I am familiar with delusions and their symptoms.
When the accountant thinks she is the queen of England, her delusion is that she ALWAYS WAS the queen of England.
When the man thinks that he always was a woman that is not proof that he is not delusional.
“When the man thinks that he always was a woman that is not proof that he is not delusional.”
Precisely. A little confusing, but correct.
We might even see it as an indication that he is crazier than he looks.