Transgender and gender-expansive (TGE) people use psychedelics in naturalistic, non-clinical settings to explore and affirm their gender identity. Interviews with 20 TGE individuals revealed three main themes: the mindset and physical setting of a psychedelic experience shape its quality; such experiences often increase self-acceptance of gender identity through greater self-compassion and a broader concept of gender; and participants reported both challenging effects like gender dysphoria and benefits like gender euphoria. The findings suggest clinicians should help TGE clients prepare a gender-affirming setting before psychedelic use and support shifts in gender understanding afterward.
An analysis of 225 Reddit posts from trans individuals describes how psychedelic experiences can both help and harm. Psychedelic-induced altered states can lead to self-acceptance, gender euphoria, and gender realization, and psychological release during trips can facilitate a journey of self-acceptance. These experiences can function as a catalyst for change but can also simultaneously support and exacerbate gender dysphoria. The findings highlight a duality in psychedelics for trans people, with both healing qualities (e.g., gender euphoria, self-acceptance) and harming qualities (e.g., exacerbated dysphoria and grief). Clinical applications should consider this duality to inform responsive and affirming psychedelic-assisted psychotherapy protocols.