, enabling a more authentic representation of self.
Positive effects
Furthermore, the social aspect of gaming proved vital. The positive effects of avatar customisation were amplified in multiplayer settings when other gamers affirmed the player’s identity—for example, by using the correct pronouns associated with the avatar.
The implications of the research extend beyond the gaming industry and into clinical practice. With traditional gender-affirming care sometimes limited or inaccessible, the authors suggest that video games could serve as a low-cost, accessible intervention.
“Our findings are not only important for cyberpsychology, but for clinicians and healthcare providers seeking to support transgender and gender diverse individuals using a low-cost intervention to enhance their wellbeing,” Dr Lolansen noted.
Dr Nikki Dean Marshall, a co-author, emphasised the shift in perspective required: “This research shows that video games can be more than just entertainment, they can be affirming spaces that support identity development”.
