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This. I think most Mottizens' model of the situation would be much improved my thinking of trans as primarily an unusual set of desires/preferences rather than as delusion or attention-seeking (or even, directly, an attempt to get one's rocks off). The thing that most transitioners (and a whole lot of others who don't go down that path) have in common is that they want, very badly, to be the opposite sex. The delusion, if it's there, is probably a consequence of that desire. Is that desire is born of a fetish or fetish-like sexual thing (AGP), or some emotional thing, or some complicated combination of these, or even of some external source like trauma? Probably each of these for different people (my money's on the complicated combination for most, though). But I strongly suspect that things almost never start with delusion.
Somewhat of a side note, but I find it relevant that quite a few philosophies and religions teach that mastering or overcoming your desires is a key to living well. Stoicism, Buddhism, and Christianity don't have too much in common philosophically, but they are all in agreement on that point. (Even then there are major differences -- Christianity teaches that some desires must be expunged and the others rightly ordered, while my understanding is that Buddhism thinks that they all have to go. But the common point is that if you can't rule your desires, they will rule you, to your detriment.)
I think this accurately describes pretty much all trans women who are making even a token effort to medically transition. For a lot of trans men (the canonical example being Ellen/Elliot Page), to me it looks less like wanting to be a man and more like wanting not to be a woman (including not being able to have children, not being someone who is the object of sexual desire etc.). For trans women, medical transition tends to scan as an attempt to fulfil a fantasy; for trans men, an elaborate form of self-harm and self-obliteration. The difference in the tone of trans memoirs is striking: trans women's tend to read like "coming out was the most joyous and uplifting moment of my life, I finally truly understand who I am and now I'm free to be my best self", while trans men's tend to read like "it was after my third suicide attempt during my second hospitalisation for anorexia (prompted by getting raped) that I finally realised I'm actually a trans man, and I am exactly as miserable and dysphoric since my mastectomy as I was beforehand".
You are probably right about that. The dynamics in the modal cases do seem different.
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