I'm very very sympathetic to people with all sorts of sexual identities, or all sorts of dysphorias and have been all my life.

But when it comes to irreversible surgery to cure body dysphoria, this is where I get off the train.

There are people with body integrity dysphoria who desperately want to cut off one of their limbs. I struggle to see the difference.

My blunt feeling is that people are wildly miserable because shit's fucked up, yo. Things are particularly terrible for young people today, and they rationally expect an unfixable ecological collapse to happen during their lifetimes, but they can do nothing about it, and even thinking about it is bad for your mental health.

So they refer the pain to other parts of their life.