There's a lot of misconceptions about being transgendered. When the majority of the information comes from tabloids and sensationalism media, it can make us looks like desperate freaks, or crazy, attention seekers, and so forth. It's really a lot more simple than that.
When we develop, our chromosomes determine our sex. Sex is our physical presentation and determines whether we will incubate eggs, or be the one to fertilize them. Even this isn't a failsafe method, though. Generally, men will have an XY genetic make up, and women will have an XX makeup. But what happens when a man is born XX with no Y chromosome? What about XXY men, a condition called Klinefelter syndrome? Are they less of men than their XY counterparts? Or how about women born with an XY configuration? She will be barren and can't have children, but does that make her less of a woman? If it does, are XX women who are infertile also less womanly than their fertile counterparts?
These genetic markers cannot accurately determine our physical sexes any more than they can determine our orientation or our gender.
No, physical sexual characteristics are not the same as the gender inside our minds. Sex and gender are two different aspects of a person. Sex is the physical, the "what you can see on the outside" while gender is in the heart and mind. Gender can easily vary from physical sex, and often does. How often this happens is indeterminate as many transgendered and intersex people don't want to reveal themselves to the public, just as many gay and lesbian people want to keep their privacy. Due to the nature of transgenderism, a accurate count cannot be made. The estimated ratio of MTF transsexuals to genetic males is between 1:2000 and 1:80,000. The estimated ratio of FTM transsexuals to genetic females is between 1:2000 and 1:125,000.1
So what does this mean for pre- and post-op transsexuals? A MTF could have a genetic makeup of XY, XXY, or even XX, just like a cisgendered female. Without actual genetic testing, this can never be determined. It is only assumed that she was originally an XY male because that is the way genetics tend to work. What about an FTM? He could have, and likely was, born an XX female. But what if he was actually born with an XY genetic makeup? A sterile, apparently female person, but with a different genetic makeup than his female peers? Again, we can never know unless he has genetic testing.
Ultimately, our genes can be pretty muddy. An extra one here, a missing one there. Sometimes this causes noticeable physical or behavioral differences- but sometimes it doesn't.
When we are born, the doctor, nurses, our parents and so forth look at our physical bodies to decide whether we are male or female, and then we are assigned that gender. Whether or not that is the gender inside our minds, and whether we identify with that gender, is impossible to tell until a later time. Usually, they are correct in their assumption of gender, but sometimes they are not. Sometimes, an apparently XY boy will actually be female gendered, and an XX girl will be male gendered.
But because, in their boundless wisdom and expectations, we are assigned the gender that conforms to our sex, and then we are raised in that gender. We are taught stereotypes based on our assumed genders, we are guided away from engaging in the "wrong" activities that are counter to the stereotypes, and we are taught how to act in our assigned gender.
It is a myth that all transgendered individuals knew from a young age that their assigned gender was incorrect. However, many transgendered people do know from the time they are children that something is different. It is also a myth that all transgendered people will pursue surgery and hormone therapy. Many won't, many will. It comes down to the individual and how comfortable they are in their lives and whether they feel strongly enough to change their physical sex to match their innate gender.
There does seem to be the belief that if only transgendered people would learn to be comfortable with themselves, that they wouldn't feel the need to go through hormone therapy and surgery. Becoming comfortable and confident in oneself is important in any endeavor, not just when going through transition. However, being comfortable and confident does not preclude someone from pursuing what is, to them, the right course of action for their own lives.
I'd like to give a couple of examples. I have needed glasses since I was 6 years old. I was extremely self-conscious about this for a very long time and resented that my eyes were "broken" and needed glasses to be able to see. In time, I came to terms with this aspect of myself, this imperfection of my body, and began to wear my glasses proudly and without resentment or embarrassment. My eyes do not work properly, and that is simply a fact. Now that I am comfortable with this, and confident, does that mean I should throw away my glasses and go about my life with impaired vision? Should I refuse medical correction of my sight and live without only part of my vision, because I'm confident and comfortable?
Why, then, should I as a confident and comfortable transgered female to male shun correction of my impaired body? Being comfortable with oneself does not mean refusing treatment, surgery, therapy, or medication to correct an imperfection or improperly working part of the body. I would go so far as to claim the opposite- being comfortable with oneself, and confident in oneself, is the perfect reason to pursue the necessary treatment. No longer is transition a desperate measure, but instead simply the next step.
I would not throw away my glasses and spend my life being unable to see, and neither would I throw away my transition and spend my life in a limbo, caught halfway between where I started and where I need to be.
Confidence and transition are not mutually exclusive to each other. Asking a transgendered person to just figure out a way to live with it is no different than asking a diabetic to just live with it, or someone with impaired vision to just live with it, or someone with a non-threatening but unattractive scar to just live with it when there are safe, routine methods of correction.
References:
1.)
FAQ - Transgenderism at MSU ---
I may add more references, or add onto this in the future.