I think the different interpretation of "standing out like a freak" part is more generational. He's not saying people with gender dysphoria are freaks—standing out like a freak is the feeling you have somewhere when you feel completely out of place and uncomfortable. Like if you're wearing yellow socks to a funeral. Nobody comments on it and you're not sure anyone even sees them, but you feel like you're standing out like a freak because you're constantly thinking about it and feeling out of place and as if you don't belong.