Topic: Not sure if I am intersex

[Rachel Montgomery]

I have been told I have something similar to Kallman's Syndrome.  I have all of the symptoms of Kallman's except that my sense of smell is normal.  The doctor labeled it Idiopathic Hypogonadotripic Hypogonadism. 


I am transgender and have been aware of that since my earliest memories (3-4 years old), though I didn't have a label for it.  I knew I wanted to be a girl, and I was told very plainly that would never happen.  so, I did my best to hide it and act like a "normal boy".  I think I pass as a fairly normal person, though I know that I am transgender.

I had some sort of surgery on my penis when I was about 2 years old.  I remember going to the hospital and ...a lot surrounding that surgery.  I clearly remember the pain when I urinated, which continued for some time after the surgery.  It was traumatic for me, and I was completely unprepared for it.  I was told that when I got older, I wouldn't remember it, but I promised myself to never forget, and I retold the story to myself regularly.

My parents remember that I had the surgery, but claim they don't know what was done or why, just that I needed it.  That isn't believable to me.  Who sends their child to have surgery on their genitalia without an explanation as to what is planned and why?  This would not be the normal course of business for my parents.  They are college educated and fairly sophisticated.  I get the impression that they know a lot more than they are willing to tell me.

Anyway, when I was 16 I still hadn't started puberty and they took me to an endocrinologist.  He diagnosed me as having "Constitutional Delay of Puberty".  He offered me testosterone, and told me it would make me hairy and masculine.  I rejected the offer.  I started puberty on my own at 18.  It was a slow process.  Even at 21 I looked like a high school kid.  But, I eventually developed into a mature looking man.

My T levels have never been above the baseline for normal males, but close.  Then, around 50, my T levels dropped to zero (the lab said they were so low they could not be measured).  This made me feel very sick, and I went to the same endocrinologist.  He diagnosed me as having metabolic syndrome, and started me on Androgel.  I was fairly emotionally stressed over taking testosterone, which emotionally felt like poisoning myself, but I felt so physically ill that I did it.

After a couple of years, I went to a different endo who told me I had something like Kallman's (he said I had IHH).  He explained that something is wrong in my pituitary/hypothalamus axis, and it causes me not to make enough LH (Lutenizing Hormone) and GnRH (Gonadotropin-releasing hormone).  I suspect that this problem has something to do with my prenatal development, and the need for surgery when I was young.  Both endos shrugg at the question and say they don't know.  (how could they know for sure, but I would suspect they have a theory).

Anyway, my question is would having IHH mean that I am inter-sexed?  I know that it isn't relevant to a diagnosis of Gender Dysphoria, but under the definition of GID being intersex would exclude that diagnosis (for some reason).  I suppose it was thought to explain the cross gender feelings whereas GID was unexplained cross gender feelings.  And, I am not really going to bank much on whatever your response to my question is.  But, it is something I wonder about.  I have no idea which doctor is right.  And, I am not sure if whatever is wrong with my physically is responsible or a contributor in my GD.

(P.S. this site has a lot of math work)

[Jessica]

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[Linde]

Hi Rachel, welcome here.
I m a medical researcher,  but not a physician, and I am an intersex person (I have the XX male De la Chapelle Syndrome) with hypogonadism to boot.  Only involved blood tests can determine if you are intersex'
I am genetically a female, but had male genitalia, but there are not so obvious intersex conditions, too.  Hypogonadism is a mutation, and does not count as an intersex syndrome.  My body never developed to be male, and I never had any real puberty either.
from what you describe, i would say you may not be intersex, but definitely have one or several mutations.
You should ask your doctor to probably do a Karyotype Test with you, or if your health insurance would pay it, a genome analysis.
Feel free to ask me questions concerning intersex, and  try to answer them as good as I can.

[BrightWindow]

Being intersex is not black and white.

