Yeah but the internal process is not just wanting to change, it also includes the not wanting to change, they are part of the same process and these opposite feelings are often the source of painful internal conflict. And the not wanting to change part is often, if not exclusively, related to external factors. So the whole internal process doesn't happen independently from the outside/societal status quo. If we lived in a world where being transgender was 100% common and there were zero forms of discrimination, the internal process would be very similar to wanting to change haircuts, put a breast implant or have liposuction. The main reason that internal process is as painful as it is, it's because transgender people, especially teenagers, get external information that paints them as freaks, abominations and they see news of transgender people being vilified and targets of violence. Remove that and the internal process would be completely different.