Just to clarify one point: the trans individual is most often NOT in conflict with themselves about their gender identification, It is with the social and environmental features of their lives that present the conflict for them.  It is remarkable that in all of the sexual variations, very, very few experience an inner conflict that lasts for very long, if at all.  The outer conflicts, however, is the long-term damaging situation that results in all of the psychological symptoms (i.e., depression) and syndromes (internalized homophobia, etc.).  The so-called "conflicted with his/her sexual identity" are the easier things to treat.  The external conflicts (even by the Church itself) are the uphill battle each LGBT person must fight to maintain a sense of integrity and balance.  It is there, at that point, that the Church and its ministers should be ready to "accompany."