There are five factors which determine a person's physical sex: chromosomes, gonads, hormone status, genitalia, and secondary sex characteristics (I sometimes abbreviate to 2SCs)

For most people these five factors clearly align to one sex. They are assigned that sex, they identify with that sex, and they keep their properties for life. Most of them do not have to take hormones and can at some point reproduce as their preferred sex, the vast majority of them can effortlessly pass as their preferred sex, and by comparison to transpeople who need to pay for surgeries or hair removal etc. they do not need to put much effort or money into looking the way they want to.

Transsexual people are those who may or may not align to the two clear groups, but do not identify with the sex they were assigned at birth. In the last century or so it has gradually become possible to safely and effectively convert genitalia, 2SCs, and hormone status from one sex to the other, which is often necessary for the mental well being of transsexual people. Functioning gonads of transsexual peoples' preferred sex cannot be given (most of them will not have been born with those in the first place,) and chromosomes cannot be changed.

Intersex people are those who for, well I'm finding it hard to express it without sounding at least a little offensive, but reasons which don't include accidents or human intervention such as HRT, do not conform clearly to the two groups. Intersex people may or may not identify as intersex: some may wish to undergo medical treatment to bring their characteristics closer to that of their preferred sex.

I get the impression that being transsexual is much more common that being intersex. Personally I am MTF transsexual (assigned male, identify as female) but as far as I know I am not intersex in any way.

From your OP it sounds like you are at least a little bit intersex as your puberty was delayed and the operation you had as a child sounds like it was probably to 'correct' your ambiguous genitalia (I cannot say for sure why exactly, as I do not know enough about your specific case). If you want to know what your chromosomes are you can have them tested. Other than that you definitely sound a lot closer towards the concept of what a male is than female, but sex is not binary, nor is being intersex.

[josie76]

There is a good deal of differing opinions on what counts as intersex. My home state in the US legally defined it however. By that definition I believe you are intersex. It defines it as being any genetic or developmental condition that prevents the full development of the genitals or internal sex organs. Essentially anything that affects an incomplete genital formation or the workings of the internal sexual reproductive organs. So a genetic mutation can definitely count. Also what you describe sounds like a hypospadias repair to the urethra of the penis. This is done when the urethra does not fully close and either leaves an open channel or a whole along its length.

Hypospadias repairs are actually one of the most common surgeries for genital birth defects. Often it is done the same time as a circumcision in the hospital.

[Rachel Montgomery]

My doctor won't do genetic testing.  He says it is unnecessary in my treatment, and he will not order it.

Do you know of any labs that do genetic testing for individuals without a doctor's order?  If so, do you have any idea what test I would need done?  And, if I pay for it personally, would my insurance company have a right to see it?

[Rachel Montgomery]

from what you describe, i would say you may not be intersex, but definitely have one or several mutations.
You should ask your doctor to probably do a Karyotype Test with you, or if your health insurance would pay it, a genome analysis.
Feel free to ask me questions concerning intersex, and  try to answer them as good as I can.

As I said above, my doctor says he won't order genetic testing.

From your OP it sounds like you are at least a little bit intersex as your puberty was delayed and the operation you had as a child sounds like it was probably to 'correct' your ambiguous genitalia (I cannot say for sure why exactly, as I do not know enough about your specific case).

Physically I am a fairly normal male.  I suspect that the surgery was to repair hypospadias and a urethral stricture, based on the scaring and my recollection of what happened.  From what I have read, these are common complications of Kallmann's (which I don't have because my sense of smell is normal, but I otherwise fit all of the diagnostic criteria).     again, he says I have IHH, which he says is the term for Kallmann's except with normal smell.  My first Endocrinologist diagnosed it as Constitutional Delay of Puberty and Metabolic Syndrome (which clearly would not be intersex).  I don't know who is right.  I just know they are different diagnosis's  based on the same symptoms, and they have the same treatment regimen.  Having the same treatment, my doctor says genetic testing is a waste of money he will not order.  "it wouldn't change the treatment or the outcome, so it is a waste."

[Maid Marion]

https://ghr.nlm.nih.gov/primer/testing/costresults
National Institute of Health pages on Genetic Testing.

