I think there is an insistence that I often see on MN, that if someone behaves in a selfish, abusive, misogynist or solipsistic way, they absolutely know what they are doing and it's deliberate. I struggled with this a lot with my ex, when his incredibly difficult behaviour led me to end the relationship. He had to know he was passive aggressive, irrational selfish, lazy, sexist and a liar, right? But he would insist he wasn't, leading to massive arguments.
It's taken me a lot of thinking to really get my head around what was going on. I've realised he needed to see himself as Mr Nice Guy so deeply, he would lie to himself and believe his own lies. He would swear black was white to make himself look good and I was always so frustrated thinking why isn't he embarrassed to just spout bare-faced lies? But he was convincing himself, so that he never had to say OK, I was in the wrong. To this day he thinks he is Mr Nice Guy. And he can be nice when he wants to be, and he performs that well to friends, so they feed that back to him.
This guy is a high-level professional, multiple-degree-holding scientist and extremely intelligent.
When you've seen this level of delusion up close, ongoing for years, you understand that some people simply cannot stand to be in the wrong or called out on anything or be a "bad person", and they will twist reality so that they can assure themselves they never are.
I'm not saying this is DH necessarily, but I am saying it can be very complex, and psychology does back that up. It absolutely is not true that just because someone has a fetish, they clearly perceive themselves and their motivations that way. The mind can be extremely good at building an alternative reality that makes your self-image feel more comfortable – and trans ideology offers that on a plate to AGPs.