If you are a heterosexual gender dysphoric then at the time of puberty a permanent connection took place between your attraction to being female and your sexual intentions towards them. That connection has become permanently fused to your psyche.
When we began our sexual awakening at puberty we developped an interest in the opposite sex or perhaps in members of our own sex. This became an instrumental step in how your dysphoria would be managed going forward. If you were heterosexual you would attempt to reconcile the two but realize that it was probably best to repress your female tendencies in favour of attracting a mate. If you were homosexual the path forward seemed more natural and in harmony with your sexual desires towards members of your natal sex. For the highest levels of dysphoria, the two groups typically divide into what we know to be early and late transitioning transsexuals.
Recently I mentioned Alice Dreger and her association with the BBL school. This group sees this condition as an inconsistent model of alternate sexual orientation for the heterosexual group and as need to attract heterosexual men in the homosexual group. The idea being that desire to transition into a female is driven by sexual motives.
I don’t know anyone who has ever weighed the idea of transition (and that includes members from both sexual orientations) who does not trace their feelings to very early childhood. So in order for the sexual motive argument to stick you need to establish that sexual connection at the prepubescent stage. This is probably the weakest link in the chain for the BBL school as young children are only beginning to barely understand the concept of sexuality at this stage.
Children know the gender group they belong relatively early and then copy the role models set before them. The behaviour they first exhibit is based on what is natural for them and then they are either encouraged or discouraged depending on whether it falls within an acceptable range. A very effeminate boy might be told by his parents to play with trucks instead of dolls and not try to try on his mother’s shoes.
Once puberty hits we start to become sexualized beings. Our genitals start to become organs of pleasure and we learn we can have spontaneous erections and ejaculations. For the heterosexual gender dysphoric the desire to become a female and his sexual attraction to be with a female somehow become linked. There is no location target error; the problem is that he wants both and they are in direct contradiction with the natural order. Women are attracted to men so the dysphoric must desperately try to repair this problem in order to attract a normal female. Invariably he will do everything to suppress the dysphoria; often at the price of his happiness and mental health.
The purchase and purge cycle that most of us go through will begin here in earnest where we appease our dysphoria just enough to help us get through a tough period but then throw everything out in disgust for having failed. Here the sexual pleasure derived from the dressing experience is serving as a way of curbing the desire to transition instead of driving it along. We are disgusted with ourselves for finding our attraction to femininity has sexual overtones and react violently to it by throwing the clothes in the bin.
As we age and our testosterone levels decline the sexual aspect wanes but the dysphoria remains intact. This is why we will typically see a married man in his forties finally begin to address his problem in earnest and seek professional help.
All of this is in direct contrast to the idea that Blanchard proposes; namely that the transition desire is driven by sexual pleasure. Were that to be the case the crossdressing would only have begun at the time of puberty as it does for people who dress for fetish reasons. Most fetishists have never considered the idea of transition nor would they want to.
But there is another way for us and by doling out the right amount of cross gender expression that curbs your dysphoria you can establish a life that works. For some this may include hormones and surgery but for others neither will be required. The idea is to treat the dysphoria and take it seriously because suppression absolutely will not work.
If Harry Benjamin was right and this is a biologically sourced and graded disorder then psychological denial will only lead to discomfort and unhappiness. However thinking that we must become fully female in order to successfully treat our dysphoria may also be an erroneous assumption that some make for themselves.
You need to do what works but that means raising the level of protection and tolerance for gender variance in our society so that this becomes possible and thankfully we are already on our way.