I think it is called body dysmorphic disorder. This is when people see themselves in a totally different way than other people see them. Fat people think they are skinny. Skinny people think they are fat. And such like that.
I saw this with my own mother. When she was mid-sixty years old 65-68, she was still convinced that every male person she encountered was trying to 'pick her up'. She really believed it. Crazy people too, like she thought the 30 year old married pastor at her Church was hitting on her. And you could not talk her out of it.
You know I could tell that when she looked in a mirror, she did not see what we all saw. When she looked in her mirror, she saw herself as she was when she was twenty years old, young and beautiful. And none of us kids would ever take that away from her. In fact, we encouraged it to some extent. After we left a restaurant I would say, 'Did you see how all the guys were checking you out?' She would smile and say, 'Yeah, I thought I was the only one who saw that...'
I think that is what is going on with this guy. When he looks in a mirror, he doesn't see what we see. In his mind, he is a beautiful maiden. OK? I guess?