First off, I would suspect most gender confusion, like most deep and difficult psychological problems, is another form of Developmentsl Trauma Disorder.
But let us say that it really is possible to be a woman trapped in a mans body, or vice versa. Such people suffer from BIRTH DEFECTS. They are deformed. Their deformities can be partially corrected through prostheses and surgery, but not eradicated. Not at the current state of science, at any rate.
Like all deformed people they warrant respect and consideration–pity, as I have said before, is best thought of as a disempowering microaggression–but NOT our consent and agreement. I will never call a biological man “she”. It is a lie. And lies are at the very top of my list of things I avoid at all costs, and hate with every particle of my being.
Such people do not have the right to make that demand, to threaten me with emotional or physical violence if I refuse to share their delusions.