https://www.theguardian.com/lifeandstyle/2025/mar/16/my-adult-daughter-wants-to-turn-herself-back-into-a-teenager
Philippa replies It sounds as though your daughter’s life is online, where curated and idealised images are likely feeding her body dysmorphia and sense of inadequacy. It seems her actions, or inaction, are motivated by external referencing. Instead of relying on her own sensations and experiences to guide her decisions, she appears to be overusing her imagination about what others may be thinking and feeling about her. This distorted external referencing can keep her paralysed, because she’s trying to live up to an imagined ideal or pre-empting imagined judgment. Moving towards internal referencing would allow her to ground herself in her own sensations, experiences and values rather than being ruled by her assumptions about others’ opinions. Being stuck in external referencing is a recipe for anxiety and depression.
This reads so much like a description of a young(ish) person with online-onset gender dysphoria part of me wonders if it's been written to be exactly that, changing the focus of the fantasy/obsession to get around the knee-jerk responses of the #AcceptanceWithoutQuestion crowd.
It breaks my heart that the caring, nuanced approach of the response is so absent when it comes to people who are obsessed with the belief their happiness depends on their becoming the opposite sex.