Dys4ia

Dys4ia (pronounced dysphoria) is an abstract, autobiographical Adobe Flash video game that Anna Anthropy, also known as Auntie Pixelante, developed to recount her experiences of gender dysphoria and hormone replacement therapy. The game was originally published in Newgrounds but was later removed by Anthropy. In 2023, it was reinstated by her on itch.io.

Plot
Touching on the 'frustrations' of transitioning, particularly taking estrogen, the game documents a six-month period in her treatment via a succession of mini-games that reflect on gender politics, identity, and personal development. While discussing the concept with the Penny Arcade Report, Anna Anthropy remarked, "This was a story about frustration—in what other form do people complain as much about being frustrated? A video game lets you set up goals for the player and make her fail to achieve them. A reader can’t fail a book. It’s an entirely different level of empathy."

Reception
After debuting at a Toronto-based art game convention between 21 and 23 February 2012, Dys4ia subsequently appeared on the social media website Newgrounds on 9 March 2012, and achieved a First Place 'Daily Feature'. Dys4ia received praise from various sources for its ability to communicate a challenging subject. The Guardian's Will Freeman commented that Dys4ia offered 'a touching and witty insight into an experience many may never even consider in detail'. In response to the mechanics of Dys4ia, Freeman suggested that the game 'does much to prove the power of games to communicate complex concepts through playful interactions'. On the UK gaming blog Rock, Paper, Shotgun, journalist Adam Smith found the content 'uncomfortable' and inherently private, yet nevertheless 'informative and moving'. Regarding the artistic merits of Dys4ia, Smith remarked that the limited visuals were 'effective communicators of extreme discomfort' and that Liz Ryerson's soundtrack to the game deserved special mention.