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I think the cleaner reasoning is that the disease appears to be memeborne and validating the meme is part of its transmission. If the finger amputation thing catches on and 5% or more people start getting their fingers cut off then there is a real cost. The hidden cost in the treatment, especially the social aspects of the treatment, is that you're spreading the infectious meme. If people only develop the illness internally then sure, a case can be made for treating it it individually. But it's rather like approaching the flu as if it were a nontransmissible issue caused by an unfortunate accident at birth and encouraging people to hug and kiss people with the flu to show that we're all sorry for them.
I don't think this is perfect. There are a significant number of people who seem to have developed something like transness, whatever you want to call it (and maybe there are different things that cluster), people who describe themselves getting off to the idea of being a woman and wanting to wear female clothes and only then learning about being trans and really wanting to be that. Here's an example, and this isn't strong cherrypicking, I linked Zack's blog in this thread.
A lot more people have this experience with 'being trans' than 'autogynephilia', and I've read the same thing about 'being trans'. I don't think this is compatible with an exclusively memetic diagnosis, even though I do think most currently trans individuals would desist and forget about everything related to it eventually if they were in a universe with no other (depending on your POV) TruTrans people / people believing in the meme. And I think as a result your ethical grounding has to actually be able to claim 'no, these people who didn't get it memetically shouldn't transition either' if you want to claim that the concept as a whole should go.
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