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Paralytic States is, as stated by lead singer Laura Jane Grace, "about a transgender person dealing with addiction and dysphoria and killing themselves in a hotel bathtub. Obviously I’m not dead in a hotel bathtub, but all the experiences of existing that way, being in that hotel room, are very much real to me, that’s a life that I’ve lived." The song was the first written for Transgender Dysphoria Blues as a remnant of Laura's original idea for the album, which was supposed to be about a transgender sex worker.