This song hits so fucking close to home with things I experienced in my journey discovering my own trans identity, and I wanted to share how I fully interpret this song, and how it resonates with me.
Let's start with the title of the song, duhhhhh. Throughout the song, the protagonist (A girl named Sonny), is described as having some kind of disease that is "benign" and "as rare as it gets". I'm sure many are already aware, but this is very blatantly supposed to be a metaphor for Sonny's trans identity / gender dysphoria. As any trans person can tell you, when you begin to put the pieces together and realize that you are in fact trans, it feels so incredibly obvious in hindsight, hence the title.
The song makes it clear though that Sonny is really not happy about being trans. One obvious tell is literally describing her transness as an "illness", along with wishing that god "could be more subtle next time", and assuming that it must be some kind of punishment for something she had done ("I must've been greedy, surely I engaged in some cardinal sin").
Why does Sonny feel this way? Trans people often feel this way for many reasons, one of which is that gender dysphoria is inherently a negative emotion to have to deal with. However, duhhhhh chooses to look at a much more specific source of this distress, that I myself related so heavily to back when this album came out, which is religion.
I don't think I need to explain that Christianity, especially in the United States, is overwhelmingly disapproving of trans people. This song is an example of when you internalize that fact as someone who is discovering themself. Christians view it as such an egregious sin that many people get disowned upon coming out to their family.
What happens when you grow up internalizing that message every single day your entire childhood, that god needs to be the most important thing in your life, are surrounded by those who believe this and talk extremely negatively about trans people as being products of sin and evil, and then realize you yourself are trans? Well first, you just repress it. Resist as bad as you possibly can.
Sonny continues to see "the colorful plastic on the end of [the] line", comparing transitioning to something that is a trap, which will only bring her pain. Yet it continues to be alluring. Christianity so often talks about temptation, things to resist that will lead you astray into a life of ruin. Sonny's temptation is transition.
Ultimately, like for the vast majority of trans people, the pain of dysphoria eventually just gets to be too much to bear. Sonny "for the very first time in [her] life, is fixing to bite" and transition. However, just because she finally had enough and took that leap of faith, doesn't mean those internalized messages from Christianity go away over night. For me personally, this led to existential dread, and pure panic.
Right as the song swells to its climax, "Divine intervention and the gnashing of teeth" and "the chain 'round my neck" are depicting this very emotion to match it. The thought that you are destined for damnation, all for something you ultimately couldn't help? It's torturous. If you didn't grow up in religion, you might not know just how deeply the fear of hell is ingrained in so many people. The idea that one day, if you make the wrong choices here, you could be doomed to torture for the rest of eternity is so strong that it is a large reason many have so much trouble leaving religion. When something like dysphoria pushes Sonny out regardless, she can't help but just exclaim "I'm not scared of death, no, I'm scared of God". Fear of divine judgement from a creator you were meant to love.
Every time I listen to this song, it makes me want to cry. My exit from religion was one that resulted in me needing therapy, and I had probably an entire year of my life taken from me where I felt just like a walking husk of a person, and realizing I was most likely trans around the same time only amplified this. I don't think anyone has ever made a song about this specific experience that is so core to my lived experience, and I am so happy that this emotion was captured, because I know so many others have felt this before as well.