I can’t really speak for trans mascs as I’m not one. for trans femmes, it’s a scalding iron, joining with societal voices to reinforce in our own heads that we are in fact men. that belief, that we are actually men, is the root of dysphoria. it means something obviously true about the world - that I am a woman - is false and the cognitive dissonance is existentially painful. it’s difficult to articulate what this pain is like because there’s no real comparison with the things you might experience day to day. dysphoria precedes thought and emotion - it warps my perception of the world and my responses to it before I’m even aware that I’ve even perceived something. that is, every single other person in the world can look at me and see a woman and I’ll still look in the mirror and see a man - literally hallucinate things into existence or out of it - just because I’ve allowed my dysphoria to grow out of control. I have to remind myself every time I look in the mirror that I can’t trust what I see, good or bad, because my senses will straight up lie to me depending on factors entirely out of my hands. have I gotten misgendered or deadnamed recently? 0% chance I see anything but a disgusting wretch of a man. I have a single point of control - to remove all the factors my dysphoria might anchor on from my body and my life well before I look in the mirror. and to fail too often means returning to the zombie-like existence I eked out prior to transition - something I cannot tolerate.

A cis person who is distressed over experiencing hair loss doesn’t take that hair loss to mean that they’ll never be/be seen as a “real” member of their gender