Many years ago (some pros were still playing persimmon woods), before terms like cis-gender existed, I worked in psychiatry, and for a while did sessions in a clinic which saw people with various complaints which included what would now be called gender dysfunction. Because gender reassignment is a big deal and may include risks and points of no return, one of the big priorities was to determine if the anxiety, distress and depression that some of the patients clearly had was really due to their perception of being in the wrong bodies, as it were. So some deep counselling/analysis was conducted and it often emerged that it really wasn't the core problem and something else was uncovered. Equally, sometimes people had reassignment and it didn't change their mindset, sometimes made it worse. On the other hand, I saw some people who had successful reassignment, usually male to female, and did well. Of course, this didn't include people with physical intersex conditions, whose issues are more endocrinological than psychological.