Exulansic's series on Jazz is very enlightening.

It's very clear that Jazz's mental and physical health issues happened ~after~ the onset of puberty suppression, and became worse after the physical castration. No one ever talks about the impact of all these hormonal and surgical interventions against his once normal and healthy body (well one black transwoman did once, and got shut down right quick by Jeanette).

Jazz has tried to talk about the trauma of the genital surgeries, and been shut down by Jeannette, because we don't want to scare people away from transitioning.

It's very apparent that Jazz is deeply uncomfortable with everything: his body, his family, his place in society. He is surrounded by people who lie to him, manipulate him and outright bully him for their own agenda. I don't think he knows what he really wants or what his own 'truth' even is, because he's never been given the space or the independence to figure it out. I also think the family is desperately afraid of what will happen when and if he breaks free of their orbit and starts thinking for himself.

It's truly tragic to watch this person constantly suffering and being humiliated on camera. A half decent family would turn off the cameras and get him some real help, but they don't want to, they don't want him to ever get better, and all their livliehoods (at least for Sander and Jeannette) depend on the show.