The truck will get warm pulling with a load, even with the fan clutch working properly, but it should not overheat. I had the same problem before going through the transmission. What is most likely happening is the torque converter is either slipping while locked up or not locking up. This creates massive heat in the transmission. The transmission fluid leaves the transmission, goes through an engine intercooler, then a transmission cooler, then back to the transmission. The heat from the transmission is actually heating the engine up, through the engine/transmission intercooler. I would say if you get your transmission rebuilt with some type of more efficient converter that will stay locked up and a valve body that provides added pressure to stay locked up, then your converter won't generate the heat, the transmission will be cooler, and therefore the engine will be cooler. That was the exact situation for me before a transmission rebuild. I recently towed my 5th wheel from Victoria BC to Anaheim CA (and return), along the coastal route with no heat issues, which certainly would not have been the case before.
Other possibilities people will chime in with: bugs/dirt blocking radiator, fan clutch issue, thermostat issue, air flow issue (upgrade air intake and/or exhaust). You should be able to hear your fan clutch kick in, it's definitely noticeable if you're listening for it.