Read Ray Blanchard.
He is probably the leading expert on all this silliness and says it is ALL a mental illness.
He wrote and chaired the committee for the DSM V.
I disagree with him when he says that in extreme cases not helped by psychotherapy they should get the change. Kinda feel they need more or better therapy. Not in a hateful way, just that doing surgery isnt a good way to treat mental illness.
If it was, libs would all get frontal lobotomies.
And on the DSM V, most all of it was bought and paid for by big pharma (how else does mental problems needing medication grow by that much?, same crew who paid docs to over prescribe narcs). There isnt a lot of money in the low level or “run of the mill” anti-depressants and psych meds and hormone treatments for this group, so pretty sure they did not buy that part of it.
Anyways, I have heard it all about “hormone cascade” and other stuff. And its all an excuse to make it not a “mental illness” problem.
Kinda like mass shooters........