I would say it is more being under a state of delusion, a man thinking they are a woman fits the definition of delusion , that is why transgenderism is a mental illness..that and the fact 40 - 50 % of them try to commit suicide. Promoting this is detrimental to society.
“Okay. I'll trust the science and researchers though”
XY = Male >49%
XX = Female >49%
X??? = Abnormalities <1%
Since most trans still have those same XY or XX chromosomes they were born with, even though they believe they’re a different gender, it means they are still their birth gender.