[josie76]

Call it intersex or not, the definition I found is that IHH is " due to deficiency in or insensitivity to gonadotropin-releasing hormone (GnRH) where the function and anatomy of the anterior pituitary is otherwise normal and secondary causes of HH are not present".
So some genetic cause of insensitivity to GnRH. This when combined with underdeveloped penial urethra could be qualified as an intersex condition. Especially if it also caused delay in normal pubescent development.

Based on all of the most recent years studies on the gender specific segments of the brain, your body's lack of T production because of a partial insensitivity to GnRH could be how you ended up transgender. But its still only a more likely link than a definite one. Studies done on larger patient sets of brain MRI's has repeatedly identified the IFOF region of the brain as being one area that is hard-patterned in the second trimester based on the level of exposure to testosterone. Some studies done prenatally identified base neural patterns that were expanded upon as the person grew. Others found the pattern established in the prenatal period could not be forced to charge later either by puberty or even cross hormone treatment. So anything that interferes with the level or sensitivity to testosterone in a genetic male fetus has a chance of preventing the masculinization of the brain.

The science is pretty interesting. I am PAIS and a trans woman.
Among PAIS patients (male born), studies have concluded that gender identity is approximately 50/50.
Among verified male born children who were exposed to the endocrine disrupting drug DES, greater than 30% report severe gender dysphoria.
Similar statistical links can be found where androgen receptor activating drugs were administered when female born children were prenatally treated. Such drugs as non human progestins.

[Linde]

If you have development irregularities, and your family physician and your endocrinologist have a different opinion on the cause, one can assume that something is not right.  But what it is can be determined only by testing.  If neither your endo nor you doc is willing to order some tests, it might be time to switch providers.
In the beginning of my journey I was visually analyzed to either have a Klinefelter syndrome, or PAIS.  Once I was tested, it turned out that neither guesstimate of my providers was right!
You could start with a simple swab test to look for DNA, and if you will be put into the analysis as a gender opposite to yours, the test may come out with a failure warning.  This way you would have some kind of idea, if you are XX or XY.  Tese tests run between $100 to $150, if paid out of pocket.  That would provide you with a rough idea.  If your gender outcome is opposite of the gender you present, it is time to do some serious testing to avoid some possible cancer situations.
You have to be pushy , because if you don't stand up for yourself, nobody will!

[Rachel Montgomery]

"Studies done on larger patient sets of brain MRI's has repeatedly identified the IFOF region of the brain as being one area that is hard-patterned in the second trimester based on the level of exposure to testosterone. Some studies done prenatally identified base neural patterns that were expanded upon as the person grew. Others found the pattern established in the prenatal period could not be forced to charge later either by puberty or even cross hormone treatment. So anything that interferes with the level or sensitivity to testosterone in a genetic male fetus has a chance of preventing the masculinization of the brain."

When I was 32 I had an MRI because I was having migraines.  After the tech did the scan, she left the room.  Being curious, I went around t look at the images which I assumed were my own.  The radiologist came in and saw me looking at the screens and told me I shouldn't look at that, it was another patients medical information.  I told him I was pretty sure it was mine.  He said I can't be because this is a woman.  I asked if you can tell the difference on an MRI and he said 100%, he ALWAYS could tell, and this was definitely a woman.  Just then the tech came back in and I asked her if the images were of me.  She check the screen and the chart and said, "Yes.  That is you."

The doctor didn't blush, he turned white and ran out of the room saying: "You are fine.  No tumors, no lesions, no stroke.  I have heard of this before, I have just never seen it.  you are a man, you are married, you are fine.  It isn't a problem.  It is unusual, that all."

So, yes.  I believe I have typical MTF neurology.  It actually made me feel better, but I would have loved to have a long conversation with him to understand exactly how I was and maybe wasn't more like a woman.

[ParkerTalks]

Just popping it say that there's a very strong link between being intersex and being trans.
Being trans means not identifying with your assigned gender. That doesn't preclude being intersex. You def sound intersex to me, but you also sound trans.
good luck.

