I, personally, had the social dysphoria first, and now it has progressed to both social and physical. I've never in my life masturbated, because the dysphoria (though I wasn't quite aware that that's what it was at the time, I just felt this way) caused me to hate my lady parts and derive no kind of pleasure from it. Needless to say, I have little in the way of relief sexually, and I became addicted to sexual Role-Play for years before my parents found out and I had to stop. I even had the typical withdrawal symptoms; irritability, shakiness, etc. Every one of my friends that knows I don't masturbate always respond with "...How do you live?!" because they don't quite understand the absolute disgust I have with my female body. My social dysphoria started with me always associating with guys more as friends, and being more guyish in my likes (card games, video games, power rangers, etc), and as soon as I got the chance to dress myself (so to speak), I began to wear men's clothing and chopped most of my long hair off, and it's gotten progressively shorter as the years have gone by. I also remember as a small child, meaning I had no real inclination of what it entailed, I used to think "I want to be a boy."