I have auditory and visual hallucinations. I hear at least three voices commenting on my actions and commanding I do things. I see these things I call shadow people. It’s just a regular looking body shape, but they have no face. It’s just blank. My first experience with this was second grade. I called the figure “blank face guy”. He follows me. I also have disorganized thinking and incoherent speech. I’m also transgender. My dad thinks my mental illnesses are what caused me to conclude myself as transgender.

A. Schizophrenia is a disorder characterized by delusions. Delusions are a consistent collection of thoughts that would lead someone to form an incorrect conclusion. Delusional thinking and thoughts are not based on what is real. Quick research on the internet will make the Diagnostic Statistical Manual (DSM) available to you. It is the most comprehensive description of mental illness that is available and it is the standard for mental illness diagnoses made in the United States. All of the delusions associated with schizophrenia are listed in the DSM. None of the delusions listed, have anything directly to do with one’s perception of gender.

You have auditory and visual hallucinations and hear at least three voices. You also have disorganized thinking. All of these things interfere with your clarity of thought. Not all thoughts of a person with schizophrenia are delusions. Some are real and some are not. The problem is that all of them seem perfectly real and reasonable. However, they are not. Some are and some aren’t, but for someone suffering with schizophrenia it is impossible to know which are real and which are false. It is important to be able to trust someone in helping you to determine what is real and what is not.

When someone with schizophrenia, clearly hears something and sees something with their very own eyes, it is exceedingly difficult to convince them that what they’ve heard and seen is not real. I think the lay public, fails to appreciate what I’ve just described.

Imagine how difficult it is when someone clearly sees and hears someone walking by their room but their mother or brother or father tells them that there was no one there. It was a delusion or a hallucination. It is far easier to believe that one’s mother or brother or father, is lying. Remember, the person suffering from the delusions of schizophrenia, both clearly saw someone and distinctly heard the footsteps. Family members, who were with you in the room, deny it. They tell you that no one passed your room. And you begin to wonder why they are lying to you and, soon, why they are all lying to you. This is how paranoid thinking develops in individuals with schizophrenia.

I do not know you. I cannot diagnose you without meeting with you in person. No one can. I don’t know the thoughts that you possess which are real and the ones that are based on delusion. Trust your therapist and those who love you. For everyone with schizophrenia, it is a confusing time. But with the passage of time symptoms should be reduced or eliminated and when this occurs you will have far further insight into thoughts of gender. Good luck my friend.

Dr. Kristina Randle