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cousin_it comments on Transsexuals and otherkin - Less Wrong Discussion
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I wonder if the is-ought distinction can help us here. Which phrase better describes your feelings in the past: "desire to be female", or "perception of being female"? If it's the former, there's nothing to argue about and I will happily strike the word "delusion" out of my mind, replacing it with "desire", and everyone's happy. If it's the latter, what gives you confidence that your perception was correct in some sense, other than the perception itself?
It is desire, more or less - if someone believes they already have body parts they actually don't, now that's a delusion. However, calling it "desire" implicitly implies that fulfilling it is optional for their well-being, and that it's somehow okay to treat them the way they don't want to be treated until then.