In the 80s(iirc) a man named Dr. Blanchard attempted to map out transsexuals and transvestites. After extensive interviewing he divided it all into 5 categories of severity. It's seen as regressive now and not appropriate this decade, and many of these "white men who identify as lesbians" are threatened by his categories because it puts them down as fetishists. Only levels 4 and 5 he figured actually necessitated hormone treatment and surgeries. He's who created the term autogenophile iirc.
I'm just going off memory here, I'm on the bus and it's difficult to find his work with this browser, if you're interested you can totally find sources to him on radical feminist forums. But here are the levels from memory, but they will be simplified:
Level 1: Pure autogenophile with no confusion. Masturbates to the thought of being a woman and cross dresses for sexual arousal. Content with his life as a man. The fetish is incidental and only a fraction of what he likes to get aroused to.
Level 2: Mostly the same as 1, but takes it a bit further and fantasizes more. Content with being a man, no qualms about genitalia. Wants to crossdress even after achieving orgasm. Still terrified of losing penis. The fetish and sexualization of being a woman is more intense than in level 1, and may be his entire sexuality rather than a kink.
Level 3: Still primarily attracted to the female sex. Iirc this is basically level 2 but with minor spells of true gender dysphoria. Blanchard did in fact say level 3s might find themselves happier medically transitioning into women but didn't find they actually suffered as a man. Still lots of fetishism and attraction to wearing women's clothing, still doesnt mind having a penis.
Level 4: Majority of them are primarily attracted to men both romantically and physically. Experiences pain living as a male. May still masturbate or use penis sexually but overall wants it gone at all times. Will find emotional relief from a successful transition. This is the level "I've always felt like a want trapped in man's body" happens, and where at some point between the ages of 3 to 6 expresses a desire to not be male, as opposed to the levels 1-3 that only start experiencing anything after starting puberty.
Level 5: Almost the exact same as 4 but more "pure". Experiences a more intense level of distress and had more severe discomfort with genitalia to the point of never using it.
Personally I never gave a fuck. Blanchard and autogenophilia were both debated and used to troll extensively in trans spaces, the opposition to him is a mix of 'thats transphobic and archaic" and basically the plugging of ears and going lalalalalalallaalala. But since my personal experiences fell under 4 I just kind of shrugged instead of rejecting him because he called my decision necessary and valid.
Maybe he is wrong or maybe not, but psychologists totally are diagnosing fat nerds with a fetish in this country because they're progressive. No further mapping out of what Blanchard figured will happen because no one wants to be mean.
He's the closest thing to being a neutral observer because he neither hated trannies nor gave a fuck about their plight in some political sense, he just wanted serious discussions.