[Rachel Montgomery]

You def sound intersex to me, but you also sound trans.

Oh, I am definitely trans.  I suppose I would need a gene test to resolve the question as to which alternative diagnosis is correct (or maybe they are both wrong).

I don't understand why they won't order the tests.  I offered to pay for them myself.  I don't suppose it really matters, unless it would suggest a better way to treat the problem.     

[Linde]

I am definitely intersex, and I consider myself being trans.  If one wants to be really technical, I am not trans because I just convert back to the gender that is indicated by my chromosomes.  This would make me cis woman.

But I had to hop over most of the hurdles every trans woman has to take.

[BrightWindow]

I am definitely intersex, and I consider myself being trans.  If one wants to be really technical, I am not trans because I just convert back to the gender that is indicated by my chromosomes.  This would make me cis woman.

But I had to hop over most of the hurdles every trans woman has to take.

I object to your saying "convert back to the gender...." since transitioning is not changing one's gender but just changing one's life in accordance to it, for example a legal name change. I was always a woman and I am merely changing my life to reflect that. Before 14, my identity did not have a strong impact on my life, for reasons I say in "Why I Came Out At 14" but I always knew I identified as a woman.

I also do no think that chromosomes dictate gender, most transmen have the same genotype as you but I do not consider them men any less because of that. There are some transwomen who have XX but still a completely male phenotype, and get AMAB, I would still consider them transwomen.

It ultimately depends on how we define being transgender, in terms of the sex you were assigned, or the the sex one was truly born as. For most these are the same, but for intersex people they may well not be.

[Rachel Montgomery]

I am new here, so making this statement seems a little risky.  I don't really know what may make enemies here, and I am uneasy about stating my beliefs.  I am not trying to argue with anyone, or tell anyone they are wrong.  I am merely expressing that I disagree and have another view.  Sometimes, I think most people are more like me than in reality they are.  Sometimes, I am wrong about facts.  Sometimes I am merely different and have based my opinion on an experience most people don't relate to.  That's ok.

I object to your saying "convert back to the gender...." since transitioning is not changing one's gender but just changing one's life in accordance to it, for example a legal name change. I was always a woman and I am merely changing my life to reflect that.

The use of the word gender to describe our inner understanding of who and what we are is somewhat new. I don't think a transgender person changes their "gender" when they transition.  I think that as we grow up, we come to understand that there are differences between the sexes, and we come to recognize our culture's norms for each sex.  Confusingly (because of the recent change in the meaning of the word "gender") these cultural sex norms are called "gender norms", but most people understand the norms to relate strictly to sex, and see us as violating these norms when we act according to our gender. 

As I understand it the word "sex" refers to anatomy.  Sex refers to the anatomical genitalia and to secondary sexual characteristics.  Intersex people don't fit neatly into either of the two main sexes, but most can certainly pass as one sex or the other.  I am not 100% sure which Disorders of Sexual Development (DSD) are consider intersex, and which one's are not.  I have a DSD.

When a child is born with a penis, it is pronounced to have male sex.  If the child is born with a vagina, it is pronounced to be part of the female sex.  But, gender is entirely within the individual.  I believe that I have always had the gender I have now.  And, I have always been the sex that I am now.  And, in my case, the two are not congruent.   I wish they were, but they are not.  And, I have not pursued life in a way to bring them together.  That was probably a mistake, but I was doing the best I could to make my way.

I also do not think that chromosomes dictate gender, most transmen have the same genotype as you but I do not consider them men any less because of that. There are some transwomen who have XX but still a completely male phenotype, and get AMAB, I would still consider them transwomen.

I suspect that genetics may also play a role in determining gender.   As I define the word "sex", chromosomes certainly affect sex determination in most people.  Environmental factors during pregnancy can certainly effect sex determination and development, but they don't change the genetics. It seems that the role genetics play is in generating and controlling hormones and hormonal levels.  So, ultimately, it is hormone levels and the timing thereof that determine sex and not genetics.  Normally, however, genes determine the hormonal levels and the timing thereof.   Regardless, it is the hormones themselves that do the work, not the genes.  So, if your mother takes DES (Diethylstilbestrol) while you are in her uterus, that can affect sexual development, and might affect gender development. 

