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To be transgendered refers to an individual that does not experience an alignment between their gender identity and their physical or biological sex. An individual that identifies as transgendered may or may not undergo gender affirming surgery to align their physical sex with their gender identity.
Transgendered individuals include both male to female and female to male transgender individuals. Individuals that identify as transgender typically experience a disconnect between their physical sex, and the gender that they identify with. These feelings often lead to an individual undergoing a gender affirming surgery whereby their physical sex is altered to align with their gender identity.