Can you find a randomized controlled study where the "affirmative" approach of aligning gender expression with identity has been compared to a "reparative" approach of aligning identity with biology? I have read a lot of studies on this and what you are saying simply is not backed by the evidence. Whenever I read a study that has been referenced on NPR or such, I read the details and the details do not support what the people citing the study say it supports.

In all other cases, if someone's mental conception of themselves was not aligned with the biological reality of their self, we would say the default is that the person should try to adjust their mental conception. A treatment that involved all of society changing, or even more extreme -- actual removal of body parts -- would need to pass a very high burden of experimental evidence. From what I have read, that burden of proof has not ever been close to being met. There are no studies that say that aligning gender expression works better than helping the person cope with or get over their dysphoria. If I have missed such a study, I would like to read it.

Do you feel that your gender identity could be changed using Cognitive Behavioural Therapy?

I do not have a gender identity and I do not have a gender. I a sex and I have an identity as a sexed being. I have a brain that has developed under the influence of testosterone, I have the knowledge of having a penis, I have the knowledge that society sees me as a male and penis-haver and all that entails. I have the knowledge that if I used a woman's locker room and exposed my penis, women would freak out, and so I do not do that. Etc. etc. I wear the clothes that I do because that is what society expects of me. There are all sorts of clothes and outfits from other cultures that I prefer aesthetically but I don't wear because they do not align with the norms of my current culture.

It's actually really difficult for me to understand how a person's fundamental well-being is intrinsically and immalleably tied to names and clothing.

Of all the possible forms of clothing humans have worn in the last ten-thousand years, only a tiny sliver of those clothing are socially acceptable for me to wear. And yet we all deal with that.

If someone were to intentionally call me the wrong name, while everyone else gets called the name they have asked to be called, that would bother me, but only because that is a power move that singles me out. If I were to, say, join a fraternity, where everyone had to have a name assigned to them, that would not bother me, and I would be fine being called that name while hanging out in the fraternity.

If someone were to call me a "woman" I would be upset because it is the reality of my biology that I am a man. Furthermore, saying you are a "woman" is usually saying, "You lack the positive qualities we usually associate with being a man -- you are weak, you are cowardly, you are whiny, etc."