Transgender is a Symptom
Like a fever that signals an underlying infection, a transgender identity often points to something deeper that deserves attention and exploration.
For years, people have argued over whether a transgender identification should be classified as a mental illness. I believe that debate misses the point entirely. Transgender identity is not the illness itself. Rather, it is a manifestation of other unmet needs, emotional wounds, developmental struggles, personality traits, social pressures, or psychological conflicts. Like a fever that signals an underlying infection, a transgender identity often points to something deeper that deserves attention and exploration. This matters because if we mistake the symptom for the cause, we fail to address the actual problem.
When a person announces a transgender identity, mainstream professionals still jump to the “born in the wrong body” assumption, which they say needs to be affirmed with no questions asked. Those who have heard enough detransitioner stories know exactly why this is false.
Although on the gender critical side, a trans ID is often conflated as a simple mental illness, despite the fact that when detransitioners tell their stories, they explain that they reached for a new identity because of unmet psychological needs. They weren’t delusional or mentally ill in the traditional sense; rather, they fooled themselves in order to cope with deep psychological pain.
The Psychological Voids that Gender Identities Fill
What purpose(s) does a new gender identity serve? Below I list some of the things which I have observed in my practice:
For many people, a transgender identity provides a sense of belonging. Many describe feeling lonely, disconnected, or purposeless before joining the transgender community. The identity fills a hole that existed before gender became the focus. It offers instant community, friendship, a shared language, symbols, flags, online groups, and a sense of belonging to something larger than themselves.
Many are drawn to the structure transgender culture provides. This is especially common among people with autism or significant social difficulties. Social scripts, pronouns, labels, rules, and rituals reduce uncertainty. Rather than navigating complicated social situations naturally, people can rely on a prescribed set of behaviors that provide predictability and comfort.
Others use transgender identification as a form of avoidance. It is often associated with young adults experiencing a “failure to launch”. Life is difficult. Growing up requires responsibility, employment, dating, independence, and resilience. Focusing intensely on identity can distract from these developmental challenges. Many detransitioners later describe spending years consumed by pronouns, appearance, social validation, and medical interventions while neglecting the ordinary tasks of adulthood.
Even deeper than that, a transgender identity can function as armor from trauma. Sexual trauma, early attachment wounds, unwanted male attention, pornography exposure, body shame, bullying, and feelings of vulnerability can make womanhood or manhood feel unsafe. Identifying as the opposite sex may temporarily shield those feelings. For girls, it can look more like running away from womanhood. For socially awkward men, having a trans identity can serve as a shield for inappropriate behaviors. Also, it can be a way to avoid the expectations of masculinity. However, during the transition, people become more dissociated from their bodies and themselves. The distress is real. The solution, however, creates more difficulties.
Some people are seeking something even more basic: attention and recognition. A person who feels invisible may suddenly receive affirmation, praise, sympathy, and concern after announcing a transgender identity. This is often not a conscious manipulation. Human beings naturally seek acknowledgment when emotional needs are unmet. Family turmoil, social inadequacies, and other factors can play a role in the craving for extra attention.
For some individuals, particularly those struggling with guilt, shame, or social alienation, the social justice status of a trans identity can be appealing in a culture that increasingly rewards victimhood and identity politics. Transgender people are often portrayed as heroic members of an oppressed class. They are celebrated in Hollywood, on social media, and even in many of their social circles. White youth who have been led to believe that they are evil oppressors by critical race theory teachings are especially vulnerable to this line of thinking, so it would make sense that a trans identity may be appealing to this group.
For others, transgender identification provides a sense of power and control. New names, pronouns, and behavioral expectations require compliance from everyone around them. Family members, teachers, employers, and friends are expected to participate. For someone who feels powerless in other areas of life, this newfound authority can feel psychologically rewarding.
