Seems to me they could be so screwed up in the head that they actually thought they were born with the mentality of the opposite sex. I’m not sure how much of that I buy into though.
I’ll have to say that it seems to me this type of person would be more a candidate for counseling rather than the rest of society having to stand on it’s head to accommodate him.
I’m only going with my gut here. I have no knowledge other than common sense here.
It is testosterone driven perversion, nothing more.