You can deny reality, but reality is a constant. So is transgenderism (sounds like a religion lol, it's an existence not a belief), dwarfism, racism and human personality. Some people do ignore the real world, as in the collective existence we all live in, and instead beautify their personal world or worldview, but in doing so they can unintentionally harm others.

I've heard that in some parts of America being trans is considered a mental affliction rather than physical. I don't agree. A body can be changed, but a personality/who you are cannot be. It is a constant, which is why there's no use referring to it as a mental issue. It's the body that is wrong.