@WalkOnGildedSplinters
A mental illness is different to a paraphilia.
I’m sure I read somewhere that the more you indulge a paraphilia the more it takes over and the stronger the urge becomes. So actually maybe for those men transitioning is a really bad idea?
I tend to think that transitioning may not be a good solution to the problem. However, it was the solution a lot of men were presented with by their therapists at one time, so to some extent it's water under the bridge for those people.
I also think there are some commonly accepted ideas about sex in our society that are rarely if ever questioned that tend to lead to the development of these problems, perhaps to the point where it's not possible to just undo them. People are told that it is ok and fine to indulge their fantasy life and very few people are told that it could lead to real problems. So it's not like most people are looking out for that or even have good strategies for coping with problematic fantasies.
But I think your point about indulging the paraphilia is what I am objecting to. That consists of imagining oneself as a woman in terms of sexual situations. So, very much a sexual act.
But according to Blanchard's research with affected men, what happens is that indulging this leads to a second, more debilitating problem, which is a kind of alienation from the person's own sexed body leading to sex dysphoria, that starts to assert itself outside just those sexual contexts. So whereas gay men who are unable to deal with their homosexuality develop this break due to not being able to integrate their sexed body with their sexuality, AGP men develop a similar break because of the effect of the paraphilia over time.
He suggests transition as a way to increase normal functioning for both types of people by alleviating the generalized dysphoria. Not as a way of being sexual in the public sphere.
Is he wrong about what's going on? It seems to me that with the rise of trans activism and letting down all boundaries there is a significant number now who are in fact publicly behaving fetishistically, basically whenever you see these men dressed in wholly inappropriate sexualized women's clothes in public, that's what's going on.
But I don't think that means that what he described as the mechanism in AGP is mistaken overall.