Not drug advice
This page describes what people report and what research shows. It does not recommend psychedelics for gender dysphoria or anything else, and it gives no dosing or "how to" information. Most of these substances are illegal in most countries. If you are struggling with your gender or with a transition decision, the support directory lists gender-exploratory therapists and detrans peer groups.
Overview
Psychedelics are drugs that profoundly alter perception, emotion and the sense of self. The classic ones are LSD ("acid"), psilocybin ("magic mushrooms"/"shrooms"), DMT (dimethyltryptamine, a short-acting psychedelic) and ayahuasca (a South American brew containing DMT). MDMA ("ecstasy"/"molly") and ketamine are often grouped with them, although they work differently. Cannabis can produce milder versions of some of the same effects.
Psychedelics come up again and again in gender identity stories, in both directions:
- Some people describe a trip as the moment their "egg cracked" (trans-community slang, from the idea of a not-yet-aware trans person as an "egg") and they realised they were trans.
- Others describe a trip as the moment a trans identity fell apart: they suddenly accepted their body, saw the trauma underneath their dysphoria, or felt that "gender" was a construct they no longer needed.
Recurring threads on /r/detrans ask exactly this question ("did anyone else have psychedelic experiences that…", "shroom trip got rid of my dysphoria"). The trans subreddits have matching threads with the opposite stories. This page looks at both sets of accounts, the brain science that explains why one drug class can push people in opposite directions, the risks, including detransitioners' own bad experiences, and how little formal research exists. It belongs with the detransition processes section, which covers the triggers and catalysts of detransition more generally.
Two directions, one drug class
Trips that started a trans identity
In trans communities, a psychedelic experience is sometimes described as the event that let someone admit they were trans. One trans woman described LSD as a "reset":
Then at age 19 I tried LSD. It basically did a factory reset on my brain. The walls I had built in my mind started to melt away… One day I was sitting in my room thinking things over, and really it just popped into my head. "I'm a girl. Holy shit... I'M A GIRL?!?!" —StopTheEarthLetMeOff, trans woman (MTF)
Some detransitioners say a trip started their transition too. One detrans male described taking ayahuasca, seeing himself as a "soft feminine person", and then quickly ordering hormones himself:
I decided to transition after taking ayahuasca and seeing myself as a soft feminine person. Immediately after the trip I got a pixie cut but my face looked too manly… I had been reading up on hormonal effects to soften my face, then got the idea to order estradiol, which I did. —Atraills, detrans male
A detrans woman described an ordinary trip moment, being angry at having to pick a bathroom at a show, as the start of her new name and pronouns (-meep-morps, detrans female). Another said her first mushroom trip made her more convinced of her transition, and she read the drug's euphoria as proof:
The first time I took shrooms they made me feel super convicted in the oath I had chosen unfortunately I thought the euphoria they bought was because I had made the right choice becoming a man. It took an uncomfortable dmt trip to make me start questioning —xnyvbb, detrans female
These accounts fit the wider egg-cracking narrative. A single intense experience is read as the discovery of a hidden "true self" that had been there all along.
Trips that ended one
The detransition accounts follow a mirror-image pattern. The details repeat: looking in a mirror, ego dissolution (also called "ego death": a temporary loss of the sense of being a separate self), and coming back with a different relationship to the body.
I didn't have any desire to detransition until after I tried mushrooms. I experienced ego death where I felt connected to everyone… I also had an epiphany that the outer appearance of my body didn't matter as long as my body was healthy and allowed me to experience life and love. The entire "gendered brain" or being in the "wrong body" just felt like such bullshit to me after experiencing ego death. —Lurkersquid, detrans female
She tells the same story in her video. For others the insight was about sex itself, not about gender losing its meaning:
Then I had a nice acid trip where I basically had a realization that everything I was doing was not going to make me male, I was simply altering a female body and was not going to become this other person. —DEVlLlSH, detrans female
Several people say the trip did not create anything new. Instead it brought up what had been underneath the dysphoria, often trauma:
It was also psychedelics for me (LSD) that led me to realizing that I'd transitioned because of being mistreated sexually and emotionally abused and neglected by my dad. The story I'd lied to myself about being a ma inside was easier to swallow than the story of my youth. —Comfortable_Elk_4941, detrans female
Two desisted women independently said that the first thing to "come back" after ego dissolution was the thought that they were autistic, and both were later diagnosed (Nut_Cutlet; JazziestCabbage). See autism and gender identity. In a video account, one detransitioned woman describes an ayahuasca ceremony in which, as she put it, her attachment to a male identity "was all ego based". By then she had already stopped hormones.
