Is crossgender identification a mental illness?

Reflections on Genspect's effort to repsychopathologize transgender identities

Photo by Melissa Askew on Unsplash

In October 2025, Mia Hughes (author of the WPATH files) announced at the Genspect conference that Genspect was calling for a repsychopathologization of transgender identities. That is, Genspect is seeking to undo what it sees as a wrongheaded attempt by organizations like WPATH to normalize crossgender identification since the 2010s.

Designated a hate group by the Southern Poverty Law Center in 2024, and generally reviled among many trans activist groups, Genspect is a non-profit organization that claims to seek a healthy approach to sex and gender. As an organization, it has taken a critical stance on the gender-affirmative approach to gender distress, while advocating for the needs of parents who are skeptical of gender-related medical interventions, as well as offering counselling and psychosocial supports for detransitioners.

The basic premise of Genspect’s repsychopathologization campaign is that crossgender identification is an ‘extreme overvalued idea’, which they define as a rigidly held, false conviction that is shared by others in a culture or subculture. They argue that having a cross-sex identification is a mental illness and should be treated as such.

My initial reaction was surprise, a bit of horror, and also a sense of resignation. This moment is a long time coming, and perhaps what we need to stem the tide of young people seeking out medical interventions to solve their existential angst.

But will it cause more problems instead of less? It’s unclear.

Where once mental illness existed shrouded in secrecy and stigma, in today’s culture the opposite is true. If you don’t have a label, you might be viewed with suspicion. In an era where young people proudly announce their mental health diagnoses on social media as a badge of honour and claim it as as an identity, I’m not certain Genspect’s efforts will do much to dissuade a portion of young people from claiming a trans identity, as long as it is deemed desirable in their peer group.

I am also worried what this campaign means for the many of us who pursued gender transitions in good faith. I followed the medico-legal advice I was given, took steps to undergo a gender transition and in return was promised accommodations to live my life in peace in my chosen gender presentation.

It was a social contract.

Speaking from my own experience, I was only offered one treatment for my gender distress — a medical one. While I was offered therapy, it was as an adjunct to a medical transition. I was told that a medical transition would resolve my depression and anxiety. The endocrinologist who started me on hormones, told me that trans was a neuro-endocrinological issue.

While my endocrinologist situated the problem in my biology, Genspect is situating it in my mind. Both approaches are incomplete. Both explanations do not take into account the context within with my distress occurred. I offer that perhaps the problem of my distress shouldn’t solely be located within the individual.

Why am I the one being labelled as mentally ill, from Genspect’s perspective, and not the doctors who inflicted this on me and others like me? What exactly was my ‘extreme overvalued idea’ here? My desire to find a solution to my suffering? My trust in the healthcare providers that I turned to for answers?

I understand the impulse driving Genspect’s campaign. By calling crossgender identification a mental illness, they are seeking to reestablish a common language of reality for the culture at large — a reality that acknowledges that males are men and females are women and that it is, at the end of the day, impossible to change your sex. The best one can hope for is to emulate the other sex, becoming a simulacrum of the thing one desires.

Given that we currently live in a society where some seem to truly believe that hormones and surgery is a pathway to gender authenticity, perhaps the hard line that Genspect embodies in its campaign is a necessary corrective to this. But at what cost?

I cannot shake my discomfort with this campaign. It situates the illness in people like me while eliding the real locus of the dysfunction — the culture at large. After all, is it a mental illness to desire belonging, to want to relieve distress, to seek safety in an unsafe world? What of a culture that tells you your body is wrong, your sexuality is disgusting?

What about the adults who turn their backs on their effeminate sons or masculine daughters? Or the women who constantly police other women’s physical appearance? What about the men who continue to use homophobic slurs to describe other men who fail to meet implicitly-held standards of masculinity?

It’s a well-known secret in older lesbian circles that some lesbians sought to transition because they got tired of the homophobia they faced. For their gender nonconformity, they faced potential job discrimination, housing discrimination, social ostracism, or even physical attacks. Were they mentally ill for wanting safety? What of the people doing the discriminating?

