Altered states, authentic selves: Trans individual’s experiences with psychedelics and their implications for Psychedelic-Assisted Psychotherapy
Tiana Bartholomaeus, Samantha J. Brown, Annette Brömdal, Mera Reyment, Tamara C. Erbacher, Amy B. Mullens, Riccardo Miceli Mcmillan, Renee Ireland, James A. Fowler
International Journal of Transgender Health June 8, 2026 DOI: 10.1080/26895269.2026.2681667 via OpenAlex
Summary
AI-generated from the abstractAn 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.
Study at a glance
| Characteristics | Qualitative study Peer reviewed |
|---|---|
| Population | Trans people who posted on Reddit subreddits r/trans and r/asktransgender |
| Keywords | Thematic analysis Theme computing Naturalism Qualitative research Gender dysphoria |
| Key finding | Psychedelic experiences can both support (self-acceptance, gender euphoria, gender realization) and exacerbate (gender dysphoria, grief) for trans individuals. |
Abstract
Background/Aim Increased attention is being paid toward Psychedelic Assisted Psychotherapy (PAP) and how this can support priority populations such as trans people. The current study analyses trans people’s naturalistic psychedelic experiences shared on the social media platform Reddit to inform PAP.Methods 225 posts from between 2019 and 2024 were recorded from the subreddits r/trans and r/asktransgender and were assessed for inclusion. Codes and themes were extracted from the data using structured tabular thematic analysis.Results Four themes were identified. The first acknowledged how psychedelic-induced altered states can lead to self-acceptance, gender euphoria, and gender realization. The second explored how psychological release during psychedelic trips can also facilitate a journey of self-acceptance. The third explored how these experiences can function as a catalyst for change. The last theme explored how psychedelic-induced altered states can simultaneously support and exasperate gender dysphoria.Conclusion This work highlights how psychedelics can have both ‘healing’ (e.g., gender euphoria, self-acceptance) and “harming” (e.g., exacerbated dysphoria and grief) qualities for trans individuals. As such, clinical applications need to consider this duality and integrate it to inform responsive and affirming PAP protocols.