I'll jump in. My response is based on these things:
1) This is not a troll thread;
2) Your psychiatrist is competent;
3) The diagnosis is correct;
4) You actually are interested in hearing what other people think.
Here's something nobody has brought up: What if, untreated, your symptoms and patterns of behavior get worse? I don't think I read anything in the thread about disease progression, either how it has progressed in the past or what a usual course of events might be in the future.
I bring this up because it seems like you may have a bit of a moral obligation to the rest of us to get treated before you become a danger to society at large, if that's a direction the disease could go. After all, you now have a) awareness, and b) a formal diagnosis of a condition that strikes me as potentially very troublesome for people not only in your direct sphere of influence (ie, people who choose to come in contact with you), but people who you choose to interact with who could become either innocent victims or collateral damage of/to your behavior.
It also seems to me that the very nature of the illness would keep you from making a perfectly unbiased decision on whether or not to seek treatment. I mean, if you don't really care, you don't really care.
I have a quirk that often causes me to be "tone deaf" to the thoughts and feelings of other people. "Impaired perspective-taking" is one term that's used to describe it. Basically it just doesn't occur to me to think how what I'm about to do or say might impact someone else. If I'm clued in, I might or might not "get it;" it's possible that someone might have to really spell it out. But when I *do* get it, it's often an "ah-ha" thing, and I can then make a decision to say, "oh, screw 'em" and do what I was going to do anyway, or say, "I see that I should reconsider."
This freedom to make a decision is important. It gives me power over situations. Sure, I can still choose to be a jerk, but I have an option rather than just being carried along by whatever I was going to do in the first place. Maybe treatment would help you get to a similar place - it's quite possible that your default mode will always be to be a jerk, to oversimplify greatly, but maybe there would be some potential benefits in learning a new way of behaving.
Seems like treatment is worth a try. My thought would be to start on the "without drugs" path, and leave that as an option if you want to explore it later.
PM me if you wish.