For a lot of transmen like me, we transitioned because our gender nonconformity put us at risk, of social ostracism, and of potential violence. We didn’t believe we were literally becoming men. Transition was a pragmatic decision, that allowed a kind of invisibility that felt safer.

In my case, the reality of what was promised failed to live up to the hype. Nevertheless, I struggle to see my transgender identity as a mental illness. I know who I am and what I am; I live under no illusions. I also believe that I deserve a life of dignity.

I have no easy solutions here, but I do have a fear: that in Genspect’s fervour to re-establish sanity in the conversation about sex and gender, they are scapegoating a group of human beings while obscuring the context within which they came to their decisions.

I share a lot of Genspect’s sentiments: I do not believe there is such a thing as a trans child, unless by trans you simply mean gender nonconforming. Nor do I believe that medicalizing pre-pubescent or pubescent bodies is healthcare. Given that many gender affirming care-promoting clinicians don’t understand the consequences of the treatments they are evangelizing, my stance is that informed consent is impossible.

What I take issue with is Genspect’s jump from criticizing unsafe and experimental medical practices, to the claim that every person who ends up with a trans identity is pathologically mentally ill.

I had a severe case of clinical depression and anxiety that preceded my diagnosis of gender dysphoria. I sought help and I did all the things I was told to do — I took medication, I saw therapists. My mental distress did not wane. I chose a radical treatment because no one was able to offer me anything else that worked and I wasn’t able to find another way forward in my life. A desperate person will take desperate measures.

I sought a solution that ultimately proved the wrong answer to the wrong question. Rather than asking: “How can I get rid of this depression and fit in better?” I may have benefited from asking “How can I live a good life despite my depression, despite not fitting in, despite the cultural dysfunction around me?” But hindsight is 20/20 and who knows if that would have made enough of a difference.

I credit my relative sanity in the present to the recognition I had from the start that what I was embarking on was an experiment and not guaranteed to succeed. I still believe it was worth the risk, because the alternative seemed even more bleak. I didn’t feel like I had anything left to lose. I didn’t believe I was literally becoming a man. But I understood that I might have a more comfortable time in society being interpreted as a man rather than a woman. I was seeking social legibility.

My eccentricities as a female seemed less sharp, less socially disruptive when I was perceived as a man. I garnered a degree of social acceptance that eluded me before I transitioned.

My transition was a pragmatic social experiment. I knew that experiments can fail. And ultimately, I see my transition as something of a failed experiment. My depression and anxiety returned after I transitioned. I struggled for many years. Then slowly I started to heal, not because of my transition but despite it. I found a decent therapist who helped me reframe many of my self-sabotaging thoughts. I gained a new understanding of my motivations for transitioning. Once I started to admit to myself and those closest to me that I believed I’d been misdiagnosed, I finally could start to truly grieve and gain some acceptance of what had happened to me.

We can learn things from failed experiments. And I’ve learned a lot — about myself, about the limits of human understanding, and about the power of love to pierce even the darkest, bleakest of moments. Even though my transition was a mistake, it allowed me to meet my wife. If I hadn’t transitioned we likely would have never met. Before she met me she identified as straight. I never hid my trans status. She knew I was trans from the start, but she was attracted to me anyway. For that relationship, I will always be grateful.

When I eventually started doubting my initial gender dysphoria diagnosis out loud and I blurted out to my wife that I believed I had been misdiagnosed, she listened. She understood. Maybe not fully, but enough. Every human is broken in different ways, she said. To quote Leonard Cohen, “there’s a crack in everything, that’s how the light gets in”. She liked my light, and I liked hers.

But what’s one story? It’s an anecdote, not data. It’s my story though. And I’m still living it. Genspect can pathologize me and those like me all they want. But when I look at some of the extreme voices who seem to relish in humiliating trans people of all stripes, I think to myself: I’d rather be me than them. I acknowledge my brokenness. But them, they are riding their wave of self-righteous fury and purity politics without much of a care for the human beings they are targeting. We are all human, at the end of the day, doing our best in a constantly evolving, complicated world.

To harken back to my early church-going days: Let he who is without sin cast the first stone.