Why are more and more adolescent boys and young men identifying as transgender? Sarah Mittermaier discussed the question with clinical psychologist Joe Burgo on the gender:hacked newsletter. His answer is not about an innate gender identity, but about a culture that abandons boys at the moment they are expected to become men. Burgo has treated boys and young men with gender dysphoria in his practice for years and sees a pattern that he believes is being systematically underestimated.

A Culture That Fails to Raise Boys

Burgo points to an accumulation of factors: the disappearance of factory jobs that once offered an obvious path to adulthood and male pride, the widespread assumption that gender is purely a social construct, therapeutic guidelines that are quick to frame masculinity as 'toxic,' and the disappearance of spaces exclusively for boys and men. The result, he argues, is a culture that, in his words, no longer teaches boys how to become men.

Two Very Different Paths

Burgo distinguishes between two groups that are often lumped together in practice. On the one hand are what he calls ROGD boys (rapid-onset gender dysphoria): generally somewhat unconventional adolescents searching for an identity and social acceptance. On the other hand are older men with longstanding autogynephilic cross-dressing fantasies who later reframe themselves within a transgender narrative. According to Burgo, both groups are drawn to 'being female' as a way out: ROGD boys find social connection and an explanation for who they are, while older men experience femininity as less demanding than masculinity—a way to escape the pressure of being a man.

Obsession as an Escape Route

Burgo describes trans identification, particularly the autogynephilic fantasy, as a 'psychological retreat'—comparable to addiction—that helps people avoid an unbearable reality and ongoing stress. The attraction lies not in gender itself, but in the way the fantasy or identity temporarily provides relief for those who feel stuck.

What Actually Works in the Therapy Room

Rather than addressing the gender issue directly, Burgo focuses in his practice on building masculine self-confidence: developing skills, making concrete plans for the future, and gaining control over one's own life. According to him, detransition often occurs when someone realizes that the fantasy did not deliver what they expected, or when they learn to understand their own attractions and desires differently. For genderid.nl, this ties in with a recurring theme: explanations for the rise in trans identification that do not assume a fixed, innate gender identity, but rather psychological and cultural mechanisms that can be properly investigated—and that can therefore be addressed in ways other than affirmation alone.