I think you need to ask a doctor/psychiatrist to get the answers you're looking for.

I can offer a couple of opinions and observations, however.

I don't think developmental impairments extend beyond aesthetics simply because I have known many people with developmental impairments but you would never know by looking at them. It's the same with physical deformities - those I have known don't necessarily have developmental impairments at all.

Do you consider being transgender as a developmental impairment? It's not, you know. It's just the way you are made and I hope you accept and embrace it.

WW