Adolescence itself also plays a part. Many young people use transgender identities as a vehicle for differentiation and rebellion. Every generation finds ways to separate from parents and authority figures. What was once expressed through fashion, music, or subcultures is now increasingly expressed through gender identities. Unfortunately, in this case, the “rebellion” is transferred into permanent medicalization.
Perhaps most concerning is that transgender identification functions as a form of self-harm. Many detransitioners describe profound self-hatred beneath their desire to alter their bodies. In these cases, hormones and surgeries become socially sanctioned forms of self-destruction rather than healing. Cross-sex hormones and surgeries are medically assisted self-harm.
Finally, for some individuals, transgender identification may be connected to sexual fetishization, usually in males. Some men report becoming sexually aroused by the idea of presenting as women. This phenomenon, otherwise known as autogynephilia, has been documented for decades and is often ignored because it complicates the simplistic narrative that all transgender identification stems from an innate female identity. Most youth have been exposed to explicit pornographic content way too early, which can contribute to this fetish.
Not Mental Illness, But Misdirected Suffering
None of this means that transgender identified people are evil or beyond help. Most are struggling human beings attempting to meet legitimate emotional, social, and psychological needs.
This is also why simply labeling transgender identification as a mental illness misses the mark. In most cases, it does not resemble traditional psychosis or other psychological disorders in which a person completely loses touch with reality and functionality. Rather, it reflects a complex combination of emotional distress, identity confusion, social influence, wishful thinking, and powerful group reinforcement.
In this sense, the phenomenon resembles cultic thinking more than classic mental illness. Vulnerable individuals who are searching for belonging, purpose, certainty, or relief from emotional pain are offered a compelling explanation for all of their problems. They are surrounded by a community that reinforces the belief, discourages skepticism, and interprets doubt as evidence that the individual needs to go further down the same path. What begins as a search for healing can become an all-encompassing identity that is protected from questioning and leads to harm.
The tragedy is that underlying struggles remain unresolved. Trauma, autism, social anxiety, depression, loneliness, self-hatred, family conflict, body image problems, and developmental challenges do not disappear because a person adopts a new identity or changes their appearance. These problems get compounded by new trust issues, living a lie, and the development of complex health issues. Yet, vulnerable people are still encouraged to view transition as the answer, rather than explore the deeper sources of their distress. Meanwhile, those who criticize the “born in the wrong body” narrative oversimplify trans as a mental illness too often.
The Answer Lies Beneath the Symptom
Since trans is really a symptom, the goal should never be automatic affirmation, nor should it be to dismiss the person as mentally ill. The goal should be understanding the individual beneath the identity. We should be asking difficult questions about what needs are going unmet and why the transgender identity became so appealing in the first place.
Transgender identification is the visible expression of deeper struggles. If we truly want to help people, we must look beyond the label, beyond the ideology, and beyond the symptom itself. Then, the real sources of distress can be understood, addressed, and resolved.
Pamela Garfield-Jaeger, LCSW is a licensed therapist with 25 years of clinical experience. She is the author of A Practical Response to Gender Distress: Tips and Tools for Family and Froggy Girl. She provides 1:1 consultations for parents through her website www.thetruthfultherapist.org and has built 5 CEU’s for other therapists who recognize that instant affirmation of gender identity is malpractice. You can find her on IG at @the.truthfultherapist, X as @pgarfieldjaeger and Substack as Pamthetruthfultherapist.
Genspect publishes a variety of authors with different perspectives. Any opinions expressed in this article are the author’s and do not necessarily reflect Genspect’s official position. For more on Genspect, visit our FAQs.
 | A guest post by
|
This definitely sums up my thoughts on transgenderism. I would offer that the strict ideology is the shield that prevents trans people from dealing with the heart of their distress. Try to take it away at your own peril! The "transphobic" and "bigot" labels are retreats when they are faced with cognitive dissonance resulting from facing their false identity.
Thank you for these clear insights. They conform with what I have seen around me and know intuitively about young people (as someone with many years behind me). It is helpful to hear them articulated by someone with the credentials and experience.