Altered states, authentic selves: Trans individual’s experiences with psychedelics and their implications for Psychedelic-Assisted Psychotherapy

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.