Gender confusion all stems from mental change primarily due to teenagers changing and developing so it is completely natural to be confused about who you are or what you look like, body dismorphia, another study shows that nearing the end of civilisations the people of said civilisations always get confused about gender, it happened with the romans, the Egyptians etc. Another thing that creates this confusion and change is social media young kids and immature adults get hooked into, trends and how to be different through manipulation and the simple fact they truly don't know what to do with themselves because their life is so easy living in a HIC.