That mismatch you are talking about is, in large part, what mental illness is. Depression, anxiety, phobias; are all often mismatches between what level of emotion is expected for a given situation in life and what level of emotion is being produced by the individual. In mental health, we don't try to match that individual's expereince to their level of emotion, we try to help them find healthy ways of managing/releasing, and reframing those emotions to make them more manageable and a closer match to reality. We don't treat illnesses like schizophrenia or paranoia by trying to "affirm" that what those individuals think and feel is correct, we try to minimize the impact of the "mismatch" b/w what they think and feel and what is reality. If we are working with a person with an eating disorder, who might have body dysmorphia; we don't concede that the person truly is obese because that is what they believe about themself (especially if they are dangerously underweight and malnourished), we try to address the lack of insight and deal with the underlying issues. "Confirming" an underweight person with an eating disorder and helping them continue to lose weight, because that is how they see themselves, would be dangerous and unethical. Trying to help a person change their sex may be politically correct and score DEI points, but in my opinion, is dangerous and unethical in the same way.