Homosexual Gender Dysphoria is a function of the relationship of sexuality to gender. Here, presenting socially, sexually and romantically as a man, when you have female sexuality, is the root of the discomfort. These individuals may strongly reject using their penises to penetrate and even refuse any sexual contact with them. They wish to appear to be feminine and to have masculine male partners, and to play the receptive sexual role; anything that conflicts with these will cause dysphoria. (The inverse applies in females.)
These indicators may become visible as early as thirty months, though more commonly around forty, and in genuinely pre-transsexual children, or transkids, will likely be ‘insistent, consistent and persistent’ by age four to five.