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Many trans people experience gender dysphoria -- distress caused by mismatches in internal and external experiences of gender. Video games engage intimately with the self, creating intense experiences involving identities, bodies, and social interaction. This combination of factors renders trans players vulnerable to gender dysphoria triggers: failures of interaction design that result in gender dysphoria. The present research undertakes a thematic analysis of four popular games, drawn from an initial corpus of 31. It contributes a definition of gender dysphoria triggers, case studies of triggering games, an initial gender dysphoria categorization to provide a useful design language, and examples of alternative designs for extant triggers. The analysis combines the authors' positionality as trans gamers; critical cultural studies methodologies, including textual analysis; a critical discourse analysis of production-side statements and interviews and player-side comments about diversity in those games; and close readings of the games themselves. The paper concludes with a call for trans inclusivity in game design, which we structure around the necropolitical concept of the relation of care.