Hate Group Calls for Re-Labeling Transness as Mental Illness
A fringe group with no expertise pushes the field of psychiatry to regress to a pre-scientific, prejudice-soaked view of trans people. It coincides with the far-right political agenda.
by Evan Urquhart
As the far right pushes increasingly extreme and violent measures to target the “enemies within,” as President Trump terms those who oppose him, anti-trans groups are escalating their demands to keep pace.
Enter Genspect’s push for the field of psychiatry to regress to a pre-scientific, prejudice-soaked view of trans people as mentally ill, adapting a rarely used framework from forensic psychology that is most closely associated with mass murderers, not regular people.
This call for “re-psychopathologization” harkens back to a time when marginalized but otherwise healthy people were frequently assigned psychiatric diagnoses for rebellious or nonconforming behavior. In addition to pathologizing otherwise mentally healthy gay men, lesbian women, and transgender people, psychology also pathologized enslaved people who fled their captors and provided a pseudoscientific framework for the ancient idea that hysteria was a mental illness reserved for women only. Modern psychiatry has attempted to close the door on that history, though the field still struggles with overbroad or vague diagnostic categories and the overdiagnosis of marginalized individuals.
The field’s dark history of over-pathologizing vulnerable communities may be why the psychiatrists who spoke with Assigned Media were so quick to reject this attempt by an advocacy group to create a new diagnostic framework.
Genspect is a group whose primary policy goal is to end access to medical transition, though they have also advocated against the acceptance and inclusion of trans individuals in society, particularly in school settings. In 2024 the Southern Poverty Law Center officially designated it as a hate group, a label the group contests.
The re-psychopathologization effort, trumpeted with a press release on Sept. 27, echoes the extreme, far-right rhetoric that seeks to conflate trans rights advocacy with terrorism, as it does the actions of everyone else viewed as an enemy. There have been some signs that this rhetoric is viewed warmly by the increasingly authoritarian Trump government, which also recently called for mass civil commitment for people with mental illness, drug addition, and homelessness.
Efforts by members of the LGBTQ+ community to advocate for the removal of minority sexualities and gender identities from diagnostic manuals of mental illness date back to the 1970s. Then, gay men and lesbians convinced the American Psychiatric Association to end the categorization of homosexuality as a curable mental illness in their official listing of psychiatric disorders known as the DSM. Pathological descriptions of trans identity lasted longer, but have been largely phased out in the most recent versions of major psychiatric manuals.
The effort to phase them out has been complicated by the need for a diagnostic code to cover necessary transition procedures, as well as the very real clinical distress and disruption caused by untreated gender dysphoria. Efforts by the professional association WPATH, along with decades of overwhelming evidence that trans people can live healthy and happy lives with no psychiatric symptoms whatsoever, have led to the adjustment of language in these manuals to reflect that reality.
Genspect’s scheme to pressure psychiatric bodies to regress to a view of transgender identities as inherently pathological arrives there through an unusual route, relying on a repurposing of a term from forensic psychiatry, the “extreme overvalued belief.”
If you’ve never heard of an extreme overvalued belief, you’re not alone. “I had to look up the term ‘extreme overvalued beliefs’ as no such category exists in the diagnostic manual,” psychiatrist Jack Drescher, a clinical professor of psychiatry at Columbia University, told Assigned Media. Drescher, who edited the chapter on gender dysphoria for the most recent version of the DSM, also wrote a paper on the history of de-pathologization of sexual orientation.
One forensic psychiatrist who was highly familiar with the term is Dr. Tahir Rahman, who recently wrote a book on the topic. “Extreme overvalued belief is a forensic definition, not a clinical one,” Rahman wrote over email. “For example: An individual may have a political opinion, but that does not mean they are going to become a violent threat. Anyone with a religious, cultural or political view might become violent when they overvalue ideology and want to establish legacy, recognition or want retribution for their belief.”
In forensic psychology, the fate of an individual who has committed mass violence can hinge on the question of legal insanity, which in practice may depend on whether the motive relied on a state of altered consciousness due to delusions. Delusions in psychiatry are strongly held ideas that are resistant to contrary evidence and specific to the person experiencing them. Extreme overvalued beliefs, in contrast, are shared and validated by other members of a subculture and can form the motivation for violence in a legally sane person.
Both Rahman and Drescher agreed that it was inappropriate to view transgender identity through this framework. Genspect, however, sees the effort as part of “restoring transgender identities to their proper place in psychiatry.”
“After years of listening to those most directly affected, our conclusion has become unavoidable: the drive to transition is rooted in unresolved mental disorder,” wrote Genspect founder Stella O’Malley in July 2025. The group holds that the new scheme does not represent a departure from their own previous claims that transgender identity arises out of gender distress and has multiple causes, but represents a new evolution of that perspective.
When asked if anyone involved in the drafting held any relevant medical or professional qualifications, Genspect cited O’Malley’s qualifications as a psychotherapist. O’Malley holds a master’s degree in cognitive behavioral therapy and has written parenting books, but has no research background.
There is no research supporting the view that transgender people share some particular belief that drives them to transition. To the contrary, like any other group of people the trans community is remarkably diverse in its views, including views about their own transitions. Some trans people don’t recall feeling any distress about their birth-assigned sex. Some trans people start treatment to help answer their questions about whether transitioning could help them, rather than starting from a place of certainty that it will be helpful. Some trans people even believe they are and will always really be a member of their birth-assigned sex, holding views that were, at least until recently, closely aligned with those of Genspect.
“One could just as easily say that Genspect holds an ‘extreme overvalued belief’,” Drescher said, referring to the group’s view that all trans people are mentally ill. “It’s the impulse to pathologize the things we don’t like, something that happens on the left and the right.
”When asked if there were experts who supported their effort, Genspect named Dr. Paul McHugh, Dr. Az Hakeem, and Dr. Stephen Levine as experts who might be willing to speak on the topic. Attempts by Assigned Media to follow up with any of the three were unsuccessful.
Genspect, in fact, lacks the research base and expert backing that would legitimize their re-psychopathologization push in medicine. In his interview with Assigned Media, Dr. Drescher stressed that giving the group undue bandwidth, even merely to debunk their ideas, could further their agenda. However, fringe ideas, ones untethered from any genuine evidence or expertise, have become a hallmark of the Department of Health and Human Services under Robert F. Kennedy, Jr. And, in the U. K., the hate group has already met at least once with Health Secretary Wes Streeting.
As the borders between science and advocacy blur, fringe ideas with no evidentiary basis or mainstream medical support increasingly carry the potential to drive policy.
Evan Urquhart is the founder of Assigned Media.