It ultimately depends on how we define being transgender, in terms of the sex you were assigned, or the the sex one was truly born as. For most these are the same, but for intersex people they may well not be.

So, I think our disagreement is based on our different understanding of definitions.  "Sex" is assigned at birth by the doctor or nurse based on external appearance.  I think when you say the "sex one is truly born" you are talking about what I am calling "gender".

So, we have Sex Reassignment Surgery, and it is also known as Gender Confirmation Surgery.  Either way, the surgery changes the anatomical sex, but does nothing about the gender.  Therefore, "Gender Reassignment Surgery" doesn't make sense.  I don't believe anyone knows how to change the gender of someone once it is set.  I don't know when it becomes set.  Is it set in utero?  Is it set at around 3 when most of us learn about sex differences?  Is it set in puberty?  I don't know.  But, by adulthood, it is set.

I remember wanting to be a girl as soon as I knew there was a difference.  Was my gender still malleable at that time?  I don't know.  I would guess that gender is set in utero and is recognized by us as we begin to understand sex differences and gender norms.  But, I don't know how many other people might share that view.

[Linde]

I object to your saying "convert back to the gender...." since transitioning is not changing one's gender but just changing one's life in accordance to it, for example a legal name change. I was always a woman and I am merely changing my life to reflect that. Before 14, my identity did not have a strong impact on my life, for reasons I say in "Why I Came Out At 14" but I always knew I identified as a woman.

I also do no think that chromosomes dictate gender, most transmen have the same genotype as you but I do not consider them men any less because of that. There are some transwomen who have XX but still a completely male phenotype, and get AMAB, I would still consider them transwomen.

It ultimately depends on how we define being transgender, in terms of the sex you were assigned, or the the sex one was truly born as. For most these are the same, but for intersex people they may well not be.

I really don't care that you object against the way I feel!  I was forced to live as a gender that I was not, neither biologically nor mentally.  And i am now the gender in accordance with my biology and my brain!  if I would be in Germany, I would not be considered, because as an intersex person you can't be transgender, but just confirm the gender wo you are (this can be either gender, or none).
Anyway, I was born with XX chromosomes, and ambiguous male genitalia, and was thus AMAB.  My body did not develop mal at all, and did not show any secondary sex characteristics of the male gender, with other words, I never had a male phenotype, but still lived as a male.  When I lived as a male, I did not have any clear gender identity, and really only knew that I was different, very different from my male peers.
Once I changed from male to female presentation, I slowly developed a female gender identity!  I don't know if this changing could be described to be a transition or not.  I consider it to be one, because I had to combat similar hurles as other trans females have to fight.
But on the other hand, I consider myself to be a cis woman, because my chromosomes and my gender identity jive with each other!

[Linde]

I remember wanting to be a girl as soon as I knew there was a difference.  Was my gender still malleable at that time?  I don't know.  I would guess that gender is set in utero and is recognized by us as we begin to understand sex differences and gender norms.  But, I don't know how many other people might share that view.

I never had this feeling, as I wrote bove, I had no gender identity at all.  I think this was because my female brain was located inside a female body, and this body ws just misused for male purposes.  My gender was right and jived with my body, and that caused the confusion that I did not know what gender I was, and thus did not develop any gender identity.

[BrightWindow]

I am new here, so making this statement seems a little risky.  I don't really know what may make enemies here, and I am uneasy about stating my beliefs.  I am not trying to argue with anyone, or tell anyone they are wrong.  I am merely expressing that I disagree and have another view.  Sometimes, I think most people are more like me than in reality they are.  Sometimes, I am wrong about facts.  Sometimes I am merely different and have based my opinion on an experience most people don't relate to.  That's ok.

It most definitely is OK! Disagreeing with someone does not mean making enemies with them by any stretch, and it is a valuable skill to be able to have constructive arguments with those with different views without getting overly violent.

