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A patient I dealt with had schizophrenia and dementia, "but I'm a man, not a little girl with panties" was his counterargument to everything.
You can only have one cigarette at a time because otherwise you lose them all and run out. "But I'm a man."
You know the doctor says your food needs to be cut up. "Do I look like a little girl to you?"
That's the communal cheese bowl, this is your plate. You can't eat from the communal cheese bowl with a fork. "Do you see me wearing panties?"
Whenever I hear people making these kind of gender essentialist arguments, they just sound pitiably out of touch with reality to me.
Have you asked him how often he thinks about wearing women's underwear?
In my head I made many cutting remarks. But the reality of this level of cognitive decline is like 90% miserably depressing and only like 10% infuriating. Plus he wouldn't be capable of understanding the criticism anyway.
That's potentially worthwhile with someone who is cognizant but just an asshole. For someone with dementia, there's no point
I don't know what it says about you if you do it deliberately but I think there's a lot to say for asking the question anyways because his speech filters don't work properly and he might not be able to censor himself.