Hi Amanda,
To better answer your question I am going to give you some background to the topic. First of all, not all people identify with the gender they are assigned at birth. For instance, a baby could be born with a penis or vagina, but it is possible that person could never feel like or identify with that gender. You see sex, i.e. the physical traits you are born with, like a penis or vagina. Yet, gender refers to the way in which you act, feel and identify.
Those who do not identify with their assigned gender are trans people. We tend to avoid the use of ”transexual”, as it refers to the genitalia, and but the emphasis on this.

You might have heard of the word “transgender” which you should not confuse with “transsexual”. This word “transgender” or ”transidentity” refers to a person that identify differently than the gender they were giving at birth. It is possible that transgendered people can identify with this term and never go through hormone treatment or surgery. Trans people might (or not) try to change their physical appearance to match their identity.

Thank you for asking this question!
Jody and Team AlterHeros