4 Common Patterns Keeping Trans Adults Stuck - From 5,000+ Assessments | Dr. Z

After 5,000+ initial assessments with transgender adults, Dr. Z shares four patterns that keep people stuck—patterns that rarely make it into blog posts or Reddit threads but show up in clinical practice constantly.

Pattern one: High achievers are the most stuck. If you've been successful in your assigned gender, you've also been excellent at suppressing your needs for external expectations. Every achievement reinforced: "See, I can do this. Maybe I should keep going." Now you face decisions with no external validation—and everything toward authenticity looks like failure from the outside. Pattern two: The partner becomes the decision maker. You've outsourced decision-making without realizing it—your partner's comfort became more important than your gender needs, so you're making your gender needs small enough to fit their comfort zone. Pattern three: The "just one more thing" loop. Each requirement seems justified, but you're creating endless hurdles before giving yourself permission to move forward. The goalpost keeps moving. Pattern four: The certainty paradox. The more certainty you demand, the less certain you become. The act of constantly questioning your certainty creates more uncertainty.

Watch to understand why these patterns are normal, why knowing about them doesn't automatically free you, and what actually helps break them.