The psychology of Sam Collins' transition explained
Sam Collins (deadname Samantha) is a female to male transgender with over 1.5 million followers on Youtube, Instagram and TikTok.
He is age 28, started transition at age 15 and got top surgery at age 19. I will use the pronoun (s)he when referring to h(er)is pre-transition periods.
Mental health during childhood
Sam has suffered from anxiety since pre-school and from depression since age 111.
He remembers:
“I had these attachment issues whenever I was away from my mom. I just couldn't be away from her when I was a kid. It was like if she wasn't by my side I wanted to die. It wasn't that dramatic, but I would cry the entire day. Remember this one time in preschool my mom was dropping me off to class. She was holding me in her arms and brought me into the class. The teacher had to literally rip me away from her because I wouldn't let her leave. I'm sure I did that so many times in my past.”
Sam speaks about this again2:
“Since I was younger I've always had anxiety. I don't even remember the age. I've had it since I was a little kid. I don't know where it came from. I was like huh maybe it came from being bullied all my life in middle school, in high school, but I had it before then, so I don't know where where the - did that come from… As I got older my social anxiety got worse. That's why I got made fun of a lot in middle school, in high school. I didn't really have friends. I had less than you can count on your hand.”
(S)he had a decent amount of friends in elementary school, but (s)he lost a lot of them when (s)he began middle school, which coincides with the start of her depression. From age 11 to age 15 (s)he suffered from severe depression. Around age 13-14 the depression became suicidal3. Depression incidence goes up at the start of puberty in both boys and girls but more so in girls.
(S)he had a close girlfriend in middle school, Sara. He says “It was always me and Sara together. We're both the weird kids and everyone hated us.”
The attachment style here again is clingy similar to the attachment Samantha had to her own mother.
Since age 12-13 (s)he and Sara4 used to get dressed like boys.
(S)he was regularly bullied in middle school because she didn't socialize. (S)he ignored the bullying (while a boy would have probably stood up to it), but she was stressed, not sleeping and pretending to be a boy.
Sam says:
“While all this was going on at school I would come home open my laptop and stay on it for the rest of the night. I used all those old websites before Twitter, any social media was even being used. I'll go online and pretend to be a boy. I was a catfish, yes I was a catfish, a girl behind the computer telling people she was a boy”.
“It was exhausting. I never slept as much as you think. I would say I'd never slept. I just cried from like 1:00 a.m. to 5:00 a.m.and then I'd go to school. I didn't sleep”5.
Prolonged, severe sleep deprivation detrimentally affects sexual hormones, ovulation in women, hence potentially also the development of secondary sexual characteristics, sexuality if it happens during puberty. The production of sexual hormones is controlled by the brain and severe sleep deprivation is the ultimate stressor on the brain.
Sleep deprivation itself probably further increased Samantha's anxiety. Anxiety and withdrawal attract even more bullying. In addition, sleep deprivation can switch a depressive episode to a (hypo)manic episode. It is sometimes used for this purpose as a short term therapy.
During (hypo)manic episodes the person may feel happy, but is susceptible to delusions, impulsive behavior. Delusion is “a false belief or judgment about external reality, held despite incontrovertible evidence to the contrary”, while impulsivity is “a tendency to act on a whim, displaying behavior characterized by little or no forethought, reflection, or consideration of the consequences”. Delusions can last for decades, waxing and waning. During high school Sam switched school four times, showing impulsivity.
Online, Sam was a self-confident boy in sharp contrast to the real life, bullied, anxious and vulnerable Samantha. Every single night Samantha would pray that she would wake up as a boy.
Sam claims to have felt a boy his entire life, although less clearly so when he was younger. If this was the case, Sam would have socialized mainly with boys, but he says that he had a close girlfriend and no other close friendships in middle school. It's common for current persistent feelings to be perceived as always having been present.
Sexuality
Since Sam can remember (s)he was attracted to girls.
When a child, Sam thought that being gay meant to be weird and liked by noone6. So, in the ninth grade (s)he attempted to be girly and heterosexual. It lasted a few months but then (s)he got a crush on a pretty girl.
According to the diet-stress-diathesis model of homosexuality, anxious introverted children may develop homosexual attractions due to their spontaneous sexual arousals being suppressed by their high social anxiety toward the unfamiliar opposite sex, but not suppressed when experienced in same sex situations. This happens slowly through the years.
On the contrary, anxiety and alertness toward the opposite sex, when in moderate levels, give rise to heterosexual attractions according to the “Exotic becomes erotic” Bem's theory of heterosexuality.
In the video “My battle with mental health” Sam explains that (s)he hated herself and knowing that (s)he liked girls made her hate herself more.
Transitioning would resolve these contradictory feelings.
Happiness after coming out
After the crush Sam felt confident that (s)he wanted to be a boy. (S)he came out as trans to her mother and felt “super happy. I really can't explain the feeling of happy”, he said.
In 2017, in the video “Dear parents of trans youth”7, Sam's mother explains that she credited transition for Sam's happiness, therefore she supported it. She was a single mother, but no matter what man had been in her life the number one priority was her child.
Sam told the viewers, “Look how happy I am now, like even the family says I'm such a different totally different person. I don't understand what a family wouldn't want to see someone happy.”
Did h(er)is depression flow over into hypomania around this time? His happiness did not continue for long.
Mental health after transition
In 2019, in the video “Anxiety is my aesthetic” he says that he has struģgled with anxiety, especially social anxiety, his whole life and he deals with it every day.
In 2020, he accepts in his video “My battle with mental health” that anxiety and depression didn't go away, “Social anxiety has followed me all the way up until now. I still have it…I still do have depression and anxiety but sometimes they can just get worse than other days. One day you might be all the way low down here and another day you might be all the way up here, it just depends.”
With the “All the way up here” he may refer to the hypomanic periods.
In 2021 in the video “I'm sorry”8, he says “I haven't posted a video in a month but that's because truth is, I'm too sad. All right, cut. For real, I am sad…I haven't posted because I haven't had, I haven't been in the best mental state to do that. Any project that I worked on, I hated it…I’ve always had depression and anxiety so it's never something that you can really ever escape.” He says that he still has the gender dysphoria 10 years after coming out.
In 2022, in the video “It's been rough”9, he again talks about his depression which was ongoing. He describes what can be a cycling between a hypomanic episode and a depressive episode. He says, “I think I burnt myself out like last year because I was doing a lot of content. I was putting out a lot of videos and then I also had a podcast that i was keeping up with…overwhelmed myself and then I think I just like burned and crashed and then I lost all creative ideas”
In 202410 Sam says that he has not uploaded a video in weeks also “due to terrible mental health”. He says “Since 2021 my mental health declined rapidly over personal matters.”
In conclusion, anxiety and depression alone were sufficient to have caused both the same sex attractions and the gender dysphoria of Sam(antha). Now he is physically neither a woman nor a man and mentally at the same place where it all started: anxious and depressed.
https://youtu.be/9JGDKwNPeG8?si=9Yu1DN3AaIZPyXZF
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https://youtu.be/6M3yqvSatJA?si=fGF5lz7WDUDifNOE
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https://youtu.be/gIgs3YrQGaU?si=ltj6BUdtLJ9RniZC
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https://youtu.be/tmYyZfYpULU?si=Pq9NM7B_I-RuCDkg
https://youtu.be/KdphuhwcF98?si=iTXlIUZsZxpqrdX1