Mental

The DSM-5 says nothing about gender non-conformance being sourced in mental illness. What it does say is that distress suffered by a person can fall under the category of something which needs treatment. What we used to call transvestic fetishism (which Blanchard ostensibly retitled AGP) fell under the category of obsession which made the person suffer. It was sold as sexually-rooted mental illness which would invariably lead them to transition.

Many people have fetishes that they enjoy which don't make them suffer. For example, you can have a foot fetish and in every other way lead a perfectly conventional and happy life.

People said to have transvestic fetishism wanted to cure themselves and felt great distress. But then we can question if the distress was there because of fear of discovery and having a life potentially destroyed. They themselves may have seen their behaviour as compulsion rather as part of the way they were.

Ray Blanchard appropriated the concept of transvestic fetishism to say that gynephilic transsexuals couldn't help but transition because they suffered from a sexual narcissistic love of self as women which drove them there. They couldn't help themselves because they suffered from a paraphilia. One would even convince themselves that they suffered from dysphoria and there was no talk of a feminine essence. Even for androphilics their drive was supposedly based on a desire to sexually attract straight men.

The point I am getting to here is that if you are perfectly happy with whatever form of gender variance you espouse then there is nothing wrong with you and you should live your life. If you have gender dysphoria then you should deal with it in the best way possible to suit your needs which may necessitate a medical transition.

En bon Francais: "Point finale".