Researchers Explore Psychedelic-Assisted Therapy for Identity-Based Trauma

Dr. Jae Sevelius (they/them) is a researcher and professor with the Department of Psychiatry at Columbia University who has dedicated their career to providing mental healthcare opportunities to members of the transgender (“trans”) and gender-diverse communities. Currently, their research and clinical work involves exploring the benefits of psychedelic-assisted therapy (PAT) using MDMA to treat identity-based trauma. Recent discoveries in clinical research on the therapeutic application of psychedelic substances, such as psilocybin or MDMA, have turned considerable scientific attention toward PAT as a promising treatment for certain mental health conditions. According to Dr. Sevelius’ work, there are important and unique ways that PAT can help transgender patients overcome past traumas.

What is Psychedelic-Assisted Therapy?

PAT involves using medically supervised administration of psychedelic drugs—such as MDMA, psilocybin, LSD and ketamine—in conjunction with psychotherapy to address certain persistent mental health conditions. Combining these two treatments has been suggested to enhance their success in providing mental health benefits.

Drugs classified as “psychedelics” (also called “hallucinogens”) are natural or synthetic psychoactive substances that affect human perception and mood, among other cognitive processes. Psychedelics are known to shift the ways individuals understand themselves, others and the world more generally, and these effects are especially important for people struggling with inflexible thought patterns that are common to many mental health disorders.

Numerous clinical trials suggest that psychedelics can be exceptionally effective for treating severe depression and post-traumatic stress disorder (PTSD). In fact, research involving MDMA and psilocybin has produced such strong evidence of success that the United States Food and Drug Administration (FDA) has recognized these two substances as “breakthrough therapies” for PTSD and depression.

However, because the US Drug Enforcement Administration (DEA) classifies psychedelics as Schedule I controlled substances, these drugs are considered addictive and have “no accepted medical use,” so they are generally illegal and difficult to obtain for medicinal application.

Psychedelic-Assisted Therapy and Trans Communities

Populations of transgender and gender-diverse people experience disproportionately high rates of PTSD compared to cisgender people, so the potential health benefits of MDMA-assisted therapy are particularly interesting for many individuals in these communities.

Throughout history and in societies across the globe, gender identities, expressions, and roles are found to be diverse, complex elements of various cultures. Trans and gender-diverse people generally are those who express and associate with a gender identity that does not conform with the cultural gender conventions attributed to the sex they were assigned at birth. Although no official U.S. census data are documenting trans populations, experts estimate that approximately 0.5 -3% of the U.S. population, about 1-9 million people, identify as trans or gender diverse.

Particularly in Western cultures, trans and gender-diverse people are often undermined and face discrimination or ridicule for expressing gender in ways that fail to conform to generally accepted social standards dictating the traditional gender binary. Thus, trans and gender-diverse populations are more likely to experience bullying, rejection, and victimization, which can even come from the people who are needed for support, like family members or healthcare providers. Transgender and gender-diverse people are also more likely to experience childhood sexual abuse than the general population. As a result, rates of trauma from stigma, abuse, and exclusion tend to be higher in trans and gender-diverse populations.

Experts are interested in the particular benefits that MDMA-assisted psychotherapy could offer trans and gender-diverse people experiencing “identity-based” or other forms of trauma.  PAT using MDMA is a promising treatment for individuals overcoming traumatic events because of the way MDMA alters brain connectivity involving the prefrontal cortex—the part of the brain that supports conscious reasoning. The drug also acts on the amygdala—the region of the brain that processes fear—which is especially active in PTSD patients.

These effects allow the brain to process trauma differently while supporting feelings of self-compassion and compassion for others. Clinicians remark that in trans and gender-expansive people, these effects help to produce a kind of self-acceptance referred to as “internalized gender affirmation,” which allows transgender PTSD sufferers to overcome identity-based trauma and feel more fully self-expressed in spite of social stigma, oppression, and marginalization regarding their gender identities. In addition, psychedelic therapy can potentially reduce individuals’ need to find gender affirmation from other people.

Finding Affirmation Within

PAT can increase gender affirmation in multiple ways, and PAT using MDMA can help by facilitating self-compassion and feelings of self-love. Because MDMA therapy increases a person’s sense of trust, these medicines can reconnect trans and gender-diverse PTSD patients, who are often made to feel like outsiders, with themselves and with others. The overall hope is that these therapies can renew connections between clients and their identities as well as other socially supportive members of the community through activating increased self-compassion and a deeper understanding of how true affirmation comes from within.

Note: Veriheal does not support illegally consuming therapeutic substances like MDMA but acknowledges that it transpires because of the current illicit status of both, which we strive to change by advocating for research, legal access, and responsible consumption. Always consult a physician before attempting alternative therapies.