The use of the word gender to describe our inner understanding of who and what we are is somewhat new. I don't think a transgender person changes their "gender" when they transition.  I think that as we grow up, we come to understand that there are differences between the sexes, and we come to recognize our culture's norms for each sex.  Confusingly (because of the recent change in the meaning of the word "gender") these cultural sex norms are called "gender norms", but most people understand the norms to relate strictly to sex, and see us as violating these norms when we act according to our gender. 

Yes, sex and gender differentiation is a very important concept. The lack of this understanding is one reason why I, and probably many other people, did not come out sooner. If only the world had come to accept this faster.

However, many people differentiate sex from gender identity. I do not object to this, but I would also like to differentiate sex identity from gender identity. That is, the former refers to which physical form you identify with, whereas gender identity is more about the social and emotional aspects. Bearing this in mind, I fail to cite this, but many people whom I have spoken to agree that the words male, female and intersex are for sex and the words man, woman, and nonbinary are for gender. I identify as a female woman, but some people may identify as a nonbinary male person or a female man, and that is entirely possible. Physical sex is a measure of how close a person's physical characteristics conform to the two traditional groups of male and female, and if so which. In my case, they are and always have been unambiguously male, so my physical sex is male, but that is incongruent with my sex identity.

When a child is born with a penis, it is pronounced to have male sex.  If the child is born with a vagina, it is pronounced to be part of the female sex.  But, gender is entirely within the individual.  I believe that I have always had the gender I have now.  And, I have always been the sex that I am now.  And, in my case, the two are not congruent.   I wish they were, but they are not.  And, I have not pursued life in a way to bring them together.  That was probably a mistake, but I was doing the best I could to make my way.

There is not necessarily anything wrong with identifying as a woman and having male sex characteristics at the same time. There are some transwomen who do not want to change their bodies and live their lives perfectly happily this way. But if you feel that your sex characteristics are not right for you, and you do not want to live with them forever, then it is possible to change them. I feel that way, and I want to change them. I wish I were a cis woman and I could let my ovaries do all the work and not need invasive SRS, but at this age I will still be able to live most of my life the same as a cis woman. It is important for each person to decide whether or not this path is right for them, and I wish you happiness whatever path you choose to take.

I suspect that genetics may also play a role in determining gender.   As I define the word "sex", chromosomes certainly affect sex determination in most people.  Environmental factors during pregnancy can certainly effect sex determination and development, but they don't change the genetics. It seems that the role genetics play is in generating and controlling hormones and hormonal levels.  So, ultimately, it is hormone levels and the timing thereof that determine sex and not genetics.  Normally, however, genes determine the hormonal levels and the timing thereof.   Regardless, it is the hormones themselves that do the work, not the genes.  So, if your mother takes DES (Diethylstilbestrol) while you are in her uterus, that can affect sexual development, and might affect gender development.

I think you may have misunderstood my point, I am not saying that there is not a causal link between chromosomes and gender identity, I am saying that it is the latter which should decide how a person's gender is regarded. I very likely have XY chromosomes but that does not mean I am any less a woman, it just means that most women have different chromosomes to me.

So, I think our disagreement is based on our different understanding of definitions.  "Sex" is assigned at birth by the doctor or nurse based on external appearance.  I think when you say the "sex one is truly born" you are talking about what I am calling "gender".

Not quite. Linde says that her body has always been female, and in a way I think I can agree to that, being intersex is a spectrum and many intersex people can still be considered closer towards one sex than another. But she was AMAB. I am saying that whether or not we consider her transsexual depends on whether we compare her sex identity to the sex that she was pronounced as, or the sex that her body actually was.

So, we have Sex Reassignment Surgery, and it is also known as Gender Confirmation Surgery.  Either way, the surgery changes the anatomical sex, but does nothing about the gender.  Therefore, "Gender Reassignment Surgery" doesn't make sense.  I don't believe anyone knows how to change the gender of someone once it is set.  I don't know when it becomes set.  Is it set in utero?  Is it set at around 3 when most of us learn about sex differences?  Is it set in puberty?  I don't know.  But, by adulthood, it is set.

