Isn’t the analogy: Trans:GID::persistent hallucinations:schizophrenia. And in this case there is a significant group saying that it’s offensive to say that you can’t be trans without it being concomitant with extreme distress (see the “transmedicalist” issue)
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I think it would be helpful to spell out that a trans person can easily be "impaired" socially or professionally due to discrimination because of how they present. Internal turmoil and distress is not necessarily the source of impairment.
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This is likely more obvious to the trans-accepting/trans literate among us, as opposed to those who are coming with a more skeptical bent. Impairment can mean inner turmoil, but it can also mean the patient cant find a job bc she wears dresses and does not pass.
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That would fall under "conflict with society". If a job had a dress code and the trans person could just dress as their biological sex, then there is no problem. If they were reluctant to dress as their biological sex because it caused distress, then you're back to the diagnosis.
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