I feel as though it'd be inappropriate to comment on the writing 1) given I'm not a poetry expert and 2) the topics discussed
Read the story now
I will say, this reminds me a lot of a poetry book I published on this site when I was 16/17 filled with poems like this. I never experienced gender dysphoria or addiction, my poems were about depression and trauma, feeling like my parents and everyone around me hated me, and incantations of saying I'm ugly and worthless—just one big cry for help, quite honestly. I asked for reviews on that collection, and I wasn't sure what I was looking for. I got good ones, they said it was honest and telling, but I think people didn't know what to say when they read it, just as I'm not sure what to say to you now.
But I'll try to say something encouraging or maybe insightful. As I am now 22, years past my teenage self, who seems like a stranger to me now. I'm about to graduate college, still haven't been in a relationship (but that doesn't bother me the way it used to), and I have confidence and can say that I'm truly happy. I deleted that book of poetry because it reminded me of a time I wanted to leave behind, albeit it made me stronger and more appreciative of how I feel today. That's not to say you should delete this since, given this is a review, the writing is fairly good. But I'd be remiss if I didn't offer some light at the end of what seems like a never-ending tunnel and say the words: It gets better, trust me.
Therapy is important, I've spent the last four years working on earning my Bachelor's in psychology, so you don't just have to take my word for it - the research backs it up. I dealt with PTSD and have gone through CBT, EMDR, and plan to do prolonged exposure - for me, the CBT was most helpful for depressive/anxiety symptoms, and I'm hoping PE will help with the reexperiencing. I can't say enough good things about therapy, it really does help. It is important to remember though that healing isn't linear, in therapy things usually get worse before they get better, you have to do your therapy homework, and unlike a broken arm, you're never really cured of a mental illness - just in remission, so even now that I'm 22 and technically don't meet the criteria for PTSD (whoop whoop) I still have some symptoms and areas of my life affected by the trauma that I'm working on treating, and I go to maintenance therapy to keep myself in remission.
Hopefully, all this ranting from me can help you see that you're not alone. I too (albeit, I always have and still do LOVE Taylor Swift) am a metal-head who wore head to toe black to high school every day with thick eyeliner and combat boots (it was a look). That fashion sense has since faded, but I still listen to all those bands (highly recommend Beartooth. The dark cloud I felt hanging over me for years has faded as well, and now I can look back at my teenage self with new, more sympathetic eyes. She got me to where I am today, and I love her for it, despite knowing that that time in my life was truly terrible and a bitch to get through. And you'll get there, too, it takes time, work (and by work I mean therapy), and honestly a bit of growing up. Don't give up, you're not alone and it does get better - I promise.