I would take this a step further and say that SRS has nothing necessarily to do with gender. Take for instance someone born with unambiguously male characteristics, XY chromosomes, who identifies as a female man and wants to change his body towards the sex he identifies as. That places him in the same boat as many transgender women, in that he has the same hormone levels, genitalia, and 2SCs as most transgender women start with before they begin transitioning medically. He does identify with the gender traditionally associated with his assigned sex, but that does not matter because he identifies fully with the female sex and if he cannot cope with living in a male body he has just as much right to SRS as I do.

I think I remember reading somewhere on the internet that gender identity is solidified at age 3 but I couldn't confirm that.

I really don't care that you object against the way I feel!  I was forced to live as a gender that I was not, neither biologically nor mentally.  And i am now the gender in accordance with my biology and my brain!  if I would be in Germany, I would not be considered, because as an intersex person you can't be transgender, but just confirm the gender wo you are (this can be either gender, or none).

Gender is not biological at all. Sex is, but when we are talking about gender that is the social and emotional elements. I have XY chromosomes and a male phenotype but that does not make me living as a man any less wrong than forcing a cisgender cissexual female woman to do the same because I identify as a woman as well. I am glad that you were able to live in the gender that you identify with, but it is you gender identity that matters rather than your physical sex.

Anyway, I was born with XX chromosomes, and ambiguous male genitalia, and was thus AMAB.  My body did not develop mal at all, and did not show any secondary sex characteristics of the male gender, with other words, I never had a male phenotype, but still lived as a male.  When I lived as a male, I did not have any clear gender identity, and really only knew that I was different, very different from my male peers.
Once I changed from male to female presentation, I slowly developed a female gender identity!  I don't know if this changing could be described to be a transition or not.  I consider it to be one, because I had to combat similar hurles as other trans females have to fight.
But on the other hand, I consider myself to be a cis woman, because my chromosomes and my gender identity jive with each other!

This is why I questioned whether transsexuality and cissexuality should be defined by comparing sex identity to the assigned sex or the sex the person's body was actually closer towards at birth. You identify as female, you were AMAB, but your body was always female. Hence whether or not you are cissexual depends on how we define cissexuality.

Anyway, I think that the world needs to understand that transitioning is not only for transgender and transsexual people. There are some cisgender and/or cissexual people who have to transition socially or medically because, for any reason, they have been placed into the wrong gender role, or have had their bodies changed by something beyond their control. They may need to transition socially to make their life in accordance to their gender identity, and/or change their body to make it congruent with their sex identity. The need to transition, I would say, is something mainly experienced by transgender or transsexual people, but it is not exclusive to them.

[Rachel Montgomery]

Gender is not biological at all.

I am not sure what that means, or how you can say that with certainty if it means what I think it means.  Gender may well have its causal element in some combination of genes.  Many (perhaps not all) transwomen have neurological brain structures and neuron density which is sexually dimorphically female.  That may be a biological thing that results in gender identity. 

Sex is, but when we are talking about gender that is the social and emotional elements.
...
This is why I questioned whether transsexuality and cissexuality should be defined by comparing sex identity to the assigned sex or the sex the person's body was actually closer towards at birth. You identify as female, you were AMAB, but your body was always female. Hence whether or not you are cissexual depends on how we define cissexuality.

Anyway, I think that the world needs to understand that transitioning is not only for transgender and transsexual people. There are some cisgender and/or cissexual people who have to transition socially or medically because, for any reason, they have been placed into the wrong gender role, or have had their bodies changed by something beyond their control. They may need to transition socially to make their life in accordance to their gender identity, and/or change their body to make it congruent with their sex identity. The need to transition, I would say, is something mainly experienced by transgender or transsexual people, but it is not exclusive to them.

I don't know what you are referring to.  There are cisgender people who need to transition?  What leads you to this conclusion?