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DiscussionTrans treatment is upside down.
With all other compulsive disorders, the treatment is to help the patient stop performing the compulsive behaviours and use psychological methods to handle obsessional thoughts. With trans compulsions, the patient is encouraged to feed into their compulsions, which results in threefold harm: harm to the patient as the cross-sex obsession spirals and leads to mental distress and bodily harm i.e. body mutilation and damage due to cross-sex hormones and surgeries; harm to the public as this patient is encouraged to trespass on the boundaries of the opposite sex, and harm to other people with trans compulsions as their disordered behaviour is encouraged and escalates due to seeing it normalised in other patients.
Trans compulsions should be treated as a PROBLEM that if left to escalate could result in the patient being bodily harmed and likely less happy overall, as well as the damage it often does to family and romantic relationships. If it's a fetish, the patient needs to be taught that the fetish is wrong and harmful and they need to be helped to stop engaging in it. If it's disordered thinking that's come about due to comorbidities or internalised homophobia, then the patient needs to be taught that these cross-sex fantasies are unhelpful and can never lead to anything as no human can change sex. I can see gendercynical-type folks saying 'but I tried to push down these thoughts for years and was miserable!' - I'm not suggesting pushing them down and being miserable, I'm suggesting getting proper psychological treatment to treat patterns of disordered thinking and harmful (and sometimes perverted) behaviour.
Ultimately, living a lie can never lead to true happiness, and your own happiness being dependent on others colluding with your lie is a recipe for disaster.