Yeah. I should have said, “outwardly, physically appearing male/female” or “possessing the bodily form of a male/female” for maximum clarity.
This is not accurate as it makes it sound like the therapist is doing their best to talk them out of it and hormones and surgery are a last resort for the desparate. It is more the case the therapist is determining that the motivation etc. for transition is consistent with being transsexual and to help ensure that they won’t regret transitioning. It is basically to weed out the misguided, like those who are gay and think changing sex is a way to be straight.
Another purpose is to make sure that there are no other issues that will hamper them when they begin transition. Body changes are stressful, and if you are already mentally unbalanced for unrelated reasons, you may not have the personal resources to cope. Hormonal changes can cause dramatic mood swings and if you are already in a fragile state when you start, it can very difficult to deal with the changes and with the hormonal transition itself. A person who responds well to being given hormones to transition to the opposite sex may still have difficulty dealing with the intermediate hormone levels and their affects. All this will be taking place along with changing your outward appearance and either beginning a new life far from your old one, or dealing with all the people you know and dealing with them and their issues with your change.
I did not mean to give that impression.
As an online discussion grows longer, the probability of a comparison involving Star Trek approaches 1.
I see it as me trying to be more considerate of your excessive touchiness. 
Well, the “difficulties at the edges” are exactly what I’m talking about. In situations where our knowledge about actual physiological conditions is still very new and/or incomplete, as in the case of gender-linked brain structure differences, how do we tell the difference between someone who “feels like a woman”, and someone who thinks they are a woman in some physiological but not easily observable way?
There is no clear demarcation between “delusions” and “feelings” or “beliefs”. Sure, at the opposite extremes it’s easy to tell a delusion from a feeling, but it’s not always easy to tell where one shades into the other, especially about such subjective issues as gender identification.
I am not seeing a contradiction in the text I bolded. If he is demonstrably a man, but OUGHT to be a woman, that is about as bad a mental health indicator as me being poor but thinking I OUGHT to get a better job.
Are you implying there is something wrong with excessive touchiness?
Actually, you started this by calling me ignorant, without sufficient information to base that judgement on. I typically become combative in those circumstances, even if I am actually ignorant. I’m sure you must have been attempting to find out more about the nature of my statements instead of intending an insult.
I don’t think we have a fundamental disagreement here. My original statements were influenced by nonsense I had seen in this thread. Concepts of behavior and identify were confused, along with general assumptions that ‘different’ people suffer disorders. I don’t think half formed theories of gender help that situation at the level of discussion. I wasn’t referring to appropriate clincal usage.
As indicated previously, I don’t know much about this area. But if there isn’t a fairly clear demarcation between delusion and feeling, delusion must be ill defined. A person who cannot distinquish between reality and fantasy based on clear objective information is definitely delusional. I don’t know how to categorize the in-between cases, but I wouldn’t consider a person who is troubled because of discordant gender association to be delusional. And I still don’t believe the gender-linked brain connection theories either. Maybe they will prove out in time, but the evidence I’ve seen presented (which is not anything like a careful study of this area) left me unconvinced. This isn’t a criticism of your viewpoint, I’m skeptical about anything that doesn’t meet a high level of proof.
Came upon this thread while searching for something else.
Just FTR, I am a heterosexual person who knows a number of transgendered people and they are as diverse a population as gay and straight people are.
No, I don’t understand it from a biological or psychological perspective. I just figure that if somebody isn’t hurting anybody, and is suffering from persecution, that person deserves acceptance and support from the rest of us.
As far as I know, transgenders do go through a gauntlet of psychiatric evaluation prior to sexual reassignment therapy. “Stuff You Should Know” recently did a great podcast about the process.
Secondly, your comparison is a bit flawed. You’re equating (to dumb it way down) “feeling girly” with believing one possesses the consciousness of a SPECIFIC famous deceased individual.
Many thanks to those providing real information and insight in this thread. It may feel like beating your head against a brick wall WRT the OP, but your words have improved the understanding of this member of the wider audience.
A former cow-orker had M2F surgery in the years since I had contact with her. She and I work in the same field, and will most likely meet up again at some point. I’d like that to go as non-awkwardly as possible. I always thought she was a great guy, and assume she has become a great woman. Threads like this one help my naive mind to wrap around the whole subject.
To the OP: I find it ridiculous to say that a person’s physical body determines who they are. Terry Scheivo stopped being herself when her brain stopped working. Christopher Reeves was still himself when given his last breath.