Is it aggressive, or is it merely an acknowledgement of reality?  Look, I'm all about treating people with with respect.  If a male is more comfortable living a feminine life or vice-versa, that's totally fine.  But when the male declares himself female or the opposite, and further demands that everyone else acknowledge it as well, that's crossing a line into pretending, and you can't force everyone to pretend along with you or you will call them names (an actual form of aggression).

I don't think people do transgender folks any kindness in this.  Instead of learning to accept what they are and move on from there, they are built up by well-meaning people into a falsehood.  When someone then accurately points out the falsehood, they are hurt.  And until everyone in the world is brought into line and agrees that a basic biological fact is fuzzier than it is, this tension will exist.

Let me tell you a story.  Once upon a time, there was a lousy school where children were underperforming.  Well, the school was learning all about how self-esteem is correlated with better grades.  So teachers started over-praising the students and treating them as if all of them were performing brilliantly.  The administrators then sat back and waited for grades to rise.  They didn't.  What actually started rising were the number of fights.

You see, the students did feel good about the teachers praising them.  But deep down, they knew that they actually weren't all that brilliant.  Students also have a sense of self-efficacy (which is actually much more important than self-esteem in students).  They know whether they can do something or not.  Well, kids being kids, they took it upon themselves to point out that very inconvenient fact to each other.  Either their self-esteem would lower itself back down to previous levels, or even lower.  Or the student would feel the need to protect their identity and attack back.  Hence the fights.  The tension between the shell and the reality cracks the student with the artificial self-esteem and causes pain.  It's part of the reason why prison populations have such high self-esteem.  The need to protect their unearned shell and often get themselves into trouble.

Meanwhile, if a smart student is called dumb, they would merely shrug it off.  Even smart students with low self-esteem have those insults nerfed.  Their self-efficacy protects them from that particular insult because, well it's just not true.

What I'm saying here is that if you called me a girl all day, I'd merely look at you funny as would pretty much anyone except those that just find the insult offending in general (honor culture, a separate topic).  However, a transgender person knows the difference and that's why it hurts.  They're living an illusion and the people around them are feeding into it because they have good intentions.  But, as happens in the example above, when the artificial shell is cracked, they are hurt.  You can't live in a bubble forever.

The answer here is not for everyone to get together and ignore reality in order to save transgender people the pain of acknowledging the truth.  That is extremely unhealthy.  It is for everyone to acknowledge exactly what transgender people are, people who feel more comfort within the culturally defined sexual differences of the opposite sex.  Once that is done, you can build the house of tolerance and acceptance on the much stronger foundation of the truth instead of the flimsy foundation of making everyone pretend and trying to bully people into falling into line, which just isn't going to happen and will cause more resentment and resistance than converts and is only going to cause more pain to the transgender individuals in the bargain.

Self acceptance may be a hard quest for some.

That's the thing.  They are trying for self-acceptance.  The people around them pretending with them and attacking anyone who doubts are also trying to help in that self-acceptance.  I don't doubt their sincerity, but I don't accept their methods or conclusions.

Unfortunately, we got stuck in the mud somewhere because of politics and now we're all living in a South Park episode.  Something as basic as male/female was got talked into being abstract instead of concrete.  It's also undercut and corrupted science and the healthcare community as a result, which isn't doing anyone any good.  Particularly in the case of young children who have no concept of what they're asking for having their bodies hormones altered.

It's both really.  They wish to self-accept that they would be happier living the life of another sex, but wish to deny the reality that they are not.  Hence you get situations like the one this thread is based around.

I don't believe these are irreconcilable though.  If a person feels like they would be happier living such a life, that's fine.  Differences in gender are largely socially defined constructs anyway.  And if they wish to mold their bodies into something that makes them feel more comfortable in living such a life, that's their business.

But acceptance of what they are also needs to be a part of it.  Whatever differences are being made are, in the end, cosmetic.  If that lingering fact causes pain, then they need to seek help in addressing it.  And the medical community needs to help bridge the gap between wish and reality instead of hand-waving it and declaring a falsehood to be true.

So what? maybe it's hard, maybe it's impossible. The solution isnt to make billions of others accept something thats untrue.