There’s a lot of talk and speculation – even calls for policy change/regulation – to tackle the rise in violence among trans-identified individuals. Many of the mass shootings that have taken place recently are by a person who identifies as trans or is dating someone who is trans. That fact alone has fueled debates, but it raises a deeper question: what do we actually know about the trans community? What is the scientific basis for this population that justifies a mental illness diagnosis?
Honestly? Nothing.
Even the National Institutes of Health has stated there are no objective laboratory tests or biomarkers for psychiatric conditions, including gender dysphoria. As one review put it, “The field of psychiatry is hampered by a lack of robust, reliable, and valid biomarkers that can aid in objectively diagnosing patients” (Abi-Dargham, 2023).
Much of what we know about mental illness – specifically those identified in the Diagnostic and Statistical Manual (DSM) – is based on subjective markers. As I wrote in a previous article, “the DSM is constructed through clinical experience, pharmaceutical influence, insurance reimbursement considerations, cultural and political pressures, and professional self-preservation.” It offers no biomarkers or empirical tests.
It’s worth noting that Thomas Insel, while director of the National Institute of Mental Health, publicly challenged the DSM’s validity in 2013, arguing that its diagnoses are based on symptom clusters rather than biology. That post, titled “Transforming Diagnosis,” sparked major criticism and was eventually removed from the NIMH website – an act many interpret as evidence of the institutional resistance to exposing the fragility of psychiatric diagnosis.
At best, the DSM provides names for a cluster of symptoms. And though “Trans” is no longer a DSM diagnosis – the terminology shifted from pathologizing identity (Gender Identity Disorder / Transsexualism) to pathologizing distress (Gender Dysphoria) – it still signals that someone is showing distress through trans-behaviors.
This pattern isn’t unique to gender-related diagnoses. The DSM applies the same approach across the board: it takes a set of distressing thoughts or behaviors, groups them together, and assigns a name to the resulting cluster. For example, Obsessive-Compulsive Disorder (OCD) is a diagnosis in the DSM. Many believe OCD is a disease that causes someone to have obsessive thoughts and/or compulsive behaviors that are distressing. Think of the person who must count how many times they lock the door or who avoids stepping on cracks.
There is no empirical evidence that OCD is a disease that can be “cured” purely by medication, claiming to rewire the brain. While drugs may ease symptoms, long-term effectiveness is limited, and relapse is common. Reviews consistently emphasize that the most effective approach is exposure and response prevention (ERP), a behavioral method that works by reducing anxiety and creating new brain pathways through neuroplasticity.
Another controversial example: Autism. Most people don’t realize that autism is not diagnosed through a biomarker or brain scan. Instead, clinicians rely on behavioral observations, questionnaires, and self-reported symptoms.
Because many believe autism is innate and unchangeable, the field is pushing terms like “neurodivergent” to normalize it and shift away from prevention—the narrative shifts from focusing on causes to emphasizing identity.
Also worth noting: in many studies, a significant fraction of those diagnosed as autistic also identify as trans or gender-diverse. Research shows that transgender and gender-diverse individuals have higher rates of autism and other neurodevelopmental or psychiatric conditions compared to biological males and females. One meta-analysis found that about 11% of individuals with gender dysphoria or incongruence were autistic, with autism diagnoses occurring 3 to 10 times more often in gender-diverse populations.
The only real winners from psychiatric diagnoses and ICD codes are pharmaceutical companies and insurance firms – not families. Pharma produces drugs meant to manage symptoms, while insurers profit from long-term treatment plans. Not once has a medication cured a mental disorder. As psychiatrist Alfonso Troisi observed, the failure of biological psychiatry to deliver on its promises of understanding mental illness and providing curative treatments stems from “invalid theoretical postulates” and decades of overreach. Despite billions spent on neuroscience and genetics, the field has produced “cool papers” but has failed to reduce suicide, hospitalizations, or deliver lasting recovery. If psychiatry can’t even ground its own diagnoses in solid science or deliver cures, it raises an obvious question: how much weight should we give to the labels it invents – especially when applied to today’s most politically charged issues?
So, what do we make of violence associated with trans-identified people? Should we fear this growing population or regulate it specially?
Trans isn’t the problem. The real issue is how certain online spaces operate as echo chambers – enclosed environments where aggressive ideas are continuously reinforced. A detailed RAND investigation into 15 cases of terrorism and extremism found that the internet often serves as a place “to confirm existing beliefs” among like-minded individuals, amplifying and normalizing extremist ideas. Stepping into a rigid identity or ideology can expose someone to rhetoric that justifies and valorizes violence.
Trans is a choice (and yes, that’s controversial). There’s no credible evidence that anyone is born trans – no biological test exists to prove it. The label itself rests entirely on self-report and clinical judgment.
If we want to address the root causes of violence truly, we must first recognize that the problem isn’t identity – it’s how we’ve chosen to handle distress and disorder. That means:
- Stop pathologizing anxiety or depression as automatic, clinical diagnoses (often they’re situational).
- Reintroduce moral structure in the home. Preferably with God present.
- Get outside and touch grass.
Everything else is just a band-aid.
Soad Tabrizi is a licensed marriage and family therapist in eight states, with a private practice based in Orange County, CA (www.soadtabrizi.com). Soad is also the founder of www.ConservativeCounselors.com.
