Abstract
BACKGROUND AND AIMS: Gender-themed lysergic acid diethylamide (LSD) experiences have been documented anecdotally but not yet studied systematically. This study aimed to explore such experiences using data from Reddit to better understand their nature and potential therapeutic implications. METHODS: In this retrospective observational study, posts and comments on the "r/LSD" subreddit reporting gender-themed LSD experiences were analyzed. Posts containing terms related to gender identity, including "gender," "transgender," and "trans," were reviewed and coded using inductive and deductive thematic approaches. RESULTS: Of 94 unique anecdotes, 47.9% of authors identified as non-cisgender at time of LSD use, with most describing experiences that enhanced gender-identity related self-acceptance (80%); 17.0% of authors were gender questioning at the time of LSD use, and most (93.8%) reported clarifying effects of LSD. Fifteen authors (16.0%) reported potential effects of LSD on gender transitioning or plans to transition. A notable minority of the 24 authors identifying as cisgender at time of LSD use (41.7%) explored non-cisgender identities during their LSD experiences, while 29.2% reported their LSD experience introduced a non-cisgender identity for the first time that persisted post-LSD. Challenging experiences were reported by 17.0% of authors, and 11.1% of non-cisgender authors reported LSD experiences that decreased gender identity-related self-acceptance. CONCLUSIONS: Our findings suggest LSD may support the exploration and acceptance of gender identity in certain individuals, highlighting a potential role in treating gender dysphoria. They also raise important questions about the need for addressing possible LSD-induced gender identity changes during the informed consent process of clinical trials. Given the fragmentary nature of social media data and challenges in analyzing it, these findings should be confirmed with surveys and prospective observational studies.