> Being transgender represents a misalignment between your internal sense of self and the sex you were born with.

These thoughts, like every other thought anyone has, are mediated by hormones. I'm not saying any particular balance or resulting thought is good/bad/right/wrong/healthy/unhealthy.

But this is akin to saying "being aggressive represents a state of excessive confidence, not elevated testosterone levels." Sure! That's true. But it's also true that elevated testosterone levels tend to increase the frequency and intensity of occasions in which people find themselves in a state of excessive confidence.