To be determined. I'm gonna guess no as she's always been an attention seeker so it may be no more than that.
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To the extent that a delusion can be 'a real thing', yes.
However, if you start to say that delusions aren't delusions, but real - even desirable - things, you can't be surprised if people then start to claim to be 'suffering' from them.
Think of it this way: today, if someone says that God talks to them, we immediately decide they're probably a paranoid schizophrenic and put them on a course of treatment.
However, back in the day when being talked to by God conferred upon one a special status, lots of people would claim to be hearing the voices. The difference is only between the truly delusional and the cynical, attention-seeking bandwagon jumpers.
Oh absolutely not. I just don't think she'll ever go down the operation required route as I doubt she really wants to be male.
Much easier to get attention by asking for us to call her a certain name, use certain pronouns, generally make an issue of it so that she gets the attention she craves.
Children cutting off / sewing on genitalia on a whim is probably not something that should be encouraged, in the same way that experimenting with setting the house on fire should not be encouraged even if playing with matches makes them happy.
I think there has been an instance when research into the long-term effect of sex-change operations on the young was suppressed by a university, in case the results went 'against the paradigm'.
Which Public Lav will James now be using, Wesley ?