Research showed that many young people grow up to be gay, and only some of them grow up to be trans. However, some cases documented in the book suggest that young people who experience traumatic events or sexual abuse tend to identify as trans quite quickly afterwards, although it may not be the majority of cases.
The question remains if young people are distressed because they're trans or if they're trans because they're mentally distressed and haven't dealt with the underlying problem. Some believe the removal of gender identity precursors could prevent irreparable damage to the body, but others argue it could compromise someone's identity.
The podcast discusses the case of an individual who could not leave his home due to mental health issues, wanting to transition. A senior clinician traveled to their location to discuss their transition options, raising concerns about consent and mental health in such cases.