I sometimes see comments like this:
"How can I stop imagining myself as a woman" which signals distress and a lack of self-acceptance.
It is also precisely what Ray Blanchard pounced upon in the 1980's with his scared patients when he basically renamed what was then known in the manuals as transvestic fetishism (which admittedly focused more on clothing than imagining oneself having a female body) .
But here's the rub: human sexuality is very complex with many scenarios possible. One involves the imprinted child who crosses into puberty with the wish to be female since early childhood with the rest being variants of what my friend Jack Molay years ago coined as Crossdreaming. In other words, what might my life be like if I were the other sex.
Some of these variants are only temporary exploration or escapism and aren't very deeply rooted in the psyche. However other cases are much more persistent and involved fighting uphill to be accepted within societies that reject them.
Small wonder so many wanted to be healed or went underground.
Gender criticals point to this trauma as signs of mental illness which most assuredly wouldn't exist had gender variant people not been taught this is what it indeed was from the outset.
Even today gender conversion channels like The Metaphor of Gender preach a soft-pedalled and genteel gospel of gender variance as something to be healed and no, not everyone needs to transition.
The key for all these cases is to put their desire for gender variance into context and determine a landing point by repairing the underlying trauma around it.
It isn't the gender variance that needs curing but the psychology which associates it with an illness thus fostering shame, guilt and in older people secrecy.
Ray Williams, as an example, contorts himself into a pretzel by accepting he has a sexual illness that he now celebrates by trumpeting "hurray I have AGP!"
It is precisely this type of outlook that I do not believe to be the healthiest of approaches.