105. Young Men Crying for Help: Dr. Joseph Burgo on Shame, Narcissism, Autism & Autogynephilia

Today I welcome the esteemed Dr. Joseph Burgo to discuss the psychological crisis of males who find refuge in a trans identity. Along the way, we explore myriad contributing factors, from shame, narcissism, and autogynephilia; to rising rates of autism and unlimited access to increasingly obscene internet pornography; as well as gender roles, norms, expectations, and recent cultural shifts.

As we unravel the narratives of ex-military men and individuals in positions of power who transition, we uncover the complexities of idealization and devaluation in trans identification and the numerous parallels with personality disorder traits. How do societal norms and social justice narratives fuel the shallow idealization of the opposite gender?

We also touch on the challenges detransitioners face in therapy and the obstacles therapists encounter in providing effective care for individuals with gender ideation. How can therapists navigate the tense climate surrounding gender identity exploration? And what role should exploration of fantasies and projections play in understanding the complexities of gender distress? 

Joseph Burgo, Ph.D. is a licensed clinical psychologist and graduate psychoanalyst who has been practicing for more than 40 years. As a writer, he’s the author of several works of non-fiction bringing his insights and experience as a therapist to a popular audience, and his articles and commentary on the topics of shame and narcissism have appeared in the New York Times, the Washington Post, the Wall Street Journal, and most of the large news outlets online. In his private practice, he currently focuses on gender distress, and works with trans-identified adolescent boys, male detransitioners, and men who struggle with autogynephilia. He can be reached at [e-mail]; find him on X @jburgo55; visit his website at AfterPsychotherapy.com; or view him in the documentary film of another former guest, Jennifer Lahl (from episodes 52 and 97), The Lost Boys: Searching for Manhood.

Dr. Burgo's books:

• The Narcissist You Know: Defending Yourself Against Extreme Narcissists in an All-About-Me Age
• Why Do I Do That?: Psychological Defense Mechanisms and the Hidden Ways They Shape Our Lives
• Shame: Free Yourself, Find Joy, and Build True Self-Esteem

All books mentioned on this podcast and written by my guests can be found at sometherapist.com/bookshop or by following the Amazon affiliate links. Thank you for purchases that support the show.

00:00 Start

[00:02:49] Autism diagnosis evolution.

[00:06:36] Psychology in developmental framework.

[00:08:02] Rise in autism due to screens.

[00:11:55] Shame and narcissism in youth.

[00:18:45] Shame defiance.

[00:21:03] Adolescence and privacy for development.

[00:25:37] Exploring views on pornography.

[00:29:36] Effects of intense porn consumption.

[00:32:55] Autogynephilia as narcissism and desire.

[00:37:40] Ex-military men and transgender identity.

[00:40:58] Grass is greener syndrome.

[00:46:03] Idealization and devaluation in identity.

[00:49:50] The impact of societal beliefs.

[00:52:17] Avoiding adult responsibilities.

[00:56:20] Emancipating children's decision-making.

[01:01:27] Detransitioning experiences.

[01:02:43] Detransitioning experiences and insights.

[01:08:15] Importance of finding healing relationships.

[01:10:15] Lack of ICD procedure codes for detransition.

[01:13:42] Self-care reminder.

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