First, we're pretty sure that GD gets started in the 12th week by, in m2f transsexuals, the male gonads not releasing testosterone at that critical time. We can retroactively tell the intrauterine testosterone environment by the growth rate of different bones in the body at different points in development. (see 2D:4D digit ratio). While it's a strong indicator in white males, it's not so good in other ethnicities, and it's not 100% determinative, but it's a damn good red flag that something didn't happen when it should, and that affected the development of the fetal brain.
Just look up the definition of GD. There is no "spectrum." Either you have it or you don't. Now, in terms of treatment, there IS a spectrum. Some people do okay just with social transition, some add hormones, some get a lopitoffofme or an addadicktome. Some can't access various treatment options because of financial, social, legal, or medical reasons.
The other "transgenderisms" are just simply not medical conditions, same as sexual orientation isn't, same as eye color isn't (except for the lack of pigment which causes problems). There's no demand for treatment, no medical reason for one.
What you describe is not transsexualism. Here's a simplified list
If you're a teenager or adult with gender dysphoria, you may feel:
- without doubt that your gender identity is at odds with your biological sex
- comfortable only when in the gender role of your preferred gender identity
- a strong desire to hide or be rid of the physical signs of your sex, such as breasts, body hair or muscle definition
- a strong dislike for – and a strong desire to change or be rid of – the genitalia of your biological sex
Without appropriate help and support, some people may try to suppress their feelings and attempt to live the life of their biological sex. Ultimately, however, most people are unable to keep this up.
Having or suppressing these feelings is often very difficult to deal with and, as a result, many transsexuals and people with gender dysphoria experience depression, self-harm or suicidal thoughts.
When they say "strong desire", think "taking a knife to it and cutting it off yourself." It's not a social thing so much as "this is SO F*ING WRONG I WANT IT GONE ANY WAY POSSIBLE - no doubts, no regrets."
Also, forget the whole "coached as to what to say if you want to go through the approval process." These assholes briefing you (and they are assholes if they're feeding you this pantload of crap) are 20 years out of date. It doesn't work that way except in some backwards gender clinics. Just. Tell. The. Truth. There are no wrong answers, and if you make sh*t up, you're more liable to screw yourself over than anything else.
If you end up dealing with someone still practicing as if it was their role to be a "gatekeeper", find someone else. Gatekeepers cannot help you nearly as well. Those gatekeepers still exist, and you can see by the "coaching" that those who have gone through them in the past feel you need to have, that they have done some serious damage.
You should never have to "sell" the idea that you're transsexual. If you feel you have, maybe it's just not right for you, or you've been given some really bad advice.
Either way, best of luck.
PS: Gender clinics will lie to you. In many jurisdictions, you no longer have to go through one to be approved for surgery, but they won't tell you that - and neither will many of the practitiioners, such as endocrinologists, because the government doesn't go out of their way to say the rules have changed. Not even the trans-specific orgs will necessarily know. There's no incentive to "get the word out" in the industry and piss off working relationships.
For example, here all you need are a letter from a psychiatrist who has known you for 6 months, a second mental health professional who has seen you at least once, the doctor (can be a GP) who has prescribed hormones for at least 6 months (and yes, GPs can prescribe hormones without you seeing a specialist for an assessment - it's called either the harm prevention (if you would otherwise get illegal hormones) or informed consent (if you have been told of the risks) model - and both meet WPATH standards), and a doctor who says you're healthy enough to undergo surgery.
And yet the gender clinic will tell you that you can only get hormones through them, that you have to be in therapy every week and group every 2 weeks for a year before, and that there's another 2 years minimum of therapy before you can get surgery. It's all about the money, baby.