A detrans male stressed that the drug was not the cause on its own:
I managed to get past the hatred of my male body through building up my self esteem through therapy and experiencing radical self acceptance while on a shrooms trip… The framework was already built out due to therapy, the shrooms just let me see the truth. —verytiredcatto, detrans male
Recurring themes
| Theme | Towards a trans identity | Away from a trans identity |
|---|---|---|
| Mirror moments | Seeing a feminine/masculine self "for the first time" | Seeing the body as fine, or the altered body as "uncanny" |
| Ego dissolution | Old identity "melts", a new gendered self is felt as true | All identity feels constructed, so gender stops mattering |
| Emotional release | Euphoria read as confirmation | Grief at having rejected one's body; trauma surfaces |
| Felt certainty | "I'm a girl" | "I was always a woman" |
Negative experiences and regretted decisions
The accounts above are mostly positive in hindsight, but many detransitioners also describe frightening, destabilising or misleading trips. These deserve as much attention.
Distressing trips. A bad trip ended one man's transition, and he describes it as horror, not insight:
I had a really bad trip on shrooms where I saw myself and my partner at the time (ftm) circling a drain in like a liquid form and exchanging bodies- idk hard to describe but I felt like I had to escape my own body. —sk3l3tonh4v3r, detrans male
Another detrans woman spiralled in a bathroom mirror on LSD, a year into testosterone:
I watched my newly sprouted beard hairs wiggle from the drugs and felt sudden disgust… I started spiralling in that bathroom, picking apart everything about myself that had changed from the hormones… I continued doing the hormones for 2 more years before I finally allowed myself to explore that feeling —scoutydouty, detrans female
A detrans male described his turning point as a festival trip in which he realised "I didn't exist", followed by "a couple more trips to hell on psychedelics" over the following months (nothingleft_butfaith, detrans male).
Psychosis. One detrans woman who credits LSD with starting her questioning also gives a warning:
I was doing LSD. Way too much actually. But it got me questioning my life in general… Be forewarned, it can trigger psychosis in susceptible individuals. I did way too much and was triggered into what might be called high functioning psychosis. —furbysaysburnthings, detrans female
Worse dysphoria, not better. Not every trip helps. One questioning commenter wrote simply: "I did psychedelics and it only made dysphoria worse." (Iriskeditall). Another detrans male said his gender dysphoria lifted after mushrooms but "has been replaced with a different kind of dysphoria, something worse and more sinister" (CastratedFemboy, detrans male).
Identity decisions made on a trip and later regretted. The ayahuasca-to-DIY-estrogen account above ended in regret about "permanent changes to my body". The reverse also happens. On r/MtF, one trans woman described detransitioning after a mushroom night and later transitioning again:
After this shrooms night, where nothing really substancial happened, i asked her to cut my hair and i detransitioned… This was 2 years ago and since then im staying away from psychedelics. The false sense of 'figuring it out' fucked me over and took another 6 months of my 20 years. —hatethislifeThrowaw, trans woman (MTF)
Using drugs to avoid doubts. Several detransitioners describe the opposite of insight: using substances to stay away from doubt. One wrote that whenever she was sober "i would have massive panic over the fact i probably did indeed fuck up by medically transitioning", so she stayed high on cannabis and alcohol "for about 3-4 years straight, the entire time i was on hormones almost" (drink-fast, detrans female). Another said ketamine "played probably the biggest part" in her detransition, while noting she had "struggled with ketamine addiction for years" (Snoo_85491, desisted female). Some commenters push back against the idea of psychedelics as treatment at all:
Drugs and alcohol are just other maladaptive and unhealthy coping mechanisms to deal with emotional pain. You don't want to switch from one horrific coping mechanism such as becoming trans identified... to another equally bad coping mechanism like drugs. —bo1555
What happens in the brain
The default mode network and ego dissolution
The default mode network (DMN) is a set of brain regions most active during self-referential thought: thinking about yourself, your past and your story. Brain imaging under LSD found that disrupted connectivity in these networks tracked how strongly volunteers reported ego dissolution (Carhart-Harris et al. 2016). Put simply, the brain system that maintains the "story of me" is temporarily loosened.
REBUS: relaxed beliefs
The most influential theory is REBUS ("relaxed beliefs under psychedelics"). In the predictive-processing view, the brain constantly predicts experience from deep, high-level beliefs ("priors"). Psychedelics are thought to turn down the confidence of those top-level beliefs, so that bottom-up information and new interpretations flood in (Carhart-Harris & Friston 2019). The authors say this can help revise "entrenched pathological priors", but only "with the right intention, care provision and context".
