OK ... but if a 5-year-old insists that they are really a little boy when they were born a little girl (or vice versa), we take their words at face value and not as a fantasy, like wishing to be a horse?  :-/  Why the difference?  Or more to the point, how are we sure there *is* a difference??  o_x

To be sure, when writing the original comment I had in mind that recent case in Colorado, where a sex-change operation was performed on an individual; they discovered that they *still* weren't happy.  Then they wanted another series of surgeries to "change them back" to what they were in the first place.  :-/  Sounded to me like someone lost in some sort of fantasyland, but I concede one shouldn't generalize from a single instance.

Thanks for your words.