The Feminine Under Threat

Something unusual is happening in adolescence today. Across the world, the number of teenage girls identifying as transgender has surged at an unprecedented pace. In the United States, one in fourteen girls now says she is trans. In Spain, minors can legally transition without parental consent. Doctors in multiple countries prescribe puberty blockers almost automatically. Behind these numbers lies a cultural shift that goes far beyond medicine: a new way of relating to the body, to identity, and to society itself.

In June 2024, a group of psychoanalysts, psychiatrists, biologists, philosophers, and sociologists gathered in Paris to try to make sense of it all. Their central question was simple but unsettling: what cultural and psychological forces are driving this sudden explosion of Gender Dysphoria in adolescent girls? And what role, if any, can psychoanalysis still play in helping us understand?

I recall two patients, separated by two decades. The first, whom I nicknamed Dora, resembled Freud’s famous hysterical patient. Dora suffered from recurring throat infections and painful sex, symptoms that spoke symbolically of forbidden desires. Her body expressed what she could not say.

“For Phoenix, the onset of puberty turned her once-familiar and loved body into a stranger. ”

Two decades later came “ Phoenix” to my office. For Phoenix, the onset of puberty turned her once-familiar and loved body into a stranger. Breasts, hips, menstruation—all became unbearable once exposed to the gaze of others. Online, she discovered the label “transgender” and clung to it as an explanation. Unlike Dora, Phoenix’s symptom was not symbolic but literal: she wanted her body changed, and interpreted it as “being in the wrong body”

This shift from symbolic to literal marks a profound cultural transformation. In Freud’s time, the problem was repression: desire was forbidden, so it returned as symptom. Today, the problem is omnipotence: the belief that everything (hair collor, breasts, bottom), - and sex itself—can be chosen or altered at will. Technology encourages us to believe we can modify not only our appearance but even our sex. Society celebrates absolute freedom over the body, yet paradoxically, it leaves no room for questioning. Therapists who hesitate to affirm transition risk being labelled transphobic.

At the Paris conference, many participants traced this phenomenon back to gender ideology—the activist-driven belief that sex is “assigned at birth” and infinitely flexible. This idea, while culturally powerful, is biologically unfounded. Chromosomes and gametes mark sex at conception; it is not a choice.  Our body is determined at birth, but in our psychosocial development we develop different ways of relating to that body.

“But why adolescence, and why girls in particular?”

Puberty has always been destabilizing. The sudden arrival of breasts or menstruation forces girls to face sexuality, identity, and separation from childhood. Some years ago, this conflict often expressed itself through anorexia: refusing food as a symbolic refusal of feminine curves. Today, the same unease finds a different outlet: the literal rejection of the female body and feminine gender, with demands for mastectomy or hormonal suppression. The anorexic says, “My body is ugly”, showing an emotional/narcisistic relationship to that body: like / not like. The adolescent with Gender Dysphoria says, “This is not my body.” , which indicates a reality denial.

The body, after all, has always mirrored the society around it. In Freud’s days, hysteria reflected the repression of sexuality. In the 1980s, anorexia and addiction mirrored a narcissistic society obsessed with consumption, independence, and control, with the idealiziation of a thin body in a woman who controls her impulses. Today, in a digital world where identities are crafted like avatars, the body itself has become disposable and endlessly modifiable. Technology tells us we can change anything—our face, our fertility, even our sex. Yet while the body is declared free, thought itself is chained. To question gender ideology is to risk condemnation. Gender binarity may be rejected, but binary thinking—“you’re either with us or against us”—has hardened.

Today we observe an  erosion of symbolic limits. In a society without prohibitions, adolescents are left to determine themselves alone. They cannot vote or buy alcohol, but they can change their gender. As Jonathan Haidt shows in The Anxious Generation (2024), childhood has become phone-based rather than play-based, and the result has been skyrocketing anxiety, depression, and now gender distress.

Freud seems to be out of date when he wrote that individuals must balance their inner drives with society’s demands. Today’s adolescents live in a society where limits have collapsed, where bodies are mutable, but where thinking is forbidden.

The task of Psychoanalysis is not to silence symptoms or accept without qustioning, but to ask what they mean. What is this suffering trying to say about the world we are building?

As Patrick Miller (2025) writes:

“What kind of powerful denial in our current culture imposes such a ban (or prohibition) on thinking around transgenderism, a kind of collective conformist craze paralyzing judgement with the violent backlashes resulting from any kind of interrogation? What is it that cannot or shouldn't be thought?  Trans patients deserve from an analyst as much interrogation and thinking through as any other patient. Beyond the trans identity tag, an analyst tries to listen to a subject's humanity. “