definitely the latter... if he actually had a partner to act it out on him he'd ironically be more confident in his gender and have less self image issues
but in his eyes, he thinks hes a "freak" or "fake" for having such a desire thats opposite of his ideals(being respected as a man) despite it only being a fetish
there are also other characters that i hc trans, so being in an environment with others like him just makes tatsumi more guilty and feel disrespectful
his want to conform to typical masculinity is killing him its crazy
i havent thought of anyone who shares the same fetish or would indulge it, so he will have to suffer alone a little more...