Virtually all the science in the last 20 years supports transsexualism being a physical birth condition.
The problem is the general public, as exemplified by your question, don't understand the concept of transsexualism. In an effort to help, I suggest you read the following:
Most people are born with a gender identity in their brain that matches the sex of their body, transsexual people are not. That's what transsexualism is, a birth condition. This leads to a life of pain and misery as their body feels profoundly wrong and nobody ever sees them as the person they truly are. Transsexual people transition (aka "sex change") to affirm their inborn gender identity by changing their body to match and assuming a gender appropriate role in society.
Transsexualism is a scientifically proven birth condition.
A primer on transsexualism:
http://forum.beginninglifeforums.com/index.php/t/15139/f98c4662d36edc533ec0ce09524e746f/
More background information about gender identity and transsexualism:
http://ai.eecs.umich.edu/people/conway/TS/TS.html#anchor107763
A short video of a Stanford University professor discussing transsexual brains:
https://www.youtube.com/watch?v=A3C4ZJ7HyuE
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參考: me-woman who was born transsexual (post-op)