For me its both.
I say gender-identety myself but I also talk about it as a medical condition. I decribe my surgery as being nessesarry and my homones as medicin.
I think identety fits better when we shall speak for all transgenders and the many diffrent varintations cause its sure not all transgender people has issues who can or would be needed medical threatment.
for transexuals in almost all caise feel a need to do threatment, but not everyone dose so that alone could be seen as a medical condition and is done in certain countrys.
Personally I identify trans cause its something who means alot to me for everyday life.
I also identify as other things, such as my nation and areas, my certain hobbies, like an artist, or a writter, and so on, its a part of me like being trans is.
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I bet people who lives a rather normal life would not identify as strickly as people who gain more trouble for being trans, or who puts more efford into it, by aktivism, or comunetys.
and so but we are also all diffrent.
One thing I yet find troublesome is when people go on being "not trans" and putting other trans people down who identify with the label, or who are more gender-bendering than they are.
I honestly feel that is foolish. saying your not trans dosent make you less trans than anybody ells.