Al Has Been Diagnosed as a Transsexual; Bob Has the Diagnosis

Al has been diagnosed as a transsexual; Bob has the diagnosis of nontranssexual gender identity disorder. What is the most significant difference between these two individuals?

A) Al is likely to be delusional; Bob has no evidence of delusions.
B) Al is preoccupied with getting rid of his sexual characteristics, Bob is not.
C) Al is likely to have genetic and hormonal defects; Bob has no genetic or hormonal defects.
D) Al is likely to have been sexually abused as a child; Bob is more likely to have been sexually abused in his adolescent years.