A belief like "I am really a man/woman inside", or "my body is wrong", is exactly the kind of high-level self-belief REBUS describes. It may be loosened. But what replaces it is not determined by the drug.
Suggestibility and false insight
Two further findings matter here:
- Suggestibility. In a placebo-controlled study, LSD increased volunteers' responsiveness to suggestion (Carhart-Harris et al. 2015). A review of modern LSD research lists increased "suggestibility", along with derealisation and depersonalisation, among its acute effects (Liechti 2017).
- False insights. Researchers have proposed that because relaxed priors make everything feel meaningful, psychedelics can produce a strong feeling of "aha!" certainty about conclusions that are wrong (McGovern et al. 2024). Lasting belief changes after psychedelic use were moderated by how impressionable people were at baseline (Timmermann et al. 2021).
So the feeling of certainty that comes with a trip says little about whether the insight is true. That applies equally to "I'm trans" and "I'm not trans".
Why the same drug pushes in opposite directions
Psychedelic research has long stressed set and setting: your mindset, expectations and environment shape the trip. Read through REBUS, the drug loosens existing beliefs, and the person's environment, intentions and available stories fill the gap. A trans commenter suggested exactly this about the shroom-then-detransition account above: that the setting with an unsupportive ex may have "multiplied a certain shame/repression" (ATWTG, trans woman (MTF)). Detransitioners use the same logic to explain trips taken inside affirming trans communities.
One /r/detrans commenter compared two friends with opposite mushroom outcomes:
In my experience, psychedelics can both open one to new perceptions & well as allow one to run 'further down the rabbit hole' & further cement their pre-existing beliefs… Robert Anton Wilson said it well: What the Thinker thinks, the Prover proves. —will-I-ever-Be-me, detrans
The same observation about cannabis:
woah were opposite lol. when i thought i was trans weed made me fixate on it more. now that i've learned i'm not trans, weed no longer makes me think this way. i think weed might just amplify the thoughts we already have? —portaux, desisted
A detrans woman gave advice to someone hoping a trip would fix their chest dysphoria: "You'll feel whatever you happen to be feeling on mushrooms, not what you wish to feel." (nervkeen_, detrans female).
One asymmetry stands out. People in either direction find trips loosening beliefs about the body. But the detransition accounts tend to end on facts that can be checked when sober: "I was simply altering a female body", "my body is healthy", "this started with abuse". Many of the transition accounts end on a felt inner identity. A felt identity is real as an experience, but a trip cannot check it against anything outside itself.
Discovered self or constructed self?
Both directions use the language of discovery: the trip revealed who I really am. Philosopher Chris Letheby argues that psychedelic therapy works mainly by "unbinding" and revising the brain's model of the self (Letheby 2021). On that view, a trip doesn't uncover a ready-made true self. It loosens the self-model so that it can be rebuilt, for better or worse.
This fits the many detransition accounts in which ego dissolution led to the conclusion that the trans identity had been constructed: from stereotypes, coping strategies, community belonging and trauma. As one desisted woman put it, "Biology matters. The gender construct does not." (No_Equivalent5665, desisted female). It also clashes with the born in the wrong body idea that a gendered essence waits to be discovered. If the "true self" can be felt as female on one trip and male on the next, the feeling is not evidence of an inner essence.
What does seem to last, in these accounts, is a change in relationship to the body rather than a new label:
What I realized is my hands are MINE. And they're beautiful and let me do so many amazing things… I suddenly stopped caring about all the bullshit that was stuffed into my brain about what my body should look like. I like my body because it's mine. End of story. —verytiredcatto, detrans male
That outcome, accepting the body while living however one likes, is the same one described on gender non-conformity without labels and healing and recovery. Several people in these accounts, though, reached it through therapy, time and life changes, with or without drugs. One detrans woman said moving away from a heavily LGBT social circle was as important as the trips (between-them012, detrans female). Another only acted on her trip insight a year later, after moving somewhere she felt safe as a woman (Comfortable_Elk_4941, above).
Cannabis, MDMA and ketamine
- Cannabis comes up often, usually as an amplifier. Some detransitioners describe a sudden realisation while high (I'd get high and immediately have the thought "what the hell am i doing to my body?", Space-A1ien, detrans female). Others describe paranoia, anxiety attacks, and heavy use to numb doubts. One woman first realised her mistake coming down after top surgery and "had a huge anxiety attack the next night" (ButterflyTurbulent30, detrans female).
- MDMA produces intense warmth and self-acceptance. One woman said it "cured my dysphoria and dysmorphia" after she had already had top surgery (detox5617, detrans female). On the trans side, the same feeling is used as a comparison for "gender euphoria". A feeling produced by a drug that floods serotonin is a weak guide to permanent decisions in either direction.
- Ketamine is a dissociative. For people whose dysphoria was partly dissociation, deliberately inducing it is a double-edged sword, and the corpus includes addiction alongside insight.
Known risks
None of the substances below is risk-free, and several risks are especially relevant to people who are already distressed about their body or identity. The table summarises known risks; it is not complete and is not medical advice.
| Substance | Known risks | Evidence |
|---|---|---|
| All classic psychedelics (LSD, psilocybin, DMT, ayahuasca) | Triggering psychosis or mania, especially with a personal or family history of psychosis or bipolar disorder; people with bipolar disorder are excluded from modern trials | People with a hallucinogen-related emergency visit had about 3.5 times the adjusted risk of later schizophrenia-spectrum diagnosis (Myran et al. 2024); trial exclusions (Nayak et al. 2021) |
| All classic psychedelics | Hallucinogen persisting perception disorder (HPPD): recurring visual disturbances long after use | Rare but documented; more often in people with prior psychological problems (Doyle et al. 2022) |
| All classic psychedelics, ketamine | Depersonalisation/derealisation during use, which can persist; panic and terrifying "challenging experiences"; dangerous behaviour while intoxicated | Liechti 2017; detrans accounts above |
| All classic psychedelics | Heightened suggestibility and "false insights": strong certainty about conclusions that may be wrong. Particularly relevant to identity, hormone and surgery decisions made during or soon after a trip | Carhart-Harris et al. 2015; McGovern et al. 2024 |
| LSD / psilocybin with lithium | Seizures | 47% of online reports combining classic psychedelics with lithium described seizures (Nayak et al. 2021) |
| Ayahuasca | Contains alkaloids that inhibit monoamine oxidase (MAO), an enzyme that breaks down serotonin and related chemicals: dangerous interactions with SSRIs/SNRIs, other antidepressants, MAOIs and some stimulants (serotonin syndrome); vomiting; raised heart rate and blood pressure | Frecska et al. 2016 |
| MDMA | Hyperthermia, severe hyponatraemia (low blood sodium, partly from over-drinking water), liver toxicity, serotonin syndrome; post-use low mood ("comedown"); evidence of serotonin-neuron harm with heavy use | UCSF Hospital Handbook; NIDA |
| Ketamine | Bladder and urinary-tract damage (ketamine uropathy) with repeated use; dependence; dissociation, delusional symptoms and memory problems in frequent users | J Clin Psychiatry review; Morgan et al. 2009 |
| Cannabis | Paranoia and anxiety; withdrawal anxiety and insomnia in regular users; heavy use as avoidance | Detrans accounts above |
| Street drugs generally | Adulterants and substitution, e.g. far more toxic NBOMe compounds sold as LSD, linked to seizures and deaths | Medscape report of a systematic review |
| All illegal substances | Criminal penalties; unregulated "retreats" and ceremonies with no medical screening | Varies by country |
A point for anyone currently on cross-sex hormones or psychiatric medication: the interaction risks above (especially ayahuasca with antidepressants, and lithium with psychedelics) are serious. Many detransitioners who had powerful trips still advise against making a permanent body or identity decision during or soon after one. The insights that held up in these accounts were the ones still standing months later, after sober reflection and often therapy. See gender-exploratory therapy.
The evidence gap
No study we could find has looked at psychedelics and detransition or desistance. All the detransition material on this page comes from self-selected online accounts.
The small body of research on psychedelics and gender identity comes almost entirely from affirming frameworks and samples of currently trans-identified people:
- A qualitative study of 20 trans and gender-expansive people found that naturalistic psychedelic use increased self-acceptance of their gender identity through "an expanded concept of gender". Some participants also reported challenging experiences including gender dysphoria (Gaughan et al. 2025).
- A survey of 346 gender and sexual minority adults found 65% said psychedelics had affected the evolution of attitudes toward their gender identity. Only a small fraction of that sample identified as trans (Lancelotta et al. 2025).
- An analysis of trans Reddit posts found psychedelics linked to "gender realization" and euphoria, but also noted that altered states "can simultaneously support and exasperate gender dysphoria" (Bartholomaeus et al. 2026).
None of these studies asked whether any participants later stopped identifying as trans, so they cannot show which direction a trip-induced "realisation" holds up over time. The detransition accounts and trans accounts are mirror images, and researchers have so far studied only one side.
More broadly, a survey of 100 detransitioners found that 38% had come to believe their gender dysphoria was caused by something specific such as trauma, abuse or a mental health condition. 60% had become more comfortable identifying as their natal sex (Littman 2021). This is consistent with the many psychedelic accounts in which a trip surfaced trauma or produced body acceptance, but the survey did not ask about drugs.
Psychedelic medicine itself is far less settled than enthusiasm suggests. In 2024 the US FDA declined to approve MDMA-assisted therapy for PTSD and asked for another trial (The Conversation 2024). Psychedelics have not been tested as a treatment for gender dysphoria. Some commenters on both sides argue they should be; others, on both sides, warn this would be dangerous or open to misuse.
Related pages
- Egg cracking: the "realisation" narrative psychedelic trips often feed
- Gender dysphoria and born in the wrong body
- Mental health, trauma and body dysmorphia and eating disorders
- Desistance, retransition and healing and recovery
- Detransition processes, plus more personal stories in the video archive
References
- Bartholomaeus, T., Brown, S. J., Brömdal, A. et al. (2026). Altered states, authentic selves: Trans individual's experiences with psychedelics and their implications for Psychedelic-Assisted Psychotherapy. International Journal of Transgender Health. source.
- Carhart-Harris, R. L., Kaelen, M., Whalley, M. G. et al. (2015). LSD enhances suggestibility in healthy volunteers. Psychopharmacology 232: 785–794. source.
- Carhart-Harris, R. L., Muthukumaraswamy, S., Roseman, L. et al. (2016). Neural correlates of the LSD experience revealed by multimodal neuroimaging. PNAS. source.
- Carhart-Harris, R. L. & Friston, K. J. (2019). REBUS and the anarchic brain: Toward a unified model of the brain action of psychedelics. Pharmacological Reviews 71(3): 316–344. source.
- Doyle, M. A. et al. (2022). Hallucinogen persisting perceptual disorder: a scoping review covering frequency, risk factors, prevention, and treatment. Expert Opinion on Drug Safety 21(6): 733–743. source.
- Frecska, E., Bokor, P. & Winkelman, M. (2016). The Therapeutic Potentials of Ayahuasca: Possible Effects against Various Diseases of Civilization. Frontiers in Pharmacology 7:35. source.
- Gaughan, S. J., Wootton, A. R., Krantz, D. et al. (2025). Naturalistic psychedelic experiences and gender-based self-acceptance in transgender and gender-expansive people. International Journal of Transgender Health. source.
- Journal of Clinical Psychiatry. Ketamine-Associated Uropathy During Therapeutic and Nontherapeutic Use: Prevalence, Clinical Features, Mechanisms, and Strategies for Risk Reduction. source.
- Lancelotta, R., DellaCrosse, M., Quinn, D. et al. (2025). Exploring Self-Reported Effects of Naturalistic Psychedelic Use Among Gender and Sexual Minorities: A Quantitative Survey Study. Journal of Psychoactive Drugs. source.
- Letheby, C. (2021). Unbinding the self. In: Philosophy of Psychedelics. Oxford University Press. source.
- Liechti, M. E. (2017). Modern Clinical Research on LSD. Neuropsychopharmacology. source.
- Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. study page.
- McGovern, H. T., Grimmer, H. J., Doss, M. K. et al. (2024). An integrated theory of false insights and beliefs under psychedelics. Communications Psychology. source.
- Medscape (2015). New Deadly Class of Synthetic Hallucinogens Mimics LSD. source.
- Morgan, C. J. A., Muetzelfeldt, L. & Curran, H. V. (2009). Consequences of chronic ketamine self-administration upon neurocognitive function and psychological wellbeing: a 1-year longitudinal study. Addiction. source.
- Myran, D. T., Pugliese, M., Xiao, J. et al. (2024). Emergency department visits involving hallucinogen use and risk of schizophrenia spectrum disorder. JAMA Psychiatry. source.
- Nayak, S. M., Gukasyan, N. et al. (2021). Classic Psychedelic Coadministration with Lithium, but Not Lamotrigine, is Associated with Seizures: An Analysis of Online Psychedelic Experience Reports. source.
- National Institute on Drug Abuse. MDMA (Ecstasy) Abuse research report. source.
- The Conversation (2024). FDA rejects MDMA-assisted therapy for PTSD treatment. source.
- Timmermann, C., Kettner, H., Letheby, C. et al. (2021). Psychedelics alter metaphysical beliefs. Scientific Reports 11: 22166. source.
- UCSF Hospital Handbook. MDMA (Ecstasy) Intoxication. source.
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