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 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study Peer reviewed |
|---|---|
| Population | Trans people who posted on Reddit subreddits r/trans and r/asktransgender |
| Topics | Psychedelic-assisted therapy |
| Keywords | Thematic analysis Theme computing Naturalism Qualitative research Gender dysphoria Function biology Perception Naturalistic observation Psychotherapist Photo elicitation Developmental psychology |
| Key findings | 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.
Comparable studies
Other qualitative studies on psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Patients’ Accounts of Increased “Connectedness” and “Acceptance” After Psilocybin for Treatment-Resistant Depression Patients with treatment-resistant depression enrolled in an open-label trial of psilocybin | 2017 | Qualitative study | n = 20 |
| LSD-assisted psychotherapy for anxiety associated with a life-threatening disease: A qualitative study of acute and sustained subjective effects Patients with anxiety associated with life-threatening diseases | 2014 | Prospective follow-up with qualitative content analysis | n = 10 |
| Patient Experiences of Psilocybin-Assisted Psychotherapy: An Interpretative Phenomenological Analysis Adults aged 22 to 69 with clinically elevated anxiety associated with a cancer diagnosis | 2017 | Qualitative study | n = 13 |
| Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts Participants who completed a psilocybin-facilitated smoking cessation pilot study | 2018 | Qualitative follow-up study using semi-structured interviews and thematic analysis | n = 12 |
| The hidden therapist: evidence for a central role of music in psychedelic therapy Patients undergoing psychedelic therapy with psilocybin for treatment-resistant depression | 2018 | Qualitative study | n = 19 |
Citations in the library
Cites 14
- Self unbound: ego dissolution in psychedelic experience Neuroscience of Consciousness 2017
- Predicting Reactions to Psychedelic Drugs: A Systematic Review of States and Traits Related to Acute Drug Effects. ACS Pharmacology & Translational Science March 5, 2021
- Psychedelic Treatments for Psychiatric Disorders: A Systematic Review and Thematic Synthesis of Patient Experiences in Qualitative Studies CNS Drugs August 17, 2020
- A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy Journal of Psychoactive Drugs June 12, 2020
- Extended difficulties following the use of psychedelic drugs: A mixed methods study PLoS One October 24, 2023
and 9 more in the library