I think (she said, speaking as a transgendered person) that the angst has a lot to do with a more pervasive sense of self-doubt among many trans people. When you have to do something fairly subversive and controversial just to feel like yourself, and can expect an enormous amount of social pressure (ranging from passive-aggressive to literally life-threatening), and you've spent most of your life likely to have no coherent idea of other people like you...yeah, it's kind of tempting to search out validation in those ways. I think this is why some trans people would love to have a diagnostic test for it -- strikes me as a bit self-defeating though.