For me and most of those I know like me, it's the first response. As early as I can remember, I've realized I was a girl. In thinking back about it, I've come to realize that that was very deep-seated, because at the time, I did not know about anatomical differences - I just knew that women acted and dressed differently than boys.
I was at some level of denial for a long time, but could never shake the sense that I was always uncomfortable in my own skin. Hormones and surgery are just steps to being complete.
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