Took some time to reflect, I communicated my question quite poorly and that is on me but I’m gonna try to ask it in a better way.

I feel somewhat strongly that trans-affirming care is the only appropriate approach to treating being trans. I have the impression that as a trans person you feel this is wholly incompatible with my sense that it is a mental health issue. I’d like to explicitly ask why my two beliefs are contradictory.

I’m asking because I am just in the past year or so suffering with severe physical and mental illnesses, and when I try to picture what the trans experience is like, I find that what I am imagining aligns very closely with my mental illnesses and not closely at all with my physical illnesses. I was extremely reluctant to accept that I have a mental illness because of both societal stigma and because in my situation, no one in their right mind would choose to treat my mental illnesses with therapy and pills when a change in living conditions would actually help enormously more, which seemed analogous to treating being trans.

That is what’s made me feel my two beliefs aren’t contradictory - I hadn’t understand how deeply I had internalized stigma against the mentally ill until I was asked to apply it to myself. I am imagining that other people would resist identifying as having mental illness in the same way I was. I picture the trans experience as emotional anguish with all physical threats as consequences of that emotional anguish. One where, also like many cases of mental illness, physical treatments are the correct option. But I don’t understand a way to liken it to my experiences with physical illness, so maybe it would be helpful to understand the physical danger and physical suffering explicitly.

I think there are extremely few situations where a mental illness should be treated as something to correct rather than accommodate without the patient being fully on board with thinking of it as something that needs to be corrected. In many cases, the only reason a patient would be fully on board is societal stigma and designed inaccessibility of accommodations, which is the impression I have of the trans experience as well. That’s the reason I don’t think of options other than trans-affirming care as okay.

I reacted badly because of recently surfaced mental health issues (blehhh) where I obsess over my character and respond to perceived character attacks as an attack on my identity even though I should just be listening. Your response seemed to focus on why I should agree with gender-affirming care and I read that as a character attack, rather than considering that you don’t see it as even possible to believe being trans is a mental health issue that should only be addressed by gender-affirming care. I was being overly wordy to try to be clear that I’m trying to understand how your experience compares with mine, and look, we’re back again.

Also I tend to read comments like that as a disgust and a need to distance from the mentally ill, and that’s something I very much need to work on because I know it’s not the intention at all. It stung more than usual in this case because I was looking to build camaraderie and tried my best to clarify that I don’t want mental illness to be an attack and that I am in favor of gender-affirming care.

This time I promise I will have the good sense to wait at least a few hours in responding to something that makes me feel bigoted. I apologize for being hurtful earlier and I’m hoping this one is less so.

tl;dr - The core stumbling block for me is this one - when I try to picture what the trans experience is like, I find that what I am imagining aligns very closely with my mental illnesses and not closely at all with my physical illnesses. I’ve elaborated way too much on why that is. I need to hear what I have imagined incorrectly, what I have overlooked.