What element of further history would most strongly support his self-diagnosis?

A 23-year-old man presented with a history of discomfort with his gender for as long as he could remember. He believed he was transsexual.

What element of further history would most strongly support his self-diagnosis?
A . a long-standing intense wish to make his body conform to that of the preferred gender
B . conscious and absolute rejection of his sexual orientation as socially unacceptable
C . seeking medical rationalisation for sexuality through genital surgery
D . sexual excitement by cross-dressing
E . the presence of gender somatic delusions that emerge and strengthen with time

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Answer: A