Is Gen Z Experiencing “Trans Fatigue”?

For years, it felt like there was only one acceptable way to talk about transgender issues. You couldn’t criticize any aspect of it. If you questioned anything about healthcare, sports, language , or women’s rights, people were quick to label you as "transphobic" or "bigoted." A viral TikTok suggests that a growing number of Gen Z are no longer willing to follow those rules. TikTok creator @likevanfleet began her video with a careful disclaimer: “Okay, no hate to transgender people whatsoever.” She then expressed her thoughts on a healthcare system that appears to assign medical necessity inconsistently, a system that seemingly favors trans individuals over biological women. “I think that the entire concept of getting hundreds of thousands of dollars of cosmetic surgery , like non-essential surgery, covered by insurance, including universal American health insurance, is unfair,” she said. “There is one prescription that I need that’s a medical necessity that insurance won’t even cover for an actual disorder that I have with my body.” She acknowledged that the American healthcare system itself may be the real problem and added that “maybe both things should be covered.” Still, her larger question remained: If distress about one person’s sexed appearance can make surgery medically necessary, why does similar distress become merely cosmetic when it belongs to a woman? “I also think that gender affirming care should be covered for women if it’s going to be covered for transgender people,” she continued. “For example, if you’re a woman and you feel like your body is too masculine, then you should also be able to get facial feminization surgeries or a breast augmentation, because that also might be affecting you mentally.” The response was enormous. More than 5,000 comments appeared beneath the video, and the most popular ones did not read like conservative talking points borrowed from older generations. They sounded like women comparing notes about what their own insurance companies had denied. “ It’s male privilege but yall don’t wanna say that, ” read one comment with more than 42,000 likes. Another commenter wrote, “they’ll cover a transgender woman’s breast augmentation surgery, but will then deny that same surgery in a woman who just beat breast cancer who HAD TO HAVE a full mastectomy in order to save her life. It’s ridiculous and unfair.” A third asked why insurers may cover laser hair removal for a transgender patient while women with PCOS or other hormonal conditions are told they cannot receive the same benefit. That comment earned more than 28,000 likes. A woman who cannot obtain medication for a diagnosed condition, treatment for PCOS-related hair growth or surgery for a physical feature causing severe distress may reasonably wonder why her suffering is classified as vanity. She is not necessarily asking for a transgender patient to lose coverage. She may be asking why the empathy used to defend that coverage seems to vanish when she describes her own body. The Rules of “Medical Necessity” No Longer Make Sense to Many Women Health insurance has always drawn imperfect lines between reconstructive, cosmetic and medically necessary care. A procedure may involve the same surgeon, technique and part of the body while receiving an entirely different classification based on the patient’s diagnosis. A breast augmentation performed solely to increase breast size is usually considered cosmetic. Breast reconstruction following a mastectomy is protected under federal law when the relevant plan covers mastectomies. An augmentation related to diagnosed gender dysphoria may be covered when an insurance plan recognizes it as medically necessary and the patient meets its criteria. Facial surgery and hair removal can face even greater variation between plans. The contradiction that women sense is therefore not entirely imaginary, although it is rarely as simple as one group receiving anything it requests while another receives nothing. Insurance companies already recognize that a person’s mental health can be affected by the relationship between the body and identity. It’s only fair that women are asking why that principle is applied so selectively. A teenage girl who feels ashamed of a flat chest is usually told that beauty standards are cruel, her body is normal and surgery will not resolve every insecurity. A trans individual expressing distress about the same feature may enter a medical framework in which altering the body can be presented as therapeutic care. There may be clinical reasons for treating those cases differently, yet the cultural messages surrounding them are difficult to reconcile. How come women with PCOS , hormonal disorders, congenital differences, alopecia, mastectomy scars or other conditions don’t get the same coverage or treatment as trans people? Are Gen Z’s Attitudes Actually Changing? Still, we have to ask if Gen Z is indeed experiencing “trans fatigue” as some people believe. A 2025 report titled The Decline of Trans and Queer Identity Among Young Americans argues that transgender, bisexual and queer identification has fallen among recent groups of American college students after climbing earlier in the decade. Eric Kaufmann, a professor at the University of Buckingham and director of its Centre for Heterodox Social Science, analyzed several surveys, including data gathered for the Foundation for Individual Rights and Expression’s college free-speech rankings. In that dataset, the share of surveyed students selecting a gender category other than male or female fell from 6.8% in 2022 and 2023 to 3.6% in 2025. Individual schools reportedly showed similar movement. At Brown University, the share identifying as nonbinary declined from approximately 5% in 2022 and 2023 to 2.6% in 2025. At Phillips Academy Andover, the figure fell from roughly 9% in 2023 to 3% in 2025. The report also found changes in sexual identity. Bisexual, queer and other non-heterosexual categories rose from approximately 7% in 2020 to 17% in 2023 within one series of surveys, while heterosexual identification declined from more than 80% to 63.5%. By 2025, the heterosexual share had risen to 77%. Kaufmann concluded that the youngest college students were less likely to identify as bisexual, transgender or queer than the students graduating ahead of them. “To the extent that the youngest represent the leading edge of new trends,” the report states, “this suggests that trans, bisexual and queer identities are declining in popularity with each new cohort.” Gen Z appears to be growing tired of the idea that criticizing the transgender movement means you're bigoted or hateful. Gen Z grew up with corporate Pride campaigns, pronouns in bios, viral coming-out videos, debates over transgender athletes and endless political fights about gender medicine. Young people were encouraged to be open-minded, although that often came with censorship around certain questions that could cost them friends or get them labeled as hateful. Now, some of the young women who stayed quiet are beginning to say what they really think. They do not appreciate being told that those concerns are either imaginary or cruel. Once one woman says it publicly and thousands of others agree, it becomes much harder to pretend no one had noticed the same contradictions before. That is what makes the response to @likevanfleet’s video so interesting. The women in her comments were not repeating broad political slogans or attacking transgender people. They were talking about breast cancer, PCOS, hormonal disorders and prescriptions their insurance companies refused to cover. They wanted to know why distress over someone’s body can be considered a medical issue in one situation and a cosmetic insecurity in another. These women are describing their own experiences of being told that painful or embarrassing conditions are not serious enough for treatment, while hearing that similar procedures can become necessary when they are connected to gender identity. Gen Z is no longer satisfied with being told that fairness requires them to ignore the ways these